PRESS RELEASE : Government considers minimum service levels in hospitals during strikes [September 2023]

• Minimum service levels (MSLs) could be extended to protect patient safety during strikes
• Nurses and doctors could be covered by new regulations
• Comes as government once again urges BMA to call off strike action as doctors receive their pay rise this month, backdated to April

The government is considering introducing MSL regulations that would require some doctors and nurses to work during strikes, in order to protect patient safety, the Health and Social Care Secretary has announced.

The consultation, launching today (Tuesday 19 September 2023), considers introducing MSLs that would cover urgent, emergency and time-critical hospital-based health services – which could cover hospital staff including nurses and doctors – and seeks views on a set of principles for setting MSLs in regulations. It will also seek evidence to inform decisions on the expansion and scope of MSLs. This follows the consultation earlier this year on introducing minimum service levels in ambulance services and brings the UK in line with countries like France and Italy whose services continue in times of industrial action.

The consultation comes in a week where both consultants and junior doctors are taking strike action, having significant impact on patients, NHS colleagues and efforts to cut waiting lists – including through almost 900,000 rescheduled appointments or procedures. While voluntary agreements between employers and trade unions can be agreed ahead of time, they can lead to inconsistency across the country, come with significant uncertainty as they are based on goodwill and are not always honoured or communicated in sufficient time. This creates an unnecessary risk to patient safety.

MSLs will provide a better balance between supporting the ability of workers to strike with the safety of the public, who expect vital services to be there when they need them. They will ensure that essential and time-critical care can continue during periods of strike action, for those who need care the most. The government could introduce MSLs in key hospital-based services next year.

Health and Social Care Secretary Steve Barclay said:

This week’s co-ordinated and calculated strike action will create further disruption and misery for patients and NHS colleagues.

My top priority is to protect patients and these regulations would provide a safety net for trusts and an assurance to the public that vital health services will be there when they need them.

Doctors who started their hospital training this year are receiving a 10.3% pay increase, with the average junior doctor getting 8.8% and consultants are receiving a 6% pay rise alongside generous reforms to their pensions, which was the BMA’s number one ask.

In the face of ongoing and escalating strike action, we will continue to take steps to protect patient safety and ensure the health service has the staff it needs to operate safely and effectively.

More widely, the government continues to recognise the crucial role of NHS staff and remains committed to working constructively to end disruption for patients.

Around 150,000 NHS doctors in England, including doctors in training and consultants, start to receive their pay rise this month, backdated to April 2023. Accepting the recommendations of the independent pay review bodies in full means first year doctors in training will receive a 10.3% pay increase, with doctors in training getting an average 8.8% increase. Consultants will receive 6% following an increase of 4.5% last financial year, alongside the most generous pension schemes in the country which allow them to accrue pension pots worth over £1 million tax-free.

More than one million NHS staff in England, including nurses, paramedics and 999 call handlers, have already received a pay rise. This means a newly qualified nurse has seen their salary go up by more than £2,750 over 2 years and staff also received 2 significant one-off payments totalling at least £1,655.

The Health and Social Care Secretary has been clear his door is always open to discuss how to improve the working lives of NHS staff and non-pay issues and ministers continue to engage with staff and talk about their concerns through round tables discussions with a range of NHS professions.

Background information

The consultation on minimum service levels in event of strike action: hospital services opened on 19 September 2023.

We ran a public consultation on minimum service levels in the event of strike action in ambulance services which closed on 9 May 2023. We will publish our response in due course.