Hospitals made a record number of requests for striking doctors to return to the wards over the weekend, as a five-day walkout prompted safety fears for patients.
NHS England’s figures, as of Monday, show 58 requests for “derogations” had been submitted. Of these, eight were approved, 23 declined, 15 were withdrawn, and the remainder are still pending a decision.
There has so far been a record number of approvals by the British Medical Association (BMA) compared to previous strike rounds, according to NHS data.
The BMA said hospitals had asked for more than 125 resident doctors to be pulled off the picket lines during the walkout.
The union has claimed some of those pleas were made inappropriately and had to be refused, while those that had been granted had to be revoked.
It also said there had been incidents where patient safety was at risk due to trusts not having enough staff to cover emergency care.
Resident doctors began their strike over pay on Friday, 25 July. The walkout is set to end at 7am on Wednesday.
The BMA’s resident doctors committee has asked the government for a 29 per cent pay increase to address what it says has been a more than 20 per cent erosion of their pay since 2008. However, talks between doctors and health secretary Wes Streeting broke down last week, failing to prevent the strike.
Last week, NHS England chiefs instructed hospital leaders to maintain elective care during the strikes, unlike during previous rounds when widespread cancellations took place.
During strikes, employers can request “derogations”, in which a union can grant permission for a doctor or multiple doctors to come into work on strike days.
An NHS England spokesperson said: “The NHS is continuing to work hard to maintain more services than in previous rounds of industrial action, and early indications show the plan is working with the vast majority of planned care going ahead.
“Derogation requests for resident doctors to work in exceptional circumstances are being made by the most senior clinical teams on the ground, and delays or refusals by the British Medical Association questions their integrity and risks patient safety.”
Over the weekend, the BMA claimed a hospital in Sheffield had requested resident doctors return to work because consultants were unable to use the trust’s new electronic records system.
The union also posted on X, claiming it had agreed to let a doctor return to work within the obstetric department at Queen’s Medical Centre, run by Nottingham University Hospitals Trust.
Other trusts cited by the union include Lewisham and St George’s Hospitals in London.
In a message to resident doctors on Sunday, the BMA resident doctors committee said: “This dispute has exposed a small number of trusts where they have planned as if strikes were not even happening. We have received a record number of derogation requests [for] this set of strikes. This is because NHS England has issued instructions to Trusts to try to keep elective activity open, despite our warnings of the risks to patient safety.”
The message claimed the BMA has received 47 derogation requests from NHS England and that these contained requests for 125 resident doctors to return to work to cover gaps.
Following requests, the BMA said it had granted 16 doctors permission to go back to work. It said the trusts where derogations were revoked were either “misinformed about their staffing, or deliberately misled”.
Other “inappropriate” derogations the BMA said it had been asked for included where trusts planned for a full rota of resident doctors, and then were “caught out when resident doctors went on strike”.
Multiple trusts had “prioritised elective activity over the safety of more urgent patients”, the BMA claimed.
It said due to “poor timing of requests”, there have been instances where patients’ safety has been at risk, “with not enough doctors to ensure emergency care”, which has led to “last-minute” requests for doctors.
Ahead of the strikes, the BMA was criticised for advising resident doctors against informing their employers of their plans to strike.
In a rare intervention, the Academy of Medical Royal Colleges published a statement to the BMA warning that this would risk patient safety.
