As the new year gets underway, we're seeing strike action across the NHS escalate.
Earlier this month, on 11 January, Unison and the GMB ran a 24-hour strike in ambulance trusts. Unison's strike covered all ambulance employees in affected trusts, as will their next one on 23 January – when Unite is also taking part.
RCN members are due to walk out of 55 trusts for 48 hours across 18 and 19 January, which is an increase in both duration of action and the number of locations where it is taking place. Meanwhile, the BMA is balloting junior doctors on whether they are willing to take strike action, with results expected soon after the ballot closes on 20 February, and an initial suggestion of a 72-hour strike in March if their members vote in favour.
The NHS is in a more perilous position than it was in December. Ambulance handover delays have increased and pressures across the whole system have intensified. While trust leaders have worked hard to mitigate the disruption strikes will cause to patient care, the extent of current operational pressures is making the impact harder to absorb than last month. It's worrying as it stands, but the potential for further escalation of action over the next few months means resolution could not be more needed, not least because of the impact it has on patients.
We've seen that strike action changes the way in which people choose to access care. When Unison and GMB ran ambulance strikes on 21 December and 11 January, there was a significant drop in demand for emergency care services on that day, with a backlog created over subsequent days. While this spared many trusts from facing the worst-case scenarios during the strike – as we saw during COVID-19, when patients delayed seeking care – patients ended up presenting with more advanced or complex conditions later down the line.
The secretary of state for health and social care Steve Barclay seems to have recognised this. On 9 January he met with union leaders and broached the topic of pay for the first time. While it is disappointing these talks did not lead to an agreement, it is a welcome sign that the government may be willing to negotiate in order to bring a stop to strike action. This is an important move, given their previously unflinching approach. And while the RCN was clear there was no resolution yet in sight following this meeting, Unison did welcome Barclay's shift in tone.
What is needed now is an urgent continuation of these talks. With both sides clear they don't want strikes to continue, and all too aware of the huge pressure which the NHS is under, there will be mutual recognition of the need to negotiate in good faith and reach an agreement which all parties are comfortable with.
It will not only be met through negotiation, but with necessary funding. For months, NHS Providers has been arguing that the government and arm's length bodies need to recognise there will be a cost to exiting strike action. There are ways of bearing this cost which will be more manageable than others, such as suggestions earlier this month of backdating the 2023/24 pay award to January. It is vital the Treasury, in particular, acknowledge this. Not to do so is to accept a continuation of strike action at a time when the service and its staff are being stretched thinner than ever. The impact this has on staff wellbeing, the health of the nation, and ultimately, the economy, must not be understated.
The NHS is already facing enough challenges. The additional challenge of managing escalating strike action can be avoided. Unions and the government must continue talks to find a way through and the Treasury must recognise and commit to the necessary funding to underpin agreements when they are reached.
This blog was first published by National Health Executive magazine.