Biggest strike day in NHS history will be ‘difficult’, chief warns
Ella Pickover, PA Health Correspondent
Tue, 24 January 2023
The biggest strike in the history of the NHS will be a “difficult” day, a senior health service leader has warned, as a top emergency doctor described ongoing chaos in A&E departments.
Chris Hopson, chief strategy officer for NHS England, said that combined action on February 6 is a “step change” in the dispute.
Nurses and ambulance staff will stage strikes on the same day for the first time in the ongoing row over pay and conditions.
It comes as the health service faced criticism over its winter preparedness plans, with one senior medic saying that December was the “worst ever” in emergency departments.
Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said that ongoing issues in the NHS “came to a head” in December, which he described as “awful”.
Dr Boyle told the House of Commons’ Health and Social Care Committee of his concern that during ambulance strikes, some vulnerable people who need support may not seek help.
Nurses and ambulance workers are set to strike on February 6 which could be the biggest day of industrial action the NHS has ever seen (Ben Birchall/PA)
Regarding the strikes, he said: “We worry that there will be people who don’t want to make a fuss, who are desperate not to go into hospital and not to bother people.”
Mr Hopson told MPs: “Next month will see a step change in the action arising from the dispute between the trade unions and the government.
“So, we expect February 6 to be the biggest strike day in NHS history for five reasons: Firstly, we’re going to have nursing and ambulance unions planning coordinated industrial action across the country.
“Secondly, we know that the nursing stoppage will last for two days, rather than one.
“Thirdly, we know that the numbers of trusts affected will go from 44 in December to 55 in January to 73 in February; there is now a shorter gap between the strikes; and this strike starts on a Monday, which effectively makes it difficult to deploy the discharge of patients to improve flow, which is what we’ve been doing in previous strikes.
“So, just to make the point, we are now entering a new and more difficult phase in the dispute
“But that said, we’re doing all we can to make sure that those who need care receive it as we’ve done so far.
“I particularly wanted to stress that is is incredibly important that any patient who does have a life-threatening emergency does call 999 and that for any other urgent care, please use 111 online.”
When asked whether winter preparation plans had worked, Dr Boyle told MPs: “I think the answer actually is demonstrated by the outcome, and we’ve had such an awful December with such terrible outcomes.
“You can make a plan, but actually the measure of whether a plan succeeds is in the outcome, and the outcomes we’ve had over this December… We’ve said the plans have not worked in the way that we needed them to.”
He added: “We’ve certainly had the worst ever December we’ve had – if you look at performance figures on every metric, what went on in in December was terrible.
“This is a complex, multi-faceted problem. I think we need to be realistic that just a little bit of money may not be just a magic fix. It’s not a magic wand.
“We’ve got serious structural problems that impair our ability to deliver urgent and emergency care.
“Things have been going wrong for quite a long time and came to a head over December.”
Data from NHS England show that a record 54,532 people waited more than 12 hours in A&E departments last month from a decision to admit to actually being admitted.
But Dr Boyle said that some of these patients could have been waiting hours before a decision was made to admit them.
The figures also show that the proportion of patients seen within four hours in England’s A%Es fell to a record low of 65% in December.
Dr Boyle called for improvements in 111 services to prevent unnecessary A&E trips, and for hospitals to share the burden of an influx of patients – instead of leaving crowds of people in emergency departments for hours on end.
He said more must be done to stop the “haemorrhage” of emergency care nurses, saying that he signed a leaving card every time he went to work.
It comes as another A&E doctor likened her department to a “war zone”.
Writing in the Express and Star, senior middle-grade emergency medicine doctor Amy Attwater said: “When I get to work, it is chaos, like a war zone.
“The noise is unbelievable and there are patients everywhere – they can be squeezed in cupboards and blocking fire exits; it scares me that if there was a fire, we might not be able to get everyone out alive as the department is like an obstacle course.”
Regarding winter planning, Mr Hopson told the Committee: “It is just worth noting that without the 7,000 extra bed or bed equivalents – virtual wards; without the extra 1,000 111 and 999 call handlers; the community falls service; the respiratory hubs; and the system control centres that we’ve added this winter, those pressures would have been significantly greater.”
He added: “We prepared for this winter we prepared for it earlier than we had done before.
“The issue was always going to be this winter was the degree to which we saw prevalence of both Covid and flu and the degree to which they combined.
“Now we’re obviously not through winter yet … but both Covid and flu peaked so far, on December 29, when we had 9,500 people with Covid in our hospital beds, and we had 6,500 people with flu in hospital beds, and then we had around 12,000 people who were medically fit to discharge and we were unable to discharge.
“So if you add that together, that means 28,000 of the approximately 100,000 beds that the NHS has, were effectively occupied by a combination of Covid, flu and medically fit to discharge patients.”
But Dr Boyle also told MPs that he was “sceptical” about plans for virtual hospital wards.
“We are a little bit sceptical about the virtual wards as a solution – I know it’s an attractive option because it looks very cheap.
“But unless it is properly evaluated we are not going to know whether it works.”
Charlotte Elton
Tue, 24 January 2023
UK Border Force strikes: Travellers warned to expect disruption as walkouts confirmed for 1 February
Travellers entering the UK on 1 February could face long queues as Border Force workers go on strike.
Members of the Public and Commercial Service (PCS) union, including Border Force staff, previously walked out over the Christmas and New Year period.
Now they are set to take part in what PCS says will be the "largest civil service strike for years". The industrial action is set to start on 1 February and last until 7 am on 2 February.
The government has advised travellers planning to enter the UK on this date to check the latest travel advice and be prepared for longer queues than normal. Anyone who can use eGates is also being advised to do so.
"If you are travelling into the UK via any entry point, you should prepare for disruption and check before you travel," the Home Office and Border Force said in a statement.
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Where in the UK could be the worst affected?
While the initial Border Force strikes primarily targeted UK airports, those on 1 February will also include ports.
International arrivals at all UK airports and ports including Dover will be impacted. UK border controls at Calais, Dunkirk and Coquelles in northern France are likely to be affected too.
Last summer, holidaymakers faced hours-long delays at the Port of Dover because of slow border checks caused by staff shortages and new Brexit controls.
Since Britain left the European Union in 2020, UK travellers face stricter border checks when travelling to the continent. At Dover, they are performed on the English side of the channel by French staff.
An arrivals board displays a message warning users of terminal 5 about industrial action by Border Force staff, at Heathrow Airport. - REUTERS/Peter Nicholls
How did Border Force strikes impact Christmas travel?
During the Christmas Border Force strikes, passport checks at Heathrow, Gatwick, Manchester, Glasgow, Cardiff and Birmingham were affected. Border Force staff at the port of Newhaven, East Sussex, were also included in the strikes.
In response, the government drafted more than 800 military personnel and civil servants to staff entry gates.
Heathrow was challenged with recruiting and training up to 25,000 security-cleared staff before the festive period, a task the airport described as “a huge logistical challenge”. Passengers who were not eligible to use eGates faced longer wait times at Border Control.
At Manchester Airport, 200 new security staff are being recruited, but won't start work until April 2023.
More than 10,000 flights carrying up to 2 million passengers arrived at the affected airports during the strike period, according to aviation analytics company Cirium.
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How might the government reduce disruption?
"Military personnel, civil servants and volunteers from across government are being trained to support Border Force at airports and ports across the UK in the event of potential strike action," the UK government said in a statement.
"Border Force are ready to deploy resources to meet critical demand and support the flow of travellers and goods through the border, however, those entering the UK should be prepared for potential disruption."
But the head of the armed forces said during previous strikes that they should not be thought of as "spare capacity" for striking workers.
"We're busy and we're doing lots of things on behalf of the nation - we've got to focus on our primary role," chief of defence staff Admiral Sir Tony Radakin told the Sunday Telegraph.
Members of the Public and Commercial Services (PCS) Union take part in a border force workers strike action near Heathrow Airport. - REUTERS/Peter Nicholls
Is there a danger of problems with passport checks?
Steve Dann has insisted that safety and security at borders will be "non-negotiable" during strike action.
However, unions have warned that military personnel are not properly qualified to carry out these jobs. PCS said that Border Force members "are specialists in their fields and can't be replaced by people with just days of training."
Why are border force officials striking?
The strike is part of a larger coordinated action by thousands of civil servants. 100,000 PCS members in 214 government departments and other public bodies voted to take action
Members are demanding a 10 per cent pay rise, citing eye-watering inflation of 10.6 per cent.
Mark Serwotka, the PCS general secretary, said that the strike would cause "significant disruption" - but added that the cost of living crisis has left workers "desperate" with no choice but to strike.
"We have no option but to take industrial action because our members are using food banks and not able to switch on the heating right now," he said.
"The government can stop these strikes tomorrow if it puts money on the table."
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