Tips for Locum Doctors During the Junior Doctor Strikes in 2023

On 20 February 2023, junior doctors in England voted to strike after a ballot by the BMA, with 98% voting in favour of action.

As a locum doctor you may be unclear on your options for booking or cancelling locum shifts booked on strike days, and uncertain about what will happen during those strike days if you are working.

In this article, we will break your rights and your options as a locum doctor during the strikes, with some practical advice for how to manage some difficult moral questions and potentially difficult situations in the hospital.

Can I strike as a locum doctor?

If you are working with a locum agency or a Trust staff bank and have already agreed to work on the day of the industrial action, then you should check the contract you have in place to see what your rights and obligations are. This is to avoid breaching the terms of the contract you have in place with your agency or Staff Bank. 

If you wish to cancel those shifts, check the what the terms of your locum contract say on giving notice to cancel a scheduled shift, and any consequences for doing so. Typically you can cancel upcoming shifts by giving the required amount of notice, so if you plan ahead this may be OK. Some Trusts may have special rules around cancelling shifts on the strike dates so keep an eye out for any notification about these rules.

If you simply pick up ad-hoc shifts either through an agency or staff bank, or have just not yet agreed to work on the strike dates, then you can simply choose not to book any shifts on those days. You are not under contract and have no contractual obligation to work if you don’t want to.

Remember, it’s the NHS junior doctor trainee contract that is being disputed, not your individual locum contract. 

If you would like to read additional guidance from the BMAs, see here. 

Should I work as a locum on strike days? Is working as a locum during a strike undermining the cause?

If you don’t support the strikes, then presumably your path forward is clear - continue as usual. If you want to use the strikes as an opportunity to pick up additional locum shifts then that is your personal right to do that. 

However, if you support the junior doctor strikes, then it may be a bit harder to decide what to do on strike days. 

Is it more helpful to refuse to pick up locum shifts, or to accept a shift so that more union doctors can join the walk-out? Is it better to ask for an enhanced rate to add impact to the strike action and demonstrate the true market value of a doctor, or does asking for an enhanced rate make you look like you are profiting off the maltreatment of your contracted peers? Are there particular departments where you should offer your locum services over others or would working on an understaffed ward on strike day make you more vulnerable to mistakes or litigation? 

A common view amongst junior doctors is that offering to work as a locum during industrial action undermines the impact of the strikes and is counter productive to the efforts of the union. While some people think that a surge of locums asking for increased locum rates to cover shifts would send a message about the market value of doctors, this is not an official stance taken by the BMA. 

You should remember that these are value judgements and matters of personal opinion, which you should consider yourself and with your peer groups.

How can I show my support for the striking doctors even if I am working?

Even some BMA members who voted for industrial action will choose to work on the day of strikes for various reasons. If you are working during strike days, you can demonstrate your support for striking doctors by wearing a pin, or defending their rights and motives if they are brought up on the day by colleagues, patients, or their families. You can also stand on a picket line after your shift ends, bring food and drinks to picketers, or share campaigns and information on social media. 

Will I be safe if I am working as a locum during the strike?

You should consider how the loss of your regular team will affect you as a locum who is ineligible to strike. It is reasonable to presume that there will be additional pressure placed on you during your shifts. 

It's important to ensure you are adequately supported and protected during the strikes, and are not more vulnerable to errors or litigation due to a reduced team.

You should speak with the Consultants within the department where you are working to understand what plans they are putting in place during the strikes. Your locum agency can support you with this if you need it. In the 2016 junior doctor strikes there was significant extra support provided by Consultants and nursing staff, but it unclear if this will be repeated in 2023 in light on the ongoing nursing industrial dispute.

Should I ask for enhanced rates during strike days?

Again, this is a personal decision.

If you want to consider asking for enhanced rates, you are entitled to do so on the basis that you will be less supported by other junior doctors. Speak to your locum agency who will be able to advocate for you.  

How can I keep patients safe as a locum on strike days?

It is important to note that the 2016 junior doctor strikes did not result in any increased deaths in hospital compared to non-strike days. This is because of the overwhelming support and action of consultants and nursing staff on strike days, and the reduced services offered during the strikes. 

If you are working as a locum on a strike day, support your team by assisting in emergency care with them, do not allow them to outsource all routine care to you on your own. If you are worried about a patient, be sure to involve the team around you and ask for help and ensure that any plans or advice provided by your seniors are documented and executed accordingly.

How should I deal with angry patients or their families during a strike?

While patient mortality may not have increased during the 2016 strikes, it is true that there was a significant amount of disruption to services as a result of the strikes. Even if the UK general population back the strikes in theory, they may still get frustrated or angry if their individual care is affected on the day. 

If you are working during a strike, patients may either badmouth the striking doctors or take out their frustrations on whoever is present. If this happens, the best thing to do is to acknowledge their distress and ask if there is anything you can do to help them in this moment. If they ask for something that can’t be managed with current staffing levels or ward pressures, then perhaps explaining that you will do the best you can but many requests will have to wait based on urgency. 

What should I do if I feel anxious or unsafe while working on a strike day?

As a locum doctor, you may feel slightly more vulnerable and less protected than the trainees in any case and this feeling may be exacerbated during the strikes. If you know you are going to work on a strike day, ensure that your medico-legal protection is up to date and valid for the work you will be doing. This not only protects you but gives you some peace of mind while working. 

At the start of the shift, be sure to establish with your seniors how you can get in touch with them if you have concerns or queries. You should feel able to escalate any unwell or complex cases as you usually would, knowing that consultants are on hand to provide support if needed. It is important that a lack of team members is not used as an excuse to force you into acting beyond your competence level. If you are ever uncertain of your plan, running it by a consultant and documenting that you have done that is crucial. 

In summary, some locum doctors may face an ethical dilemma during junior doctor industrial action. If you support the strikes, there are many ways that you can demonstrate your support whether you are working or not, but it is important to ensure that you are also protected in the event that you do need to work on a strike day. 

If you have any questions or comments about this article, please do not hesitate to get in touch with us at support@messly.com.

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This article is part of a wider series of resources and guides that are designed to support you as a locum doctor, covering areas such as getting your first job, managing your finances, understanding your rights, and many more. Visit our Locum Doctor Hub for everything you need to know about locuming today.

Additionally, if you're considering an F3 year, you might also find it useful to look through the selection of resources we've put together in our F3 Resource Hub.