Junior doctors' stike: Preston and Chorley hospitals face ‘ten days of disruption’

Lancashire Teaching Hospitals NHS Foundation Trust (LTH), which runs the two facilities, says that it has prioritised cancer patients and those people who have already been waiting a long time to be seen, in order to try to avoid any delays in the care of either of those two groups.

However, the hospitals’ chief executive told the Lancashire Post that he could not guarantee there would be no last-minute rearrangements for any patient booked in during the course of the four-day strike, which begins on Tuesday (11th April).

Kevin McGee also warned that the disruption is likely to continue for a further week after clinicians have returned to work – and appealed for people to use emergency hospital services wisely while the walk-out is on.

However, he stressed that steps had been taken to ensure that the Preston and Chorley sites would both be operating safely and remain available for those in need of medical help.

Junior doctors are set to strike for 96 hours from 7am on Tuesday in a dispute over pay. The British Medical Association (BMA) wants a 35 percent rise for junior grade staff, claiming that their wage has waned in real terms by 26 percent since 2008/09.

Mr. McGee said that the stoppage would be more difficult to recover from than the first occasion junior doctors downed tools in the current row last month - for 72 hours - both because it covers a longer period and also comes straight off the back of the four-day Easter weekend.

He added: “It’s also the middle of the kids' holiday period, so we’re going to have a lot of staff on leave anyway.

“We [will have to] stand down a lot of planned activity - that's the majority of outpatients [and] day cases and some inpatient work. We are [protecting] A&E, acute medicine, neonatal [and] critical care - so the emergency flow won’t be compromised at all [and] the hospital will still be safe.

“We are not standing down everything - we are prioritising cancer care and some long waits for elective work, so…the message to the public is that unless we contact you, if you've got an appointment, please come in,” Mr. McGee said, adding that most patients whose appointments are going to be changed will have been advised last week.

He said that the trust’s “objective” was not to delay any cancer appointments, but acknowledged that he could not rule out some short-notice postponements for any patient in the coming days, because of the chance of rostered staff calling in sick, especially with Covid prevalence remaining high.

The hospital chief also said that some routine appointments next week - after the strike has ended – were also likely to be affected.

“Because we’re asking the senior staff to work differently [during the strike period]...they then need time back in terms of recovery. So it’ll take us a couple of weeks to get back into the flow of full activity [and] it's going to have a really significant impact on elective [care] ," Mr. McGee added.

He said that while efforts would be made to re-book postponed patients “as quickly as possible”, the volume of work that will be pulled means that it will take “quite a period to reinstate” - but the trust will reschedule appointments on the basis of “clinical need”.

“So some people will wait longer than we would hope, but we have no option - the capacity just isn't there to replace the work quickly.”

Nationally, 175,000 appointments were put on hold as a result of the last junior doctors’ strike, but this time it has been estimated that the figure will top a quarter of a million.

LTH has also appealed to those seeking unplanned hospital care this week to think carefully about whether they really need it.

Mr. McGee said: “Clearly, if you do, our emergency services will be there, but if there are other ways you could go, think about [NHS] 111, community pharmacists, GPs [and] self care.

“It’s going to be really busy in the hospitals - there will be long waits for things…simply because of the staffing numbers that we've got. So please bear with us and if you can avoid coming into hospital, please do so.”

The government has dismissed the BMA’s pay claim as “unreasonable”, but Mr. McGee said that while he was not “taking sides” in the dispute - and supported the right of staff to strike - he hoped that all parties could find a swift resolution to ensure that this week’s walk-out is the last, as each one becomes “harder to cope with”.

He wants to be able to focus on the recovery work that was already under way to clear the longest-waiting patients from the backlog caused by cancellations during the earlier part of the pandemic.

The Post understands that that national target to clear all waits of longer than 78 weeks will broadly have been met by LTH when figures are published shortly, but that there will be a small number who remain on the waiting list either as a result of the last doctors’ strike or because individuals have chosen to wait longer for their procedure.

“My hope is that we’re allowed, before we get into the summer holiday period, [to] just focus on recovery. Because once the kids are [on holiday] and then you get back in September, it is basically into planning for winter then.

“So we’ve got a really short window [during which] we really need to push in terms of the recovery numbers for elective work,” Mr. McGee said.

The BMA said when strike action was first mooted earlier this year that “the lack of investment in wages by the government has made it harder to recruit and retain junior doctors”.

“This puts further pressure on the NHS and makes it harder to deliver care to the standards expected by professionals.”

A Department for Health and Social Care spokesperson said last month when the latest strike dates were announced: “Our door remains open to constructive conversations, as we have had with other health unions, to find a realistic way forward which balances rewarding junior doctors for their hard work while being fair to the taxpayer.”

‘Hospital workforce is tired - but carries on brilliantly’

Kevin McGee has paid tribute to Preston and Chorley hospital staff at all levels for their mammoth effort and commitment in the three tumultuous years since Covid struck.

“[They] are brilliant, they have coped with so much. Clearly, there was all the work that went on [early in] the pandemic, now there is all the recovery and all the strikes and [the need to be] covering for one another.

“It is a depleted and tired workforce, but they are magnificent - from people who work in offices, estates and catering, through to the medical and nursing staff, every one of them does so much good work - and I’m really thankful to them for their professionalism and the way they carry on.

"We're filling all of our rotas [during the strike period] and the staff have been brilliant working with us - particularly our senior staff, [who] have been really flexible," Mr. McGee said.

He also told the Post that the last six months had been the toughest he had known for the NHS.

“It was really quite a difficult winter - higher…activity [and] high numbers of very poorly patients. We also had a flu season, a large number of Covid patients [and] staff who were tired anyway from the pandemic.”

Once recovery work and the need to mitigate a raft of strike action by nurses, ambulance staff and, latterly, junior doctors had been factored in, Mr. McGee said that there had been little time for preparation for the year ahead.

“Most of it has just been dealing with day-to-day flow issues, managing the strikes [and] making sure we can keep patients safe.”