Hospitals face paying £8,000 a shift to cover striking doctors
Advice on the British Medical Association (BMA) website says consultants asked to cover shifts overnight in a hospital should have a second consultant on call with them to cover higher-level duties.
According to the BMA's rate card, for each junior doctor's overnight shift during the strike, two consultants in London would cover it for £334 per hour, or £4,008 for an overnight shift, totalling £8,016 for both consultants.
Hospital leaders described it as 'worrying' and said the funds needed to cover a striking doctor were 'unacceptable'.
One junior doctor, who is not striking in this round of industrial action but did last year, said some consultants were 'slower' at day-to-day activities on the ward, which sometimes led to multiple consultants covering one overnight shift.
'The type of things that you are doing overnight [are] quite different to the job that you do as a consultant during the day [but] something that the junior, the resident doctors, core and foundation trainees do all the time. Some of these might be quite practical and logistical things that if you're a consultant [you are] not physically used to doing on the computer system. They're the kind of things you need to do quickly overnight,' the doctor said.
While consultants could very ably clinically assess patients, they might be 'a bit slow' at the tasks needed overnight, the doctor suggested. 'Sometimes they feel safer, I think … having more of them on because, more from a speed perspective,' the doctor added.
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BMA guidance says some consultants may have 'concerns' about working on wards. ''Acting down' to provide cover for absent resident doctor colleagues may involve tasks that you have not had to perform for many years, and you may have concerns about the ability to carry out certain tasks involved in ward work,' the advice states.
'A consultant has a professional obligation to act within their sphere of competence. As such, you need to be clear with your employer that you do not feel that you can safely and competently perform the work required and that doing [so] may expose you to enhanced risk of medico-legal consequences. If your employer refuses to take the necessary action to make alternative arrangements […] then, as above, you will need to follow our guidance on raising concerns.'
One hospital executive said that while the hospital had not used more than one consultant to cover shifts, the cost of cover ran 'into the millions' and further cuts to NHS services might be needed as a result.
'The cost of consultant cover during the period, which runs into millions of pounds, [is a] huge amount of money that is unfunded. It's well publicised that there's a real tension at the moment in the NHS between safe timely services and financial viability,' said the executive, who did not wish to be named.
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'We're trying to navigate our way along that. Inevitably, if we accumulate debt as a result of paying consultants more to pick up these shifts, that money is not going to be funded by our NHS. So it would be down for each individual NHS organisation to make further cuts to offset the cost of the strikes.'
Saffron Cordery, the deputy chief executive of NHS Providers, said: 'Trust leaders are working to minimise the harm and disruption caused by the strike. Ensuring adequate cover to keep patients safe is expensive and there is no extra money to cover this so the unexpected cost is bound to impact on the services they can provide.
'It's really worrying to see the demands for excessive rates to provide this cover. The withdrawal of labour by one staff group should not be seen as a financial opportunity for another. That is totally unacceptable.'
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