Closed consultation

Minimum service levels in event of strike action: hospital services in England, Scotland and Wales

Updated 16 October 2023

This was published under the 2022 to 2024 Sunak Conservative government

Applies to England, Scotland and Wales

Foreword

As Secretary of State for Health and Social Care, protecting and improving the health and wellbeing of the public is my primary focus. A key priority for this government is to ensure that our health services can continue to deliver vital services to treat and support patients at their time of need. I am grateful to our dedicated and skilled healthcare staff across the NHS for their continued efforts to care for patients and adapt to the changing health needs of our population.

Keeping patients safe during industrial action in health services is essential. Disruption caused by industrial action can cause worry for patients and uncertainty for employers, while adding risk to patient safety because of inadequate staffing to provide treatment and the cancellation of planned appointments, operations and other services.

The ability to strike is an important part of industrial relations in the UK. However, we need to maintain a reasonable balance between the ability of workers to strike with our obligation to protect the lives and health of the public.

Earlier this year we launched a consultation on introducing minimum service levels in ambulance services, given the central role those services play in responding to patients in emergency situations. We would now like to hear your views on introducing minimum service levels in essential hospital-based services. Your feedback will help to inform the decision on whether a minimum service level is introduced for these services, and if so, where the level is set to ensure that patient safety is prioritised.

Our preliminary proposal would require some hospital staff to work during strikes to ensure that essential and time-critical care can continue during periods of strike action, for those who need care.

Currently, during strike action employers negotiate with trade unions to seek agreement to provide a certain level of cover for priority health services to protect life and health. These agreements, known as ‘derogations’, mean that certain staff members or groups of staff are exempted from strike action in order to provide the cover needed to care for patients at risk of harm.

Derogations are entirely dependent on goodwill from unions and staff. During some strikes, in some places, derogations have been agreed in good time, but in others, unions have not agreed them until very late or have not agreed them in advance of the strike commencing, which has particularly affected hospital services. This has resulted in staff not attending work when employers had understood they would do, and patient safety being put at risk while situations were resolved: urgent appointments have been cancelled on the day, wards closed unexpectedly, and emergency care compromised. For example, during the strike by junior doctors in August 2023, the British Medical Association (BMA) refused 17 applications for derogations where both local clinical leaders and their own local representatives had agreed it was necessary and reasonable to keep patients safe.

The significant risk of harm to hospital patients when unions have refused to agree sensible voluntary derogations is the reason that we have decided to consult on whether, and at what level, to put in place statutory minimum service levels for hospital services.

Thank you for taking the time to respond to this consultation, to ensure that the NHS remains ready to help all of us when we need it the most.

Rt Hon Steve Barclay MP, Secretary of State for Health and Social Care

Background

The Secretary of State for Health and Social Care is required, by section 234F of the Trade Union and Labour Relations (Consolidation) Act 1992, to consult before making minimum service level (MSL) regulations as to which, if any, health services should be in scope and what the level of service should be. The Secretary of State for Health and Social Care has launched this consultation in order to meet these requirements in respect of hospital services.

The Department of Health and Social Care (DHSC) is seeking views regarding the introduction of regulations in England, Scotland and Wales (that is, Great Britain). If implemented, these regulations would mean that an employer could issue a work notice requiring an individual to work through strike action, in order for the time-critical hospital-based services set out in the MSL to continue. If introduced, the regulations would be brought forward under the powers provided to the Secretary of State for Health and Social Care in the Strikes (Minimum Service Levels) Act 2023.

The UK Government has already consulted on the application of MSLs for other sectors. It is now proposing that most essential and time-critical hospital services - those which deliver urgent medical treatment, and if unavailable could cause significant harm to patient safety - should be covered by MSLs. Your answers to this consultation will help to inform decisions on:

• whether hospital services should be covered in regulations
• if so, which hospital services should be covered in regulations and whether any health services outside hospitals should be included
• if so, the appropriate minimum service levels required

The target audience is:

• the general public (including patients and family members or carers)
• trade unions
• NHS and health service employers
• representative organisations and professional bodies
• workers within health services
• workers within any other services affected by strikes in the NHS
• patient groups

Strikes (Minimum Service Levels) Act 2023 summary

Overview of the act

The act makes amendments to the Trade Union and Labour Relations (Consolidation) Act 1992 to:

• establish powers for the government to make regulations to set minimum service levels in certain services within key sectors, such as healthcare, fire and rescue, and transport services. As set out in the act, the government must consult before it brings forward regulations for Parliament’s approval
• enable employers within specified services to issue work notices to roster the workforce required to secure the minimum service level on a strike day
• add a new obligation for unions to take reasonable steps (outlined in the draft code of practice) to ensure compliance with work notices to the list of requirements necessary for the union’s strike action to be protected from liability in tort, where minimum service levels have been made

How MSLs work

The act includes powers for the Secretary of State to set MSLs in regulations. The act aims to limit the impacts of strike action on the lives and livelihoods of the public and to ensure balance between the ability of unions and their members to strike with the rights of the wider public to be able to access key services during strikes.

The introduction of MSL legislation is designed to enable people to continue to travel to their place of work, access education and healthcare, and go about their daily lives during strikes, while balancing this against the ability to strike. Where MSLs are applied, there should be a more consistent level of service for the public from strike to strike, as well as minimising the circumstances in which there are no services at all. This will help protect the public and guard against disproportionate risks to lives and livelihoods.

Work notices

Where MSL regulations are in place, and where a trade union gives notice of strike action to an employer which provides a relevant service (as specified in the regulations), the employer can issue a notice (known as a ‘work notice’) to specify the persons required to work and the work they must carry out to secure MSL for that strike period. The employer must consult the union about the numbers of people to be identified and the work to be specified in the work notice and have regard to their views before issuing the work notice.

Geographical scope

The act applies to Great Britain. The act enables the UK Government to apply MSLs to key sectors across Great Britain, including health services. In some cases, this will affect employers operating services where responsibility for those services is devolved to the Scottish or Welsh governments. As part of the development of minimum service levels and the consultations that are legally required to inform these, the government will seek the views of the Scottish Government and the Welsh Government on the geographical scope of the regulations - recognising that in some cases application of minimum service levels could affect employers operating services that are devolved. As employment law is devolved for Northern Ireland, it is for the Northern Ireland Assembly to assess whether to introduce legislation that would allow for minimum services levels to be set in the event of strikes.

Legal context

The International Labour Organization (ILO) is a specialised agency of the United Nations which promotes social justice and workers’ rights. The ILO has stated that minimum service levels are justifiable in some situations to protect essential services.

Our proposal to introduce MSLs in time-critical hospital services aims to protect life, safety and health. The government believes that it is a legitimate and proportionate interference with the right to strike, because it is an ‘essential service’ which, if interrupted, would ‘endanger the life, personal safety or health’ of the public. As such, we consider that the proposal strikes the right balance between the ability of workers to strike and the protection of others’ freedoms and rights.

International comparisons

Minimum service level provisions are already in place to varying degrees in several Western European countries, to maintain access to essential service during strike action. In Italy, health services including emergency services, such as intensive care units and ambulance services, are considered essential public services and have to be guaranteed under Law 146/90. For services such as diagnostics and therapeutics, a level of service provided during public holidays should be maintained. In France, the staffing levels provided on Sundays or public holidays are considered the reference point when employers and unions agree what minimum service level needs to be provided during industrial action.

Summary of proposal

The need for a hospital MSL

Patients are at the heart of healthcare services, and their wellbeing, safety and continuity of care is our priority, especially during industrial action. In normal circumstances, every hospital patient has a right to receive timely and quality healthcare services, whether they are attending a routine check-up, managing a chronic condition, seeking urgent care or requiring specialised treatment. This includes mental health, eating disorder services and sexual assault referral centres where they are operated by hospitals as well as physical health problems.

Industrial action poses a significant risk to the smooth functioning of these services, potentially leading to harmful delays, restricted access to essential care and an increased burden on staff and resources. Patients in need of emergency care, urgent procedures and other time-critical treatment are particularly vulnerable to service disruptions. These conditions often require immediate intervention or uninterrupted attention to prevent serious complications or even death, meaning that reliability of this kind of service is critically important, even during strikes.

We have gathered evidence about the impact that industrial action has had on NHS hospital-based services since December 2022. This evidence shows that strike action has both been hugely disruptive, and at times significantly increased the risk of compromising patient safety. Despite organisations working hard to mitigate the impacts of all strike action, to date nearly 900,000 appointments have been rescheduled due to strike action since December 2022.

In addition, there were 22 critical incidents declared due to industrial action. In 2 instances, some critical care patients and gynaecology patients had to be moved to other hospitals due to insufficient staffing numbers. Some urgent cancer surgery and chemotherapy appointments had to be rescheduled and some urgent surgery on trauma patients could not go ahead. Minor injury units, urgent treatment centres and one emergency department were closed. This is in addition to the cancellation of planned surgery and routine appointments which were not urgent or life-threatening. While there were reduced waiting times in emergency departments during some of the strikes, this was in part because other parts of the NHS offered a significantly reduced service, or no service at all, on strike days.

When strikes are called, the NHS does all it can to protect essential services. In some instances, unions have supported this through voluntary derogations that have been agreed in good time. However, in other services where derogations were agreed shortly before the strike started, some staff did not attend work when employers had understood they would do, and patient safety was put at risk while situations were resolved, urgent appointments have been cancelled on the day, wards closed unexpectedly, and emergency care was compromised. For example, during the strike by junior doctors in August 2023, the BMA refused 17 applications for derogations in particular hospitals where both local senior clinical leaders and their own local representatives had agreed it was necessary and reasonable to keep patients safe.

As such, experience has demonstrated that there is a risk of harm to hospital patients through relying solely on voluntary derogations, especially where a union will not agree derogations. It is for that reason we have decided to consult on whether and at what level to put in place statutory minimum service levels. This risk would be increased further if separate trade unions chose to call more than one professional group to take industrial action at the same time, for example doctors and nurses.

The scope of this consultation focuses on hospital services. If, at a later date, it becomes clear that strike action is impacting the risks to life and life-changing harm for patients who need to receive healthcare in community settings, there may be a case for further consultations that cover these parts of NHS services. We ask for your views on this in this consultation.

Proposed MSL for hospital services in the event of industrial action

We propose that hospitals will treat people who require urgent or emergency treatment in hospital and people who are receiving hospital care and are not yet well enough or able to be discharged, during the period of industrial action as they would on a non-strike day. This would mean the following sets of patients could expect to be treated as they would on a non-strike day:

• in-patients already receiving hospital care
• existing patients requiring urgent elective treatment that would normally be delivered during the period of industrial action (for example, people on priority 1 or priority 2 elective surgery lists (surgery that is required within 72 hours for priority 1, or 4 weeks for priority 2), people requiring dialysis, transplant patients where a potential donor match is identified, elective caesarean or induction of labour)
• existing patients who could or will need emergency, critical or urgent assessment, diagnostics or treatment in hospital (for example, cancer or cardiac diagnostics and treatment, but not, for example, routine knee or hip replacement)
• new patients presenting to hospital that require unplanned assessment, diagnostics and/or treatment in hospital (for example, people presenting to emergency departments, people in active labour)

When deciding which treatment needs to go ahead during the period of strike action, the duration of the strike action needs to be considered. For short periods of action, service provision might look similar to what is usually available on a Sunday. However, this is not a hard and fast rule and would need to be adjusted for a longer period of strike action. For example, care would be provided to people presenting to emergency departments, people in active labour, cancer or cardiac diagnostics and treatment, people on priority 1 or priority 2 surgery lists, people requiring dialysis, elective caesarean or induction of labour and people requiring transplant surgery but not, for example, routine knee or hip replacement.

If the industrial action is planned to last for more than 24 hours (or is adjacent to a weekend), other considerations will need to be accounted for as there are numerous hospital services which do not normally happen on a Sunday but are clinically significant and would need to be accounted for in such strike action. For example, radiotherapy and dialysis do not normally run on a Sunday but would need to be available to patients at some point during longer strikes to prevent harm. Cardiac, paediatric and obstetrics care (such as elective caesareans) are other examples of time-critical procedures. These types of treatments and procedures would need to be available for clinical reasons during any longer period of industrial action so that patients are not put at risk of losing life or of life-changing harm by interrupting the clinical treatment pathway. The leadership of each hospital would need to determine how many staff, in which professional groups, they would need to appropriately manage these time-critical services during the proposed industrial action, to determine how many people would need to receive a work notice.

We propose that all the relevant supporting services run by hospitals would also need to be provided to ensure that the minimum level of service described above can operate safely and effectively. Examples of these supporting services include theatres, catering and cleaning, discharge support, mortuary services, pathology, information and communications technology (ICT) support, estates and patient transport.

It is also our view that the cumulative impact of industrial action would need to be accounted for when deciding to issue work notices to provide the minimum service level described at the start of this section. We would expect the NHS to consider whether more than one union or profession is to take strike action at the same time.

We are not proposing to introduce MSLs for procedures or services where the delay does not cause risk to life or significant harm, even though we fully recognise that those delays may cause distress to the patients involved. This would include, for example, joint replacements, non-urgent diagnostic tests and out-patient reviews. These services would significantly reduce or close during a period of industrial action and would only continue if they could be provided by staff not covered by the strike mandate or because they had voluntarily indicated in advance that they were not planning to take industrial action.

We are not proposing that staffing for the MSL would need to be sufficient to respond to an unpredictable major incident. Our expectation is that sufficient NHS staff would return to work to participate in a major incident response on a voluntary basis, irrespective of whether they have the expressed support of their union, locally or nationally. This is in line with their professional obligations as clinicians.

Given the varied and local nature of NHS services, we are proposing that local NHS trusts, health boards, and their commissioners are best placed to determine precisely how services should operate and the number of staff needed in order to provide the minimum level of service set out at the start of this section. For example, trusts and health boards may consolidate some services to a single site or on particular days of the industrial action period rather than have reduced levels of services across multiple sites or days.

Examples given in this consultation are illustrative of how the proposed principles of a minimum service level could be applied. We have not attempted to include all possible examples of the broad range of hospital services that could be encompassed by the proposed minimum service level.

NHS hospitals in Great Britain are operated by NHS trusts or health boards. NHS trusts and health boards may sub-contract some of their work to other organisations. For example, this can include contracting out cleaning or other support services to a private company or entering into arrangements where one trust provides elements of care across a larger area, for example physiotherapy services. Third sector providers, such as social enterprises or charities may be commissioned to deliver some services. Other NHS organisations may also deliver services that support hospital treatment, for example blood and transplant services facilitate treatment requiring blood platelets or donated organs.

This means that NHS trusts or health boards may not employ all the staff who are essential to the care provided by hospitals. As only the organisation that employs a member of staff who may strike can issue a work notice, we are seeking your views on whether the MSL should cover all organisations that provide services on behalf of hospitals.

How to respond

Please respond using the online survey.

If you require any clarification on the consultation document, email hospitalmslconsultation@dhsc.gov.uk. Do not send any personal information or consultation responses to this email address.

The consultation is open for 8 weeks. The deadline for responding is 11:59pm on 14 November 2023.

Consultation questions

Hospital-based services MSL proposal

During strike action, employers negotiate with trade unions to seek agreement to provide a certain level of cover for priority health services to protect life and health. These agreements, known as ‘derogations’, mean that certain staff members or groups of staff are exempted from strike action in order to provide the cover needed to care for patients at risk of harm. Derogations are entirely dependent on goodwill from unions and staff. During some strikes, derogations have been agreed in good time, but in others, unions have not agreed them until very late or have not agreed them in advance of the strike commencing, which has particularly affected hospital services.

To what extent do you agree or disagree that current arrangements are sufficient in providing cover for essential services?

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree

Please explain your position and provide any supporting evidence (maximum 250 words).

We are proposing to introduce minimum service levels as a further measure to ensure continuity of access to essential services during strike action. The proposal is that hospitals will treat people as they would on a non-strike day who require urgent or emergency treatment in hospital during the period of industrial action and people who are receiving hospital care and are not yet well enough or able to be discharged.

To what extent do you agree or disagree with the proposal to introduce minimum service levels during strike action to achieve this aim?

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree

Please explain your position and provide any supporting evidence (maximum 500 words).

To what extent do you agree or disagree with the proposal to introduce minimum service levels during strike action for in-patients already receiving hospital care:

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree

Please explain your position and provide any supporting evidence (maximum 250 words).

To what extent do you agree or disagree with the proposal to introduce minimum service levels during strike action for existing patients requiring urgent elective treatment?

For example priority 1 or priority 2 elective surgery lists, dialysis, elective caesarean, or induction of labour?

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree

Please explain your position and provide any supporting evidence (maximum 250 words).

To what extent do you agree or disagree with the proposal to introduce minimum service levels during strike action for existing patients needing emergency, critical or urgent assessments, diagnostics or treatment?

This does not include routine procedures like knee or hip replacements.

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree

Please explain your position and provide any supporting evidence (maximum 250 words).

To what extent do you agree or disagree with the proposal to introduce minimum service levels during strike action for new patients presenting to the hospital requiring unplanned assessment, diagnostics and/or treatment?

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree

Please explain your position and provide any supporting evidence (maximum 250 words).

We propose that hospitals will treat people as they would on a non-strike day who require urgent or emergency treatment in hospital during the period of industrial action, and people who are receiving hospital care and are not yet well enough or able to be discharged. As such, the minimum service level that is required to ensure this treatment is delivered to patients in hospitals during strike action should be informed by expert clinical judgement, meaning the following sets of patients could expect to be treated as they would on a non-strike day:

• in-patients already receiving hospital care
• existing patients requiring urgent elective treatment that would normally be delivered during the period of industrial action (for example, people on priority 1 or priority 2 elective surgery lists (surgery that is required within 72 hours for priority 1, or 4 weeks for priority 2), people requiring dialysis, transplant patients where a potential donor match is identified, elective caesarean or induction of labour)
• existing patients who could or will need emergency, critical or urgent assessment, diagnostics or treatment in hospital (for example, cancer or cardiac diagnostics and treatment, but not, for example, routine knee or hip replacement)
• new patients presenting to hospital that require unplanned assessment, diagnostics and/or treatment in hospital (for example, people presenting to emergency departments, people in active labour)

To what extent to you agree or disagree with allowing local clinicians to determine whether their patients fall under the categories for MSL outlined in the principles listed above during strike action?

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree

Please explain your position and provide any supporting evidence (maximum 250 words).

NHS hospitals in Great Britain are operated by NHS trusts or health boards, who may sub-contract some of their work to other organisations. This may include cleaning or other support services being contracted to a private company, third sector providers, such as social enterprises or charities delivering some services, or other NHS organisations delivering services that support hospital treatments, including blood and transplant services which facilitate treatment requiring blood platelets or donated organs.

This means NHS trusts or health boards may not employ all the staff who are involved in the delivery of essential care provided by hospitals. In writing the MSL regulations the Secretary of State may specify the type of organisations the MSL applies to. This could limit the types of employers who are able to issue a work notice to ensure the continuity of essential hospital services during strike action.

If MSL regulations are introduced for hospital services, which types of employers should be specified to follow these regulations during strike action?

• All organisations involved in delivering NHS hospital services including NHS trusts and health boards, other NHS organisations, and private companies and third sector organisations such as charities and social enterprises
• All NHS-affiliated organisations contracted to deliver hospital services
• Only NHS trusts and health boards
• No employers should be specified by MSL regulations
• Don’t know
• Prefer not to say

Please explain your position and provide any supporting evidence (maximum 250 words).

We are proposing to introduce a minimum service level that would apply only to hospital care. This measure would not include health services available in the community such as pharmacies, GP surgeries and community health teams.

To what extent do you agree or disagree that MSLs should not include community-based health services?

• Strongly agree
• Agree
• Neither agree nor disagree
• Disagree
• Strongly disagree

Please explain your position and provide any supporting evidence (maximum 250 words).

Do you think there is an alternative option to introducing MSLs in hospitals, to ensure continuity of access to essential services and protect patients from risks to life and life-changing harm during strike action?

• Yes
• No
• Don’t know

Please explain your position and provide any supporting evidence (maximum 250 words).

Impact of strike action in hospitals

Individual experience

Were you, or anyone you know, in hospital or needed to go to hospital for any health-related reason on a day when you were aware that strike action was taking place?

• Yes
• No

Do you think that industrial action since December 2022 has affected your health, or the health of someone you know?

• Yes
• No
• Don’t know

Please explain your answer (maximum 300 words).

If you have a personal experience, please do not provide any detail that could identify yourself or other people, such as your name.

Staff experience

Do you think that industrial action since December 2022 affected the health of your patients?

• Yes
• No
• Don’t know

Please explain your answer (maximum 300 words).

If you have a personal experience, please do not provide any detail that could identify yourself or other people, such as your name.

Which, if any, of the following patient categories do you think were affected by industrial action since December 2022?

• Patients with emergency and critical health needs
• Patients with other time-critical health needs (for example, dialysis, cancer care, maternity services, neo-natal, cardiac)
• Patients with non-emergency hospitalisations (for example, medical wards, mental health in-patient care, diagnostics, discharge support, end of life care)

Please explain your answer (maximum 300 words).

If you have a personal experience, please do not provide any detail that could identify yourself or other people, such as your name.

NHS trust or health board experience

Does your NHS trust or health board run a hospital that was affected by strike action since December 2022?

• Yes
• No

Acknowledging that precise figures may be unavailable, please provide your best estimate for the following questions.

What was the total number of days that the hospital or hospitals you run were affected by strike action?

• 0 to 10
• 11 to 20
• 21 to 30
• 31 to 40
• 41 to 50
• Over 50
• Don’t know
• Prefer not to say

How many hours did your NHS trust or health board managers and clinicians collectively spend preparing for the most recent period of strike action affecting your organisation?

• Under 25 hours
• 26 to 50 hours
• 51 to 75 hours
• 76 to 100 hours
• Over 100 hours
• Don’t know
• Prefer not to say

If you requested a derogation from a union to mitigate the impact of the most recent period of strike action, how many hours did NHS trust or health board managers and clinicians collectively spend on submitting the derogation request?

• Under 25 hours
• 26 to 50 hours
• 51 to 75 hours
• 76 to 100 hours
• Over 100 hours
• Don’t know
• Prefer not to say

How much do you estimate it cost your trust or health board to continue to provide time-critical hospital services during the most recent period of strike action that affected your organisation? This may include, but is not limited to, expenses such as overtime payments. Please provide your best estimate and specify the types of costs included in your calculation (maximum 250 words).

Based on the hospital MSL proposal outlined in this document, how would you compare the time commitment required for implementing this proposal to that of how you currently prepare for industrial action?

• Less time-intensive than the time currently spent preparing for industrial action
• About the same as the time currently spent preparing for industrial action
• More time-intensive than the time currently spent preparing for industrial action
• Don’t know

Please explain your position and provide any supporting evidence (maximum 250 words).

Do you anticipate incurring additional costs at the trust or health board, either one-time or recurring, as a result of implementing a MSL for hospital-based services?

• Yes
• No
• Don’t know
• Prefer not to say

Please explain your position and provide any supporting evidence (maximum 250 words).

Trade union experience

Has your trade union called industrial action in any NHS hospital since December 2022?

• Yes
• No

Provide an estimate for the total number of hours spent by your trade union officials to work with local hospital managers and national authorities such as NHS England, to ensure essential health services remained available during the most recent strike action your union was involved in.

This includes but is not limited to discussions on special arrangements like derogations. Select the closest range.

• Under 25 hours
• 26 to 50 hours
• 51 to 75 hours
• 76 to 100 hours
• Over 100 hours
• Don’t know
• Prefer not to say

Considering the proposal for a hospital MSL and the draft code of practice on reasonable steps trade unions should undertake, how do you anticipate the time commitment for your union officials to take these reasonable steps will compare to the time currently spent working with NHS trusts or health boards in preparation for industrial action?

• Less time-intensive than the time currently spent preparing for industrial action
• About the same as the time currently spent preparing for industrial action
• More time-intensive than the time currently spent preparing for industrial action
• Don’t know

Please explain your position and provide any supporting evidence (maximum 250 words).

Do you anticipate that your trade union will incur new costs, either one-time or recurring, in implementing the reasonable steps as outlined in the draft code of practice?

• Yes
• No
• Don’t know
• Prefer not to say

Please explain your position and provide any supporting evidence (maximum 250 words).

Public sector equality duty (PSED)

Are there groups of people, such as (but not limited to) those with protected characteristics, who would benefit from the proposed introduction of minimum service levels in some or all hospital services?

• Yes
• No
• Don’t know

Which groups do you think will benefit and why?

Are there groups of people, such as (but not limited to) those with protected characteristics, who would be negatively affected by the proposed introduction of minimum service levels in some or all hospital services?

• Yes
• No
• Don’t know

Which particular groups might be negatively affected and why?

Privacy notice

Summary of initiative

DHSC is seeking views regarding the introduction of regulations in England, Scotland and Wales (that is, Great Britain). If implemented, these regulations would mean that an employer could issue a work notice requiring an individual to work through strike action, in order for the time-critical hospital-based services set out in the MSL to continue. If introduced, the regulations would be brought forward under the powers provided to the Secretary of State for Health and Social Care in the Strikes (Minimum Service Levels) Act 2023.

The UK Government has already consulted on the application of MSLs for other sectors. The border security consultation is also live. In health, our intention is that minimum service levels would protect the ability of workers to strike while protecting patient safety. This consultation will help to inform a decision as to what health services should be covered in regulations. Our proposal is that hospital services should be covered in regulations as a priority. This consultation will help to inform a decision as to whether hospital-based services should be covered and if so, the detail regarding the minimum service levels required in hospital-based services.

Data controller

The Department of Health and Social Care is the data controller.

What personal data we collect

Data to be collected includes IP address and geographical location.

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The consultation confirms in what instances you may be contacted via your email address.

The processing of personal data (namely, demographic information about respondents) is necessary to ensure that the government complies with the public sector equality duty (PSED) and captures if and how certain groups, such as those with protected characteristics, may be positive or negatively impacted by the policy.

It will be used to, for instance, compare how support or opposition to the policy, or views on its scope, may differ by characteristics.

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Under the General Data Protection Regulation, the lawful bases we rely on for processing this information are:

• article 9(i) conditions for processing special category data (public health)
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The information will be stored in DHSC secure systems in the UK.

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We anticipate retention of data for 12 months to enable time for analysis of responses. The data will then be destroyed or securely disposed of.

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Anyone who is still not satisfied can complain to the Information Commissioners Office. Their website address is www.ico.org.uk and their postal address is:

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Changes to this policy

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