Striking junior doctors have been called back to work at a hospital in the Midlands that claimed it's "unable to deliver emergency care" – but the British Medical Association (BMA) has told them to hold firm.
Junior doctors have taken their first industrial action in 40 years because of a row over new contracts and pay conditions, designed to ensure better cover at hospitals on weekends – a key Conservative manifesto pledge before the 2015 general election.
Ministers offered an 11% pay rise to compensate for the extra hours, but the BMA has warned that it's a bad deal for junior doctors, who could receive a real-terms pay cut, and that safeguards on excessive hours are being eroded.
The Sandwell and West Birmingham Hospitals NHS trust told doctors on Tuesday morning that they should return to their posts because of a "level 4" incident.
A level-4 incident is when "all actions have failed to contain service pressures and the local health system is unable to deliver comprehensive emergency care".
Dr Roger Stedman, the trust's medical director, said in a statement: "Over the last two days we have had very high numbers of patients come to hospital, and fewer than usual discharged.
"Because of that we decided to require trainee doctors allocated to ward work to attend Sandwell during today's strike."
But the BMA told its members to continue striking unless or until it confirms there is a "major unpredictable incident".
It said in a statement: "Junior doctors should continue with industrial action until NHS England has confirmed and the BMA has agreed – via the agreed escalation process – that a major unpredictable incident is taking place for a specific trust.
"The BMA will notify members as soon as such an incident is in place."
It emerged that the trust prepared its letter to junior doctors yesterday and was planning to recall them before the strike started, not due to a single emergency but because of a recent "surge in activity" and patient backlog.
Hannah Fosker, a junior doctor from Leicester, told BuzzFeed News there was no need for hospitals to recall doctors because of staffing shortages.
"I'm glad to say senior colleagues in Leicester have been supportive but I have heard of this happening elsewhere in the Midlands," she said.
"Hospitals are operating with the same junior doctor numbers as any weekend or bank holiday today, plus full consultant cover. Therefore there should be no need for trusts to declare an emergency based on staffing levels.
"Of course if there were any major incidents we would attend to work instantly to keep the public safe."
Anne Rainsberry, national incident director for NHS England, said that the Sandwell trust was simply asking doctors to return to work as part of a pre-agreed protocol.
"Sandwell Hospital has reported that it has been experiencing exceptional and sustained pressure. In line with the local agreement between the trust and the BMA, their medical director has asked junior doctors to return until such a time as the pressure is relieved," she said.
"The local NHS is actively reviewing the situation to support the trust. Nationally, we are continuing to work closely with our BMA colleagues to ensure patient safety."
Calls to executives at the Sandwell and West Birmingham trust went unanswered on Tuesday morning.
Patrick Smith is a senior reporter for BuzzFeed News and is based in London.
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Laura Silver is a reporter for BuzzFeed News and is based in London.
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