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NHS leaders are bracing themselves for the prospect of hospital consultants walking out for two days if an ongoing ballot on industrial action proves successful.

The British Medical Association has announced the prospective dates for July in the run-up to a three-day strike by junior doctors next week.

If the ballot is successful, and the government does not present the BMA with a “credible offer,” consultants will strike on 20 and 21 July.

Consultants will provide just “Christmas day cover,” meaning routine services will need to be paused. Their ballot concludes on 27 June.

It comes as HSJ revealed more than 800 consultants in London will refuse to cover junior doctors’ shifts unless their trusts pay higher overtime rates.

While the government is implementing a pay deal for Agenda for Change staff this summer, despite disagreements from some unions, there has been minimal traction with doctors over the last few months.

A consultative BMA ballot suggested a “yes” vote is likely among consultants, but leaders will hope any strike action, though disruptive, will not coincide with another nurses’ walkout. Either on the same day or close to it.

In any case, the NHS is in for another long summer.

Supported seven named

NHS England has named the systems it has deemed the most “off target” on their emergency care recovery.

Seven integrated care systems and one ambulance trust have been placed in “intensive” central support from NHSE as part of its new intervention regime for emergency care.

The seven troubled systems, which have been placed in the “first tier” of support, are: Cheshire and Merseyside; Cornwall and the Isles of Scilly; Devon; Greater Manchester; Kent and Medway; Norfolk and Waveney; and North East London ICS. The only ambulance trust in the first tier is South Western Ambulance Service Foundation Trust.

A further seven systems and two ambulance trusts have been placed in a “secondary” tier of intervention, which will include support from NHSE’s regional teams. These are: Frimley; Hampshire and Isle of Wight; Herefordshire and Worcestershire; Hertfordshire and West Essex; Humber and North Yorkshire; Shropshire, Telford and Wrekin; Staffordshire and Stoke-on-Trent. The second tier trusts are East Midlands Ambulance Service Trust and East of England Ambulance Service Trust.

“First tier” organisations will receive support including help with analytical and delivery capacity, “buddying” with leading systems and “targeted executive leadership”. The support for “second tier” organisations include “deep dives to diagnose challenges and drive improvement”.

HSJ analysis of this data shows that many of these systems are outliers for these performance measures. For example, Cheshire and Merseyside ICS had 36.6 per cent of available beds taken by long stays of 14 days or more in March – the highest proportion in the country.

Also on today

In London Eye, Ben Clover explains why he thinks London trusts may have to cave in on the consultant rate-card row. And in comment, Alan Clamp says that as the government’s recently proposed reforms will shape the future of healthcare regulation, it’s imperative to ensure the changes work not just for the professionals but also for patients.