Medical Director Interview Questions & Answers

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About this NHS interview question bank

To prepare for a Medical Director NHS interview, expect a board-level panel to test how you would hold accountability for medical professional standards: Responsible Officer duties and revalidation, managing concerns about doctors under MHPS, mortality and learning from deaths, PSIRF, medical workforce and industrial action planning, and how you behave as a member of a unitary board. Prepare spoken answers built on real leadership situations you have handled, know the trust's quality, workforce and financial position, and be ready to show your values under pressure.

This bank contains 40 original practice questions with first-person model answers written for doctors applying for Medical Director posts at executive (VSM) level, with a selection pitched at Deputy Medical Directors preparing to step up and at Chief Medical Officers working across groups and integrated care systems. It covers the statutory and regulatory side of the role, including revalidation, GMC referral, Fit and Proper Person requirements and the Duty of Candour, alongside the human side: supporting doctors, protecting whistleblowers, meeting bereaved families and leading through industrial action. Each question explains what the panel is really assessing, the points you must hit, the mistakes to avoid and the frameworks worth reading, so you can rehearse answers that sound like a credible, safe and humane medical leader.

 

What this question bank covers

• Motivation for medical leadership
• Unitary board duties
• Fit and Proper Person requirements
• Responsible Officer and revalidation
• Managing concerns about doctors and MHPS
• GMC referral
• Practitioner Performance Advice
• Mortality, SHMI and learning from deaths
• Medical examiners
• PSIRF and patient safety
• Never events and Martha's Rule
• Duty of Candour
• Clinical governance and assurance
• NICE and clinical effectiveness
• Medical workforce strategy
• Resident doctor industrial action
• Guardian of safe working
• Medical education and deans
• Freedom to Speak Up
• Culture, civility and sexual safety
• Differential attainment and fair referral
• Safeguarding and allegations against doctors
• Caldicott and information governance
• Digital and AI governance
• Health inequalities and system working
• Personal leadership and resilience

 

40 NHS interview questions with full model answers. The first 8 are free to read below. Unlock the remaining 32 for £2.99 (12 months' access).

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why do you want to be a Medical Director, and why now?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine reason rooted in your experience, not ambition for its own sake. They are listening for an understanding that the role is about accountability for the whole medical workforce and for quality, and for evidence that you are ready for the loneliness and weight of an executive post.

 

Model answer

I'll start with a slightly uncomfortable truth. For a long time I didn't want this job. I enjoyed being a consultant, I liked my patients and I was a little suspicious of people who moved into management. What changed my mind was about six years ago, when I became clinical director for a medical division and found myself sitting with a family whose father had died after his deterioration was missed overnight. The individual doctors weren't bad doctors. The system around them had let them down: thin night cover, an escalation process nobody trusted and a rota that had been patched for months.

I realised that the decisions shaping that night had been made in rooms I wasn't in. Since then I've taken roles that put me closer to those rooms. As associate medical director for quality I led our learning from deaths work and our move to PSIRF, and as deputy medical director I've been the decision maker on several concerns about doctors under MHPS. Those cases taught me how much a fair, timely and kind process matters, both to patients and to the doctor at the centre of it.

Why now? I think I've done enough of the component parts to understand how they connect. Revalidation, mortality review, job planning, the guardian's reports and the freedom to speak up data are all telling you about the same thing, which is whether doctors here can do good work safely. I'd like to be the person who holds that picture for the board and acts on it.

I'm also clear about what it costs. It's a role where you'll sometimes be unpopular with colleagues, and where you carry decisions home. I've talked that through with my family and with a mentor who's been a medical director. I'm going in with my eyes open, and I'd still like to keep some clinical work, because I think it keeps me honest about what the job is like on the ward at three in the morning.

 

Why this answer works

The answer opens with a specific, believable turning point and links it to system causes rather than individual blame, which is exactly the lens a Medical Director needs. It shows a credible progression through the component parts of the role and gives a realistic account of the personal cost, which reassures the panel that the candidate is ready.

 

Key points to include

• A real moment that moved you towards medical leadership
• A clear progression of roles that has prepared you for executive accountability
• Understanding of how revalidation, safety, workforce and culture connect
• Realism about the pressure, isolation and unpopularity of the role
• What you would bring that is distinctive

 

Common mistakes to avoid

• Talking about career progression or status rather than patients and doctors
• Listing job titles without saying what you learned in them
• Underplaying the weight of MHPS, GMC and board accountability
• Saying you will give up all clinical contact without explaining how you will stay connected to front-line reality

 

NHS values and standards

Commitment to quality of care; Improving lives; Everyone counts; GMC Good Medical Practice: leadership and management

 

Further reading

• GMC Leadership and management for all doctors
• GMC Good Medical Practice
• NHS Constitution for England
• NHS Leadership Competency Framework for board members

 

 

Question 2: You will be an executive director on a unitary board. What does that mean to you as a doctor?

NHS Values question  ·  NHS Values

 

What the interview panel is assessing

The panel is testing whether you understand collective board responsibility, not just your professional portfolio. They want to see that you will speak on finance, operations and strategy as well as quality, that you will challenge and accept challenge, and that you can hold both your GMC duties and your corporate duties without confusion.

 

Model answer

To me it means I stop being the doctors' representative and become a director of the whole organisation who happens to bring medical expertise. On a unitary board every member, executive and non-executive, shares responsibility for every decision. So if we approve a financial plan that takes out beds, I own that decision as much as the chief finance officer does. I can't sit back and say finance isn't my area, and I can't say the quality risks were somebody else's job to spot.

That works in both directions. I'd expect to be challenged by non-executives on mortality data, on how we manage concerns about doctors and on whether our assurance is real or just reassurance. And I'd expect to contribute properly when we're discussing the operational plan, estates or the capital programme, because nearly every one of those decisions has a clinical consequence somewhere.

There's a tension I'm aware of. As a doctor my duties under Good Medical Practice don't switch off when I join the board. If I believed patients were at serious risk, I'd raise it inside the board first, clearly and in writing, and I'd escalate beyond it if that failed. In practice, the way to avoid ever reaching that point is to be open early. I'd much rather bring an emerging risk to the quality committee when it's half understood than present a polished paper once it's already gone wrong.

I'd also think carefully about how I behave in the room. The Fit and Proper Person requirements and the board leadership competency framework set expectations about candour, openness and how we treat each other. I want to be the kind of director who says, I don't know yet, I'll find out, and who supports colleagues publicly once a decision is taken, even if I argued against it, unless it crosses a line on safety.

Finally, I'd stay visible. Being on the board can make you remote very quickly, so I'd keep walking the wards and listening to doctors. That's where I'd get the intelligence that makes my contribution at the board table worth having.

 

Why this answer works

This answer shows a clear grasp of collective responsibility and the difference between representing doctors and directing the organisation. It handles the potential tension with professional duties maturely and links board behaviour to the Fit and Proper Person framework and leadership competencies.

 

Key points to include

• Collective responsibility for all board decisions, not only quality
• Willingness to challenge and be challenged, including by non-executives
• How GMC duties sit alongside corporate duties
• Raising risks early and transparently
• Staying connected to front-line reality

 

Common mistakes to avoid

• Describing yourself as the voice of the doctors on the board
• Implying finance and operations are outside your concern
• Suggesting you would go public before using internal routes
• Confusing assurance with reassurance

 

NHS values and standards

Working together for patients; Commitment to quality of care; Everyone counts; GMC Good Medical Practice: leadership and openness

 

Further reading

• Code of governance for NHS provider trusts
• NHS Leadership Competency Framework for board members
• Fit and Proper Person Test Framework for board members
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
• GMC Leadership and management for all doctors

 

 

Question 3: As Responsible Officer, a consultant has missed two appraisals and is now close to their revalidation date. How would you handle it?

Technical question  ·  Technical

 

What the interview panel is assessing

The panel wants to see that you understand the RO's statutory duties and the options available to you, and that you apply them fairly. They are looking for curiosity about why the doctor is not engaging, support before sanction, clear documentation and correct use of GMC processes.

 

Model answer

My first step would be to find out why, rather than reach for the non-engagement form. Missing two appraisals is unusual for a consultant, and in my experience there's often something behind it: ill health, a family crisis, burnout, a dispute with the department, or sometimes a doctor who's quietly struggling with their practice. I'd ask the appraisal lead for the full history, check our records for any concerns or complaints, and then meet the consultant myself, in private, with a genuinely open question about what's going on.

Alongside that, I'd be clear about the expectations. Under the Responsible Officer regulations and GMC guidance, a licensed doctor has to take part in annual appraisal and provide the supporting information needed for revalidation. I'd explain that plainly and agree a realistic plan with dates: an appraiser allocated, the supporting information they'll need, including colleague and patient feedback, and a meeting booked well before the submission date.

If there's a genuine reason, such as a period of sickness, I can request a deferral from the GMC. Deferral is neutral; it simply gives more time, and I'd make sure the doctor understands that. I'd also offer occupational health or Practitioner Health if health is part of the picture.

If, after support and fair warning, the doctor still won't engage, I would have to consider notifying the GMC of non-engagement. That's a serious step that can lead to the GMC considering withdrawal of their licence, so I'd only take it with a clear audit trail showing reasonable opportunities and reminders, and I'd discuss it with our GMC employer liaison adviser first.

Whatever the outcome, I'd look at the system lesson. If one consultant can drift through two missed appraisals before it reaches me, our appraisal monitoring isn't working well enough. I'd want the appraisal team flagging missed appraisals within weeks, and I'd report engagement rates through the annual board report on revalidation.

 

Why this answer works

The answer balances compassion with statutory responsibility, uses the correct revalidation options of recommendation, deferral and non-engagement, and involves the GMC employer liaison adviser. It also turns a single case into a system improvement, which is what boards expect of an RO.

 

Key points to include

• Explore the reason for non-engagement before acting
• Clear expectations and a dated plan
• Correct use of deferral as a neutral option
• Non-engagement notification only after documented support and warnings
• Use of the GMC employer liaison adviser and a system fix to appraisal monitoring

 

Common mistakes to avoid

• Jumping straight to a non-engagement notification
• Presenting deferral as a sanction
• Failing to consider health or personal circumstances
• Ignoring the governance gap that allowed two missed appraisals

 

NHS values and standards

Respect and dignity; Commitment to quality of care; GMC Good Medical Practice: maintaining and improving performance

 

Further reading

• Medical Profession (Responsible Officers) Regulations 2010 (as amended)
• GMC guidance on revalidation and supporting information for appraisal
• NHS England framework of quality assurance for Responsible Officers and revalidation
• Academy of Medical Royal Colleges guidance on medical appraisal

 

 

Question 4: Concerns are raised about a consultant surgeon's outcomes and behaviour in theatre. Talk us through what you would do in the first few days.

Clinical Scenario question  ·  Clinical Scenario

 

What the interview panel is assessing

The panel is testing whether you can protect patients immediately while treating the doctor fairly and lawfully. They are listening for knowledge of MHPS in England, early use of Practitioner Performance Advice, proportionate interim measures, separation of roles and attention to the doctor's wellbeing.

 

Model answer

The first question in my head is whether patients are at immediate risk. So on day one I'd meet the clinical director and the person who raised the concern, get the facts as they stand, and look at what's scheduled for that surgeon in the coming days. If there's a credible risk, I'd act straight away but proportionately. Often that means restricting the surgeon to certain procedures, or making sure they operate with another consultant present, rather than exclusion. Exclusion should be a last resort, used only where there's no reasonable alternative, and under MHPS it has its own rules on reviews and on informing the board.

I'd ring Practitioner Performance Advice at NHS Resolution early, ideally that same day. They're a valuable independent sounding board and MHPS expects them to be consulted, particularly before any exclusion. If there's a possible fitness to practise issue, I'd also speak to our GMC employer liaison adviser, even if it's too soon to decide on a referral.

Next I'd set up the process properly. That means a case manager who's not been involved, a case investigator with the right surgical understanding, often from outside the department, and a non-executive designated board member to oversee the case. As Medical Director I need to be careful about my own role, so I'd decide early whether I'm the case manager or keeping myself clear for later decisions.

Then I'd meet the surgeon, with HR, and explain the concerns clearly and in writing, tell them about their right to be accompanied, and point them to support: occupational health, Practitioner Health and their defence organisation. I've seen how isolating these processes are, and I'd make sure a named person checks in on them regularly.

Finally I'd look at the data properly. Outcome concerns need careful interpretation, with case mix, national audit data and a look-back where justified. And I'd keep the patients in mind. If the review finds harm, Duty of Candour applies to those families.

 

Why this answer works

This answer puts patient safety first but avoids knee-jerk exclusion, references MHPS roles accurately and uses Practitioner Performance Advice early. It also shows humanity towards the doctor and awareness of conflicts in the Medical Director's own role, which panels value highly.

 

Key points to include

• Immediate assessment of patient risk with proportionate interim measures
• Early advice from Practitioner Performance Advice and the GMC employer liaison adviser
• Correct MHPS roles: case manager, case investigator and designated board member
• Fair, written communication and support for the doctor
• Careful analysis of outcome data and Duty of Candour where harm is found

 

Common mistakes to avoid

• Excluding the surgeon immediately without considering alternatives
• Taking on every role yourself and compromising fairness
• Ignoring the doctor's wellbeing and risk of harm to themselves
• Judging outcomes without case-mix adjustment or benchmarking

 

NHS values and standards

Commitment to quality of care; Respect and dignity; Everyone counts; GMC Good Medical Practice: protecting patients

 

Further reading

• Maintaining High Professional Standards in the Modern NHS (MHPS)
• NHS Resolution Practitioner Performance Advice guidance
• GMC guidance for employers on referring doctors
• Duty of Candour: Regulation 20, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
• Check local policy for Scotland, Wales and Northern Ireland, which have their own frameworks

 

 

Question 5: Our SHMI has moved into the 'higher than expected' range. What would you do?

Patient Safety question  ·  Patient Safety

 

What the interview panel is assessing

The panel wants to know that you understand what SHMI can and cannot tell you, and that you will neither dismiss it as a coding issue nor panic. They are looking for a structured investigation covering data quality, case mix and real care quality, with transparent reporting to the board.

 

Model answer

I'd take it seriously but not jump to conclusions. SHMI compares the deaths we've had, in hospital and within thirty days of discharge, with the number expected for our patients. It's an indicator, a smoke alarm rather than a verdict. A higher than expected SHMI can reflect real problems with care, but it can also reflect coding, recording of comorbidities, palliative care provision in the community, or how many patients we admit compared with other trusts. My job is to find out which, honestly, and quickly.

So I'd ask for three lines of work at the same time. First, the data: are we recording diagnoses and comorbidities accurately, has anything changed in our clinical coding or depth of coding, and which diagnostic groups are driving the change? Second, the care: for those groups, I'd want structured judgement reviews of a sample of deaths, alongside our existing medical examiner and learning from deaths findings. Third, the context: has something changed in the pathway, like a new frailty unit, community bed closures, or more patients coming to us to die because hospice capacity has dropped?

I'd be careful not to let the coding work become a way of making the number go away. Even if coding explains part of it, I'd still want the case note reviews to tell us about quality.

I'd report this to the quality committee and the board early, with an honest statement of what we know and don't know, and a date when we'll know more. I'd tell the ICB and, if needed, the regulator, rather than let them find it in published data first. I'd also want our clinical teams to hear about it from us, framed as a joint investigation rather than a hunt for someone to blame.

If the reviews do find problems, such as delays in recognising sepsis or deterioration, I'd make sure the improvement work is specific, measured and reported back, and that any families affected receive Duty of Candour.

 

Why this answer works

The answer explains SHMI accurately as an indicator rather than a measure of avoidable deaths, and sets out parallel workstreams on data, care and context. It guards against the temptation to fix the number rather than the care and shows proactive, transparent reporting.

 

Key points to include

• SHMI is an indicator that prompts questions, not proof of poor care
• Parallel review of coding, care quality and pathway context
• Structured judgement reviews and medical examiner intelligence
• Early, honest reporting to board, ICB and regulator
• Duty of Candour where reviews find harm

 

Common mistakes to avoid

• Dismissing the signal as just a coding problem
• Treating SHMI as a count of avoidable deaths
• Waiting for perfect information before telling the board
• Blaming individual clinicians before understanding the system

 

NHS values and standards

Commitment to quality of care; Improving lives; Everyone counts; GMC Good Medical Practice: openness and honesty

 

Further reading

• National Quality Board guidance on Learning from Deaths
• NHS England SHMI methodology and publication
• Royal College of Physicians structured judgement review methodology
• Medical examiner system guidance (statutory in England and Wales)

 

 

Question 6: A resident doctor raised a concern through Freedom to Speak Up. They now tell you their supervisor is treating them badly because of it. What do you do?

Conflict question  ·  Conflict

 

What the interview panel is assessing

The panel is testing whether you will genuinely protect a whistleblower, including from senior colleagues. They want to see you take the allegation of detriment seriously, act quickly, keep the original concern alive and change the culture rather than just resolve one case.

 

Model answer

I'd start by thanking them for coming to me, because by this point they've taken two risks: speaking up in the first place and then telling the Medical Director it's gone wrong. I'd listen carefully, ask what's actually happened, such as changes to their rota, comments, being left out of theatre lists or a poor supervision report, and write it down with them. I'd also ask what they need right now to feel safe at work.

Detriment for speaking up is serious. It's against our own policy, it's contrary to the national speak up policy, and it may give the doctor legal protection under whistleblowing law. So I'd involve the Freedom to Speak Up Guardian and HR straight away and agree who will look into the detriment allegation independently. It shouldn't be someone in the same department.

In the meantime, I'd look at practical protection. If the supervisor writes their educational report, I'd speak to the director of medical education and the postgraduate dean's team about whether a different educational supervisor should take over, so the doctor's progression isn't affected by a possible conflict. I'd be careful to frame that as protective, not a finding against the supervisor, who also deserves a fair process.

I'd also check on the original concern. Sometimes the detriment story distracts everyone and the issue the doctor raised gets forgotten. I'd want to know it's being investigated and that they're getting feedback.

Then I'd speak to the supervisor, with HR, explain what's been raised and what's expected of them, and offer them support too. If the investigation shows deliberate detriment, I'd treat it as a conduct matter, and for a consultant I'd consider whether it also raises professional standards issues.

Finally, I'd take the learning to the board. Detriment cases tell you a lot about culture. I'd want our speak up reports to track them, and I'd want doctors to see that when someone speaks up here, the person who gets protected is the one who spoke.

 

Why this answer works

This answer shows warmth to the doctor, immediate practical protection and a fair process for the accused supervisor. It remembers the original concern and connects the case to board-level oversight of speak up culture, which is the leadership behaviour panels want.

 

Key points to include

• Listen, document and ask what the doctor needs now
• Involve the FTSU Guardian and arrange an independent look at the detriment
• Practical protection such as changing educational supervision
• Keep the original concern moving with feedback
• Fair process for the supervisor and board learning on culture

 

Common mistakes to avoid

• Treating it as a personality clash rather than possible detriment
• Asking the supervisor's own clinical director to investigate
• Losing sight of the original concern
• Promising outcomes before any investigation

 

NHS values and standards

Respect and dignity; Working together for patients; Everyone counts; GMC Good Medical Practice: raising and acting on concerns

 

Further reading

• NHS England national Freedom to Speak Up policy
• Public Interest Disclosure Act 1998
• GMC Raising and acting on concerns about patient safety
• Freedom to Speak Up guidance for boards
• Local Freedom to Speak Up and grievance policies

 

 

Question 7: You are told that one of your consultant paediatricians has been arrested in connection with an allegation involving a child outside work. What do you do?

Safeguarding question  ·  Safeguarding

 

What the interview panel is assessing

The panel wants to see that you put children's safety first, follow the correct multi-agency route through the LADO, and do not run your own criminal investigation. They are also looking for fairness, confidentiality and an understanding of your Responsible Officer and GMC duties.

 

Model answer

The welfare of children comes first, so my immediate concern would be whether this doctor poses a risk to the children we care for. Even though the allegation relates to life outside work, it's directly relevant to someone working with children, so I'd treat it as a safeguarding matter from the start.

Within the day I'd speak to our named and designated safeguarding professionals and make sure the Local Authority Designated Officer, the LADO, is informed. The LADO coordinates the management of allegations against people who work with children, and they'll usually convene a meeting with the police, children's social care and us as the employer. I'd be guided by that process and by the police on what can be said and done, because I mustn't do anything that compromises a criminal investigation, like interviewing the doctor about the allegation or tipping off people.

As the employer I'd need to decide on interim measures. Given the role, it's likely we'd need the doctor away from clinical contact with children while things are clarified. Depending on the facts, that might mean temporary restriction to non-clinical duties or exclusion under our MHPS procedure, with advice from Practitioner Performance Advice. I'd make sure it's a neutral act and is reviewed regularly.

As Responsible Officer I'd consider whether the GMC needs to be told, and I'd speak to our employer liaison adviser. An arrest connected with a child is very likely to meet the threshold for referral, and the GMC can consider interim orders. I'd also think about the doctor's other work, such as private practice or another trust, where information sharing may be needed in a lawful and proportionate way.

Throughout, I'd be careful about confidentiality. Only those who need to know would know. The doctor hasn't been convicted of anything, and they'll need support too, so I'd make sure they have access to occupational health and know about their defence organisation.

Afterwards, whatever the outcome, I'd make sure any learning from the LADO process comes back into our safer recruitment and supervision arrangements.

 

Why this answer works

This answer follows the correct statutory route through the LADO and police, avoids interfering with a criminal investigation and uses proportionate interim measures. It also shows understanding of RO duties and GMC referral, plus fair treatment and confidentiality for a doctor who has not been convicted.

 

Key points to include

• Children's safety first, even for allegations outside work
• Inform the LADO and follow multi-agency processes
• Do not compromise the police investigation
• Proportionate interim measures under MHPS with advice
• Consider GMC referral and information sharing about other employers

 

Common mistakes to avoid

• Running an internal investigation before the police and LADO
• Waiting for a conviction before taking any protective steps
• Sharing details beyond those who need to know
• Forgetting the doctor's private practice or other employers

 

NHS values and standards

Everyone counts; Respect and dignity; Commitment to quality of care; GMC Good Medical Practice: protecting children and young people

 

Further reading

• Working Together to Safeguard Children (current statutory guidance in England)
• Children Act 1989 and Children Act 2004
• Maintaining High Professional Standards in the Modern NHS (MHPS)
• GMC Protecting children and young people
• GMC guidance for employers on referring doctors

 

 

Question 8: Resident doctors have announced a period of industrial action. How would you plan for it?

Operational Scenario question  ·  Operational Scenario

 

What the interview panel is assessing

The panel is testing whether you can maintain safe care during strikes while respecting doctors' lawful right to take action. They are looking for structured planning with operational colleagues, clear senior cover, sensible use of derogations, honest communication and attention to relationships afterwards.

 

Model answer

I'd start from two principles that I'd say out loud to everyone. Patients must be kept safe, and resident doctors have a lawful right to take industrial action. I wouldn't let anyone in a leadership role criticise them for it, and I'd make sure no one is pressured or penalised for striking or for choosing to work.

Practically, I'd work alongside the chief operating officer through our emergency preparedness structures, because strikes are an operational incident as well as a medical one. We'd model the expected gaps by department, using what we know about likely participation while recognising doctors don't have to tell us in advance. Then the clinical directors would draw up cover rotas, with consultants and SAS doctors stepping into resident roles. I'd want those plans reviewed centrally, so I can see where the real risk sits, usually emergency medicine, acute medicine, obstetrics, anaesthetics and paediatrics overnight.

We'd have to make difficult choices about elective work. I'd want clinical prioritisation, so urgent and cancer patients are protected wherever possible, and patients are told early and properly when operations are postponed.

If, despite everything, we couldn't staff an area safely, there's a nationally agreed route to request derogations, where some striking doctors are asked to return for specific patient safety reasons. I'd only use that with clear evidence that all other options had been exhausted, and I'd work with the local BMA representatives in good faith.

During the action itself, I'd be visible, I'd chair or attend the daily huddles, and I'd watch incident reporting closely. And I'd look after the consultants, who often work long, hard shifts doing jobs they haven't done for years.

Afterwards, I'd do two things. A proper debrief, because previous rounds have often shown that senior-led front doors make faster decisions, which is worth learning from. And some deliberate repair. Whatever the dispute nationally, resident doctors here need to know they're valued, and I'd want to hear what's behind their frustration locally, from rotas to rest facilities, and act on what we can.

 

Why this answer works

The answer sets out balanced principles, uses emergency planning structures and a realistic sequence of planning steps, and describes derogations accurately as a last resort. The emphasis on wellbeing and repairing relationships afterwards shows mature leadership.

 

Key points to include

• Respect the lawful right to strike and protect patients
• Joint planning with operations through emergency preparedness structures
• Consultant and SAS cover with central oversight of the riskiest areas
• Clinical prioritisation of elective work and honest patient communication
• Derogation only as a last resort, then debrief and repair relationships

 

Common mistakes to avoid

• Criticising or pressuring striking doctors
• Planning only within the medical directorate without operational colleagues
• Requesting derogations routinely rather than as a last resort
• Forgetting consultant fatigue and post-strike relationships

 

NHS values and standards

Working together for patients; Respect and dignity; Commitment to quality of care

 

Further reading

• NHS England emergency preparedness, resilience and response (EPRR) framework
• Current national guidance on managing industrial action in the NHS
• Trade Union and Labour Relations (Consolidation) Act 1992
• GMC guidance on industrial action and patient safety

 

 

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