Leading Through Strikes When You Care About Both Staff and Patients

A patient wants to know why their appointment has been postponed. A colleague wants reassurance that their concerns about pay and working conditions are being heard. Another member of the team is worried about how the service will manage. As a leader, you may understand each person’s frustration while having limited power to resolve the dispute bringing them into your office.

Industrial action can place healthcare leaders in an emotionally difficult position. They are responsible for helping services prepare, maintaining clear communication and supporting people through disruption. They may also work closely with colleagues taking action and care deeply about the patients whose treatment could be affected.

Consultant doctors in England have announced strike action for 25 and 26 November, according to NHS Employers’ announcement on 26 October. The Daily Round has covered the development in NHS Consultants Announce 48-Hour Walkout as Pay Dispute Escalates. Alongside the operational preparations, leaders need to consider how they will manage the conversations, relationships and personal pressure surrounding those dates.

You can understand more than one perspective

Healthcare leaders do not have to experience a dispute in simple terms. They may understand why colleagues feel strongly enough to take industrial action and also feel concerned about patients facing further uncertainty. They may be frustrated by the circumstances while remaining committed to helping their teams work through them.

Holding those concerns together can feel uncomfortable, particularly when others expect a clear declaration of which side you are on. Yet leadership often involves recognising several legitimate needs at once. Acknowledging a patient’s distress does not require dismissing a colleague’s concerns. Listening respectfully to staff does not prevent a leader from taking disruption to care seriously.

Conversations become more difficult when people feel their experience is being used to silence someone else. Leaders can help by keeping discussion specific, listening carefully and avoiding assumptions about another person’s motives. Colleagues may disagree strongly and still need to work together with trust and professionalism.

Patients need clear information and room to be upset

For a patient, a postponed appointment can mean more than a change in the diary. They may have arranged transport, taken time off work or spent weeks preparing themselves for a difficult conversation. A delay can bring uncertainty about their health as well as practical inconvenience.

The person answering their questions may have had no involvement in the decision, but they are the person available. Recognising that can help a leader respond with empathy without taking personal responsibility for the entire situation.

Start with what is known. Explain the position using the organisation’s agreed information, acknowledge the effect on the patient and set out the next step. Where details are still being confirmed, say so clearly. Reassurance should stay within what the service can reliably promise.

A response such as, “I understand you arranged time off for this and that the uncertainty is upsetting. I can explain what we know and who can help with your next appointment,” recognises the person’s experience while keeping the conversation focused on useful action.

Patients should also know where to raise concerns about their care or seek advice if their circumstances change. Staff need accurate, accessible information about those routes so they can respond consistently.

Empathy does not require accepting abuse

There is a difference between someone expressing distress and someone threatening or abusing a member of staff. Leaders should make sure teams understand the organisation’s procedures for handling abusive behaviour, getting support and reporting incidents.

This matters particularly for reception, administrative and patient-facing teams who may receive repeated complaints throughout the day. Giving them a briefing about service changes is only part of the preparation. They also need to know when a conversation should be passed to a senior colleague and what to do if they feel unsafe.

Leaders should avoid leaving the most confident or accommodating employee to absorb every difficult interaction. Sharing responsibilities, providing appropriate breaks and checking in after a distressing exchange can help make support visible.

A patient’s concern may be valid even when the way it is expressed is unacceptable. It is possible to take the concern seriously while setting a clear boundary around behaviour.

Protect working relationships during disagreement

Industrial action can expose differences within teams. Some colleagues may be taking part, others may be working, and people may hold different views about the dispute. Leaders should be careful about allowing those differences to become judgements about commitment, compassion or professional worth.

Avoid inviting people to defend their position in informal team discussions. Keep operational conversations focused on the arrangements staff need to understand, and seek appropriate workforce or HR advice where questions concern industrial action procedures.

The language used by leaders matters. Frustrated remarks made during a busy meeting can linger long after the immediate pressure has passed. Describing colleagues in ways that question their character can damage relationships that the service will continue to depend on.

Respectful communication leaves room for disagreement while maintaining expectations about how people treat one another. That becomes especially important when teams return to their usual working arrangements.

Notice what you are carrying yourself

A leader may finish the day remembering the angriest complaint, the conversation that went badly or the question they could not answer. After several days of preparation and difficult discussions, it can become hard to recognise where their own responsibility ends.

A useful review asks what required action, what has been handed over and what needs escalation. It should also recognise what was handled well. If a patient received clear information, a distressed colleague was supported or a concern reached the right person, that work has value even when the wider dispute remains unresolved.

Leaders need somewhere appropriate to discuss their own experience too. A conversation with a line manager, trusted peer or professional support service can provide space to reflect while respecting confidentiality. Asking for help with a particularly difficult interaction is a reasonable part of managing the work.

Providers and senior teams should consider how support reaches those coordinating the response. Repeatedly relying on the same people to remain available, calm and responsive can leave their needs overlooked.

Make time to review the human impact

Once the immediate disruption has passed, teams will need to review practical arrangements and outstanding work. That discussion should also include how people experienced the period.

Were staff given information early enough? Did they know where to direct difficult questions? Were particular teams left handling more distress than expected? Did managers have sufficient support and cover? Answers to those questions can improve preparations for any future disruption.

There should also be space to repair strained relationships. Where conversations became personal or someone felt unsupported, allowing the issue to sit unaddressed may make everyday teamwork harder.

Leading through industrial action involves decisions and emotions that cannot all be resolved by one person. Clear information, respectful relationships and shared responsibility give leaders something practical to work with. They can care about colleagues and patients while also asking for the support they need to guide a service through a difficult period.