Impact of doctors' strike on local NHS trust 'extremely challenging'

Resident doctors working for Royal Free London NHS Foundation Trust are planning to walkout again next week, reports Joe Ives, Local Democracy Reporter

North Middlesex University Hospital is run by Royal Free London NHS Foundation Trust

A doctors’ strike is set to hit several North London hospitals next week and plunge an NHS trust into further financial difficulty.

In a statement released today (Monday 8th), Royal Free London NHS Foundation Trust said resident doctors are due to go on strike from 7am on Monday, 15th June until 6.59am on Friday, 19th June as part of their dispute over pay.

It’s the second time the NHS trust’s resident doctors, formerly known as junior doctors, have gone on strike in recent months, with industrial action also occurring in April.

“All our hospitals will be impacted by this industrial action — Barnet Hospital, Chase Farm Hospital, North Middlesex University Hospital and the Royal Free Hospital,” the NHS trust confirmed, adding: “We are working hard to ensure we minimise disruption to services.

“Emergency care and acute services will be prioritised, and patients seeking urgent treatment will be seen.”

The trust advised patients to use non-hospital services for advice and treatment during the strikes “where appropriate”.

It could be unwelcome news to patients as well as those tasked with balancing the books at Royal Free London.

At a board meeting last Wednesday (3rd), members discussed how the April strike had put further pressure on the trust’s already stretched finances.

The NHS body ran up a £11.9million deficit in April alone, the first month of 2026/27 financial year. It had been planning an overspend of around £8.1m for the month, but said it spent a further “unplanned” £2.9m to maintain essential services during industrial action.

The organisation also estimates the strike cost a further £1.7 to £3m in “lost elective activity income”.

Speaking at last week’s board meeting, Vicky Clarke, chief financial officer at Royal Free London, said: “We control industrial action costs very tightly, but as a really big group with three busy emergency departments, we’re heavily impacted, because we can’t close those A&Es during a period of industrial action and need to procure additional support during that time.”

Clarke added that the trust will have to “absorb” these costs and described the situation as “extremely challenging”.

The NHS trust’s financial chief said “cash is the real concern”, explaining that the organisation does not have “the cash headroom” to absorb “external, unplanned shocks” like industrial action.

It is “really important,” Clarke told the board, that the trust recovers this money and looks at what it can do to “stabilise our cash position”.

If it can’t, she said the trust will have to look at entering the national cash regime, something “which we know is very onerous and very limited in terms of the support that you’re able to get”.

She said the trust would be looking at using its “cash committee” as well as “an action plan for cash management” to get “a tighter control” over its debts.

Nevertheless, she admitted that some of these measures “would not be without impact” meaning the trust could potentially be unable to “top up” other areas of the budget, like building improvements, if they were to go over budget.

“It really does change the dynamic of how we’re working currently,” Clarke concluded.

Speaking at last Wednesday’s meeting, Royal Free London chair Mark Lam urged the trust’s executive teams to “stay very focused” and pointed out that some were delivering on their financial targets “a lot better than other parts of the group”.

“We need everybody up to the same level,” he added.

North Middlesex University Hospital NHS Trust was merged into the Royal Free London NHS Trust in January 2025 in a bid to improve services and reduce costs.

The enlarged trust now runs four major hospitals, including three accident and emergency (A&E) departments, across the North London boroughs of Enfield, Barnet and Camden, with North Mid also serving large parts of Haringey.

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