Intended for healthcare professionals

Opinion Primary Colour

Helen Salisbury: Bank holiday blues

BMJ 2022; 378 doi: (Published 20 September 2022) Cite this as: BMJ 2022;378:o2262
  1. Helen Salisbury, GP
  1. Oxford
  1. helen.salisbury{at}
    Follow Helen on Twitter: @HelenRSalisbury

Bank holidays are always a bit of a headache in general practice. The demand from patients doesn’t go down but is, instead, squeezed into fewer days of the week. Most bank holidays fall on a Monday, and each organisation will have devised its own rules to try to ensure fairness—otherwise, someone who doesn’t normally work on that day will miss their extra holiday and feel hard done by.

GPs are used to organising our way around expected holidays, but having one sprung on us at a week’s notice is a new challenge that has caused much grief to the GP community. There doesn’t seem to have been any national plan, and it was left to each practice to decide individually whether or not to open. We were probably in a lose-lose situation: if we closed we would have been portrayed (again) as lazy; if we remained open we would have been accused of lacking respect.

Some practices book all their appointments on the day they take place, so although they would now face a lot of extra demand on Tuesday, they had no need to cancel booked patients. Emergencies were diverted to the out-of-hours service (which also had to find staff for an extra day at short notice). Other practices mostly work with pre-booked appointments, and they therefore had a harder choice to make. For some there was no option: although we were advised that there was no statutory entitlement to time off and that it was “a matter for discussion between individuals and their employer,” this is not much help when a large number of your doctors, nurses, and reception staff have young children and the schools are suddenly closed.

In our practice, we opted to close to on-the-day emergencies but to keep our booked appointments, as this was what the doctors and nurse concerned were happy to do. Some patients have already waited as long as two weeks to see their GP, and it seemed unfair to cancel and rebook. We were surprised that only one patient chose to postpone.

Will patients be harmed by this bank holiday? It seems inevitable that some will go longer without the treatment they need, and some will have a delay in the diagnosis of a serious condition. In hospitals, operation lists and clinics have been cancelled, adding to the huge backlog of work for the NHS. At a time when we have 6.8 million people in the UK waiting for treatment, perhaps whoever made this decision believed that losing another day’s worth of work wouldn’t really make a difference. But the patients whose appointments have been cancelled may feel otherwise.