Rising fears of highly disruptive industrial action by NHS workers this autumn are revealed in documents seen by HSJ.

The concerns coincide with growing union anger at public sector job cuts, pay freezes and attempts to reform public sector pensions.

A Department of Health email to strategic health authorities on 21 June said public bodies’ responses to a coordinated strike that month were being used by unions as a “litmus test for action in the autumn”.

The DH urged SHAs to review contingency plans for industrial action and requested details of union membership and likely “pressure points”.

Since March, SHAs have also been asked to submit monthly reports to the DH on the readiness of organisations in their region for industrial action and on any risks identified, the correspondence shows. These have been discussed in DH deputy chief executive David Flory’s monthly meetings with SHA finance directors, in addition to a “cross government meeting” on 18 July.

Workforce leads have discussed a range of concerns internally.

NHS London committee meeting minutes for 26 April acknowledge “government concern” was increasing.

They also warn: “There is a risk that only a small number of organisations have a contingency plan. There seems to be a lack of urgency at local level around industrial action.”

The difficulty of persuading staff to cover for striking colleagues was discussed in a 15 July meeting at NHS London. In correspondence between NHS South West and local trusts in June, one organisation said that in the event of an NHS strike a “significant number of employees” would stay away from work and some “who are employed in non-clinical areas will need to be redeployed into frontline services”.

Volunteers, retired clinical staff and final year students would also be called on.

However, guidance from NHS Employers, drawn up with solicitors Beachcroft and released last Friday, warns trusts that before asking staff to cover striking colleagues, “the potential long term consequences for staff relations should be considered carefully”.

As HSJ went to press, unions attending the annual Trades Union Congress were set to call for industrial action against pension reforms. HSJ understands any action would probably happen in November.