Doctors at several major North London hospitals are set to go on strike next week, adding further financial pressure to the Royal Free London NHS Foundation Trust. Resident doctors—formerly known as junior doctors—at Barnet Hospital, Chase Farm Hospital, North Middlesex University Hospital, and the Royal Free Hospital will walk out from 7am on Monday, June 15, until 6.59am on Friday, June 19.
Second Strike in Months
This industrial action follows a similar strike in April, making it the second such event in recent months. The NHS trust confirmed that all its hospitals will be affected, stating: "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." Patients have been advised to use non-hospital services for advice and treatment where appropriate during the strike period.
Financial Impact Already Felt
The strike comes at a challenging time for the trust, which reported an £11.9 million deficit in April—the first month of the 2026/27 financial year. The trust had planned an overspend of around £8.1 million but spent an additional unplanned £2.9 million to maintain essential services during the April industrial action. Furthermore, the strike is estimated to have caused a loss of £1.7 million to £3 million in "lost elective activity income."
Speaking at a board meeting last Wednesday, 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." She added that the trust will have to "absorb" these costs, describing the situation as "extremely challenging."
Cash Concerns
Clarke highlighted that "cash is the real concern," noting that the organisation lacks the "cash headroom" to absorb external, unplanned shocks like industrial action. She stressed the importance of recovering this money and stabilising the trust's cash position. If unable to do so, the trust may have to enter the national cash regime, which she described as "very onerous and very limited in terms of the support that you're able to get."
The trust plans to use its cash committee and implement an action plan for cash management to gain tighter control over its debts. However, Clarke admitted that some measures "would not be without impact," potentially preventing the trust from topping up other budget areas, such as building improvements, if they exceed their budgets. "It really does change the dynamic of how we're working currently," she concluded.
Call for Consistency
Royal Free London chair Mark Lam urged the trust's executive teams to "stay very focused," noting that some areas were performing better than others on financial targets. "We need everybody up to the same level," he added.
Background
North Middlesex University Hospital NHS Trust was merged into the Royal Free London NHS Trust in January 2025 to improve services and reduce costs. The enlarged trust now operates four major hospitals, including three accident and emergency departments, across the North London boroughs of Enfield, Barnet, and Camden, with North Mid also serving large parts of Haringey.
