Health Ministry sets minimum services at 100% in emergency departments ahead of medical strike

The Regional Ministry of Health of Castilla-La Mancha has established the minimum healthcare services to be provided by the Castilla-La Mancha Health Service (Sescam) during the medical staff strike called starting November 16, 2026. The decision is detailed in the Resolution of 09/11/2026, published in the Official Gazette of Castilla-La Mancha no. 218, of November 13, 2026 (reference 2026/8113), and establishes percentages of 100% of staff in the most critical care units. The text comes after the High Court of Justice of Castilla-La Mancha endorsed very similar minimums set a year ago for another strike by the same group.

The resolution consolidates three calls with the same subjective and territorial scope but different timeframes into a single document: that of the Medical Union of Castilla-La Mancha (CESM-CLM), of regional scope, and the two from the United Doctors Union (SMU), of national and regional scope. The Regional Government justifies the joint treatment on the grounds that a separate approach would “denature the global vision of the impact” and prevent the weighing of the proportionality of the minimums. The personnel scope covers all medical staff of Sescam, including residents in training and regardless of the type of contract.

The legal framework invoked is Article 28.2 of the Spanish Constitution, Article 10 of Royal Decree-Law 17/1977, of March 4, on labor relations, and Article 6.2 of Decree 78/2010, of June 1, which grants the head of the Regional Ministry of Health the authority to determine these services. The general criterion applied is that of staffing for a public holiday, reinforced for non-deferrable services and nuanced by the professional nature of the group and the cumulative duration of the strikes.

Two overlapping strike calendars

• CESM-CLM: indefinite strike from November 16, 2026, every Monday, Wednesday, and Friday, from 00:00 to 23:59 hours.
• SMU: indefinite strike from 08:00 hours on November 16 until 08:00 hours on November 28, 2026, a thirteen-day uninterrupted interval with the possibility of renewal upon express notification.

The resolution specifies that the right may be exercised during the entire shift by those who start before the beginning of the strike but carry it out within the interval, and also by those who start their shift within that period even if it ends afterward. The Regional Minister of Health, Jesús Fernández Sanz, signed the text in Toledo on November 9, 2026.

One hundred percent in emergencies, dialysis, and oncology

The annex reserves 100% of the usual staff for services whose interruption directly affects the clinical evolution of patients:

• Emergency and critical care units, with 100% of the usual staff.
• Dialysis, with scheduled and urgent activity at 100%.
• Oncohematological Day Hospital, with scheduled and urgent activity at 100%.
• Radiation Oncology, with 100% continuity of ongoing treatments.
• Assisted reproduction and fertility units, with 100% continuity of tests and treatments.
• Health response service (CCU) and the Castilla-La Mancha regional transplant coordination unit, both at 100%.
• Urgent care in each Basic Zone and scheduled on-call shifts at each PAC, with 100% of the staff planned for a public holiday.
• Hospital pharmacy, with two-thirds (66.6%) of the staff who ordinarily provide the activity.

Primary care at 33% and hospital care at 40%

For the remaining primary care centers and services, 33% of the staff of a non-holiday day is guaranteed, while in the hospital and specialized care sector, the percentage increases to 40%. In both cases, rounding up to the nearest whole number is permitted when the fraction is equal to or greater than five tenths, with a minimum of one staff member, and the same number of on-call staff as exists ordinarily is maintained.

The Department argues that the autumn season, with the start of the peak season for acute respiratory infections, increases the scenario of impact compared to the previous strike. It also emphasizes that the minimums set in the Resolution of 11/26/2025 (DOCM 235, of December 4, 2025) were considered lawful and proportionate by Judgment 431/2026, of November 4, 2026, of the Contentious-Administrative Chamber, 2nd Section, of the TSJCM, which cited favorable resolutions in La Rioja and Cantabria with higher percentages.

Effects and means of appeal

The resolution takes effect on the day of its publication in the DOCM, and the designation of the staff who will cover the minimums corresponds to the heads of the various managing bodies. Against the text, which ends the administrative route, an optional appeal for reversal may be filed within one month before the Regional Minister of Health, or a contentious-administrative appeal within two months before the TSJCM.

The regulation affects all patients and professionals in the region during a period in which three calls for action coincide and up to thirteen consecutive days of strike in the case of SMU. Citizens should be aware that urgent care, oncological treatments, dialysis, and fertility cycles are protected at 100%, while ordinary activity and scheduled consultations will suffer delays during the strike days.

Source: Official Gazette of Castilla-La Mancha, no. 218, of November 13, 2026, section I (General Provisions), page 40021 (official reference: 2026/8113).