Doctors’ strikes can have surprising benefits – but are they sustainable?

Doctors’ strikes can have surprising benefits – but are they sustainable?

When the latest wave of walkouts by resident doctors in England concluded, some NHS leaders recalled how the strikes had inadvertently improved hospital efficiency. “Strikes act like a firebreak,” said a hospital chief executive, reflecting on the December 2023 action. Despite initial concerns about disruptions, the system reportedly ran more smoothly during the strike period, with reports of quicker decision-making and shorter patient wait times.

Following the five-day strike by British Medical Association (BMA) members, NHS England noted that over 25,000 doctors were absent daily. However, the impact on hospital operations was unexpected. At King’s College Hospital, a study revealed that patients were processed faster during the strike, even with reduced staffing. No increase in mortality or readmissions was observed, suggesting the temporary shift had positive outcomes.

Other hospitals echoed similar findings. At Royal Berkshire Hospital, the four-hour A&E target was met in 82% of cases during the strike, compared to 73% the prior week. Dr. Layla McCay of the NHS Alliance highlighted that consultants’ increased presence in emergency departments allowed for more decisive, confident care. “The enhanced experience of senior doctors leads to faster, less risk-averse decisions,” she stated, but cautioned that this solution is not long-term.

Dr. Damian Roland from the University of Leicester explained that junior doctors often take more time with patients, delaying their journey through the system. “Each extra layer of assessment slows down progress,” he noted. Yet, training resident doctors remains vital for building the consultant workforce of the future. “When current consultants retire, we’ll have no replacements if trainees leave due to low pay and job shortages,” warned Dr. Jack Fletcher of the BMA.

Some trusts are experimenting with new strategies to replicate strike benefits on regular days. For instance, cardiology consultants now stand at the front door every Friday at one hospital, inspired by the strike’s success. “Junior doctors are more cautious, so having experts on-site reduces unnecessary admissions,” said Nick Hulme, former chief executive of East Suffolk and North Essex NHS Foundation Trust. These adjustments aim to maintain efficiency without full strikes.

“Lower bed occupancy before Christmas was a gift,” said Roland, emphasizing how the strike accelerated patient discharges. “Flow improves, and that enhances the overall experience.” Patients also noticed the change. One woman called her strike-day visit “a blessing,” while a mother praised the swift care her son received, attributing it to an experienced consultant taking charge.