Doctors’ strikes can have surprising benefits – but are they sustainable?
Doctors’ Strikes Can Have Surprising Benefits – But Are They Sustainable?
After a recent doctors’ strike concluded, NHS trust leaders shared insights with BBC News, noting that the system had operated more smoothly during the walkout. One hospital administrator described the strike as a “firebreak,” a term that emerged as they observed reduced patient waiting times, quicker decision-making, and a more tranquil environment. However, they also highlighted that these benefits stemmed from improvised solutions, which could come with significant financial implications.
During the December 2023 strike, over 25,000 doctors were absent each day, according to NHS England. The five-day walkout, organized by British Medical Association (BMA) members, was criticized by ministers as “irresponsible and dangerous.” Yet, within at least one hospital, the impact was notably positive. The trust’s chief executive remarked that the strikes coincided with a decline in flu cases, creating an opportunity for improved efficiency. “Lower bed occupancy before Christmas was a gift,” they told the BBC, emphasizing that consultants taking on front-line roles in A&E allowed for faster patient assessments and smoother admissions.
Researchers at King’s College Hospital analyzed the first junior doctor strikes in 2023 and found that patients were processed more quickly on strike days, despite reduced staff. The study revealed no increase in deaths or readmissions. Similar results were reported at Royal Berkshire Hospital, where the A&E four-hour target was met in 82% of cases during the strike, compared to 73% the prior week. Dr. Layla McCay of the NHS Alliance, representing trusts, acknowledged the temporary nature of these gains. “While the presence of consultants in A&E led to quicker decisions, this approach is not a long-term fix,” she said, warning of potential consequences for the future workforce.
Dr. Damian Roland from the University of Leicester explained that the extended decision-making process during non-strike days often involves multiple layers of senior input, slowing patient flow. “Every additional step in the pathway delays care,” he noted. This is particularly true for early-career doctors, who may order more tests and seek broader approvals. In contrast, consultants on strike days streamlined procedures, leading to faster discharge rates. For instance, a mother recounted how her son received swift asthma treatment during the strike, attributing it to an experienced consultant. “It was the quickest he’d ever had,” she said.
Some hospitals are now testing new strategies on non-strike days, inspired by the strike’s outcomes. At one trust, cardiology consultants are stationed at the front door every Friday, reducing weekend admissions. Nick Hulme, former chief executive of East Suffolk and North Essex NHS Foundation Trust, explained the rationale: “Junior doctors tend to be more cautious when dealing with chest pain, so having consultants available helps cut unnecessary delays.” These adjustments aim to replicate the strike’s efficiency without relying on full-scale action.
While the immediate effects of the strike appear beneficial, the long-term sustainability of such measures remains uncertain. Dr. Jack Fletcher of the BMA warned that the current generation of trainee doctors is leaving due to low pay and poor working conditions. “When today’s consultants retire, we’ll have no replacements unless this trend reverses,” he said. The challenge lies in balancing immediate operational needs with the essential role of training resident doctors to build the future consultant workforce.