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

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

Last December, a hospital manager described the relief felt when a group of resident doctors in England walked out, calling strikes “a firebreak.” Now, after the recent strike concluded, NHS trust leaders who spoke to BBC News noted that the system operated more efficiently, with some claiming it ran smoother than usual. Previous walkouts, they suggested, did not lead to the anticipated disruptions, instead resulting in shorter wait times, quicker decisions, and a calmer environment.

The December strike, which lasted five days, involved around 25,000 doctors absent from work. It was criticized by ministers as “irresponsible and dangerous,” but at least one hospital saw a different outcome. The trust’s chief executive remarked that the strike coincided with a decline in flu cases, which helped improve operations. “With consultants at the front door, decisions are made swiftly, and admissions decrease,” they explained. “Lower bed occupancy before Christmas was a gift.” This allowed for faster patient flow, a term used in healthcare to describe the timely movement of individuals through the hospital system.

A study at King’s College Hospital revealed that during the 2023 junior doctor strikes, patients were seen, treated, and discharged more quickly, even with fewer staff. Researchers found no increase in deaths or re-admissions. Similar trends were observed elsewhere, such as the Royal Berkshire Hospital, where 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 while the presence of consultants in emergency departments improved decision-making, this was a short-term fix with potential long-term consequences.

“The enhanced presence of consultant colleagues in A&E, with their additional experience, can mean quicker, less risk-averse decision-making, which is good for patients,” McCay said. “But this is a temporary, unsustainable solution with knock-on effects.”

Dr. Damian Roland of the University of Leicester noted that having more doctors involved in a patient’s journey slows down the process. “The more doctors involved, the longer everything takes,” he observed. However, he acknowledged the necessity of training resident doctors to ensure a steady supply of consultants for the future. Dr. Jack Fletcher of the BMA warned that the retirement of current consultants would leave a void if trainee doctors continue to leave due to low pay, poor conditions, and a lack of job opportunities.

Some hospitals are experimenting with new strategies on non-strike days. At one trust, cardiologists are stationed at the emergency department entrance every Friday, inspired by the impact of the strike. Nick Hulme, a former chief executive, explained that “junior doctors are more cautious” when handling cases like chest pain. “After seeing the strike’s effects, we realized this was a smart way to reduce weekend admissions,” he said.

Patients also noticed the difference. One woman called her strike-day visit “a blessing,” while a mother credited an experienced consultant with providing her son, who often required asthma treatment, the quickest care he had ever received. NHS England reported that thousands of patients were safely discharged home ahead of Christmas, despite the strike action.