Doctors’ strikes can have surprising benefits – but are they sustainable?
Doctors’ Strikes Can Have Surprising Benefits – But Are They Sustainable?
During the December 2023 walkout by British Medical Association (BMA) members in England, one hospital leader described the impact as a “catalyst for efficiency.” This sentiment echoes the experience of NHS trusts, which reported smoother operations and faster patient throughput during the strike. Despite initial fears of disruption, the absence of resident doctors led to unexpected improvements, including reduced wait times and quicker decision-making.
Efficiency During Strikes
According to NHS England, approximately 25,000 doctors were absent daily during the five-day strike, which coincided with the Christmas holiday period. However, the effect on the system was positive for some institutions. At King’s College Hospital, researchers observed that patients were processed more rapidly on strike days, with no increase in adverse outcomes like deaths or re-admissions. Similar patterns emerged at the Royal Berkshire Hospital, where the A&E target of four-hour waits was achieved in 82% of cases during the walkout, compared to 73% the prior week.
“With consultants on the front door, decisions are made fast and admissions fall. Lower bed occupancy before Christmas was a gift,” said a trust chief executive, highlighting the role of senior doctors in streamlining care.
The efficiency gains were attributed to consultants stepping into frontline roles, allowing for more direct patient assessments. Dr. Damian Roland of the University of Leicester explained that fewer layers of approval during strikes reduced delays in the patient journey. “The more doctors involved in a patient pathway, the longer everything takes,” he noted, emphasizing the impact of streamlined staffing.
Challenges of Sustaining Gains
While the results were promising, experts warn that these improvements are temporary. Dr. Layla McCay, director of policy at the NHS Alliance, stated that the increased presence of consultants during strikes led to quicker, less risk-averse decisions. However, she pointed out that such measures are costly and rely on improvised solutions. “This is a temporary, unsustainable fix with knock-on effects,” she added.
Training resident doctors remains critical for building the future consultant workforce. Dr. Jack Fletcher of the BMA highlighted that the retirement of current consultants could leave a gap if trainees continue to leave due to low pay, poor conditions, and limited job opportunities. “When today’s consultants retire, we have no one to replace them,” he said, underscoring the long-term need for proper staffing strategies.
Some hospitals have since adapted by implementing new protocols on non-strike days. For instance, one trust now places cardiology consultants at the entrance every Friday, inspired by the efficiency observed during the strike. “Junior doctors are more cautious, and cardiologists rarely admit someone with chest pain,” explained Nick Hulme, former chief executive at East Suffolk and North Essex NHS Foundation Trust. “After seeing the impact of the strikes, we realized this was a smart way to reduce weekend admissions.”
Patients also noticed the difference. One individual described their strike-day visit as a “blessing,” while a mother recounted how her son received the fastest asthma treatment during the walkout. These testimonials, combined with performance data, suggest that strikes can temporarily enhance the patient experience. Yet, the sustainability of these gains hinges on addressing the root causes of staff shortages and ensuring a balanced approach to staffing and training.
