This site is intended for health professionals only

Junior doctors’ strike had ‘significant impact’ on patient care, finds study

Junior doctor strike

The junior doctors’ strike in 2016 had ‘significant negative impacts’ on patient care, a report into the protests over contract changes has concluded.

Thousands of appointments were cancelled over the four periods of industrial action, with significantly fewer hospital attendances and A&E admissions, according to the research published in BMJ Open.

The effects were the most significant during the unprecedented walkout of emergency care over 48 hours in April 2016.

Researchers, led by Daniel Furnivall from the department of primary care and public health at Imperial College, examined Hospital Episode Statistics (HES). They said the action provided an opportunity to look at the effectiveness of current systems and weaknesses in responding to staff shortages.

During the strike periods admissions dropped by 9.1% (or 31,651), the number of patients arriving at A&E fell by 6.8% (or 23,865) and the number of outpatient appointments fell by 6% (or 173,462).

The impact was most pronounced during the April walkout which saw a 15.4% (18,194) drop in all admissions, with a 7.8% (3,383) drop in emergency admissions and a 19.9% (14,811) drop in planned admissions.

There was an average reduction of 7.09% in A&E volume across all strike days.

A&Es in Yorkshire and the Humber saw the largest drop of 8.05%, followed by the North East, with a reduction of 7.8%.

The impact was more limited in the East of England, which saw a drop of 5.93% and the North West, with a drop of 6.24%.

More appointments were cancelled in London, the South East coast and Yorkshire and the Humber.

Overall providers cancelled 294,844 appointments – 52% more than expected.

The south central region had a much smaller increase in cancellations than elsewhere, the research found.

More operations were affected during the first strike day on January 12 and the last days of action on April 26-27 – when junior doctors in A&E also went on strike.

There was a 9% drop in A&E attendances on January 12, even though casualty was not affected by the strike that day.

Researchers said ‘many patients may have consciously avoided going to hospital during this period’, perhaps because of intensive media coverage and requests from providers to avoid unnecessary visits.

Hospital mortality was not higher than expected. During strike days 3,209 patients died in hospital during emergency admissions.

However deaths caused by poor care are not likely to show up immediately and it was not clear if patient health might have worsened because of delayed appointments and procedures.

This pattern was similar in findings analysing previous strikes and could be because ‘staffing priority is given to critical care’ during industrial action.

A BMA spokesperson said: ‘The decision to take industrial action was based on genuine concerns from junior doctors about the impact of proposed changes on patient care.

‘In recent weeks we’ve seen large numbers of patients being affected by the cancellation of operations because the health service is unable to cope with demand. This highlights the scale of the pressure the NHS is operating under, which was a key concern of junior doctors during the dispute.’