Doctors’ strikes can have surprising benefits – but are they sustainable?
Doctors’ strikes can have surprising benefits – but are they sustainable?
In December, a walkout by resident doctors in England sparked a sense of relief among hospital administrators. One senior executive described the strikes as a “firebreak” for the system, highlighting how they can temporarily alleviate pressures. Now that the latest strike has concluded, NHS trust leaders who spoke to BBC News are reevaluating its impact, noting that the healthcare system seemed to operate more efficiently than usual. Some reported that non-strike days often felt more chaotic, while the strike period brought about quicker patient decisions and reduced waiting times.
The five-day industrial action, organized by the British Medical Association (BMA), coincided with the pre-Christmas slowdown, a period when hospitals typically aim to discharge patients promptly. Despite initial criticism from ministers, who called the strike “irresponsible and dangerous,” the results within at least one hospital contradicted these claims. The trust chief executive noted that the reduced number of junior doctors allowed consultants to take on more direct roles, leading to faster admissions and improved patient flow.
“With consultants on the front door, decisions are made fast and admissions fall. Lower bed occupancy before Christmas was a gift,”
the executive told BBC News. This shift in staffing, according to the trust, enabled more efficient handling of emergency cases, as consultants could swiftly determine whether patients required urgent care or could be redirected to community services. At King’s College Hospital, a study revealed that strike days saw patients processed more quickly, with no increase in deaths or re-admissions, even as fewer staff were on duty.
Dr Layla McCay, representing NHS trusts through the NHS Alliance, acknowledged the benefits of this approach. “Anecdotally, we’ve noticed that consultants’ presence in A&E leads to quicker, more confident decision-making, which benefits patients,” she said. However, she warned that such solutions are short-lived and could have broader consequences. “This is a temporary fix with lasting effects,”
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McCay added, emphasizing the need for long-term strategies to sustain the system.
Dr Damian Roland of the University of Leicester explained that the complexity of patient pathways often slows down care. “The more doctors involved in a patient’s journey, the longer everything takes,”
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he noted. Junior doctors, still in training, frequently order additional tests and seek multiple approvals, whereas consultants tend to act more decisively. This dynamic became evident during the strike, when decision-making was streamlined, leading to faster discharges and improved efficiency.
While the strike helped hospitals meet their targets ahead of the holiday season, it also exposed challenges in training the next generation of doctors. BMA’s Dr Jack Fletcher pointed out that the current workforce is aging, and without adequate pay and job stability, trainees may leave the profession, leaving a gap in the consultant ranks. “When today’s consultants retire, we’ll have no one to replace them,”
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Fletcher warned, underscoring the importance of addressing these systemic issues.
Some trusts are now experimenting with new models to replicate the strike’s efficiency on regular days. At East Suffolk and North Essex NHS Foundation Trust, cardiology consultants are stationed at the entrance every Friday, following insights from the previous strike. “Junior doctors are more cautious, so we realized placing experts at the front door could cut weekend admissions,”
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Nick Hulme, the trust’s former chief executive, explained. This approach reflects a growing awareness that strikes, while beneficial in the short term, may offer lessons for improving routine operations.
