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

Doctors’ Strikes Yield Unexpected Advantages, Yet Sustainability Remains in Question

When the latest round of doctors’ strikes concluded in December, NHS trust leaders began to reflect on the unexpected outcomes. One hospital administrator, recalling the impact of a previous walkout by resident doctors, remarked: “We sighed with relief—strikes act like a firebreak.” This sentiment echoed among several leaders, who noted that the system appeared to operate more efficiently during the strike, with some reporting smoother operations than usual.

The December strike, led by members of the British Medical Association (BMA), saw around 25,000 doctors absent from work each day. Despite ministers labeling the action as “irresponsible and dangerous,” the results within at least one hospital suggested otherwise. A trust chief executive explained: “Lower bed occupancy before Christmas was a gift.” This reduction in patient numbers, they argued, allowed for quicker decision-making and improved flow through emergency departments.

At King’s College Hospital, a study revealed that during the 2023 junior doctor strikes, patients were processed faster—seen, treated, and discharged—despite fewer staff on duty. Researchers found no increase in mortality rates or readmissions. Similar patterns emerged at the Royal Berkshire Hospital, where the four-hour A&E target was met in 82% of cases during the walkout, compared to 73% the prior week. These improvements, however, relied on temporary fixes that may come with hidden costs.

“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,” said Dr Layla McCay, director of policy at the NHS Alliance. Yet she warned this was a short-term solution with potential consequences.

Dr Damian Roland of the University of Leicester highlighted how the shift in staffing during strikes streamlined patient pathways. “The more doctors involved in a patient journey, the longer everything takes,” he explained. However, he stressed that training resident doctors is vital for building the consultant workforce of the future.

Dr Jack Fletcher of the BMA pointed to a growing concern: as senior doctors retire, there may be no qualified replacements if trainee doctors continue to leave due to low pay, poor conditions, and limited job opportunities. This has led to a dilemma—strikes provide immediate relief, but they risk exacerbating long-term staffing shortages.

Some hospitals have adopted new strategies inspired by the strike experience. At one trust, cardiology consultants now station themselves at the emergency department every Friday. “Junior doctors are more cautious,” said Nick Hulme, former chief executive of 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.”

While the Christmas strike accelerated patient discharges, the long-term viability of such measures remains uncertain. Leaders acknowledge that the efficiency gains were partly due to reduced demand, but they caution that this model cannot be sustained indefinitely without addressing the underlying issues in the workforce.