News Junior doctor strikes in England had ‘significant impact’ on patient care by Kate Wighton -- 20 February 2018 The 2016 junior doctors strikes in England had a ‘significant’ impact on the provision of healthcare, with thousands of appointments cancelled. -- Health at Imperial, said: “Our research showed that the junior doctors’ industrial action had a significant impact on care. As a result of the strike there were over 100,000 outpatient appointment cancellations and more than 25,000 fewer planned admissions than expected.” The research, published in the journal BMJ Open, showed there was no obvious change in the death rate during any of the strikes. In the first four months of 2016, junior doctors from all specialties across England went on strike in protest against contractual changes brought in by the government. Before these strikes there had been only one other strike in the previous 40 years, in 2012. Each of the four strikes lasted 24–48 hours: 12 January; 10 February; 9-10 March; and 26-27 April. This last was the only strike that included withdrawal of emergency care. -- The researchers, who were funded by the National Institute for Health Research, therefore compared hospital activity the week of each of the strikes with that from the preceding and following weeks. They focused on numbers of admissions, outpatient appointments, and A&E attendances. -- million outpatient appointments, and 3.4 million A&E attendances. Compared with the weeks preceding and following the strikes, there were over 9% (31,651) fewer admissions, nearly 7% (23,895) fewer A&E attendances, and 6% (173,462) fewer outpatient appointments than expected. April’s strike had the largest impact on services: there were over 15% (18,194) fewer admissions, including nearly 8% (3383) fewer emergency admissions, and almost 20% fewer planned admissions. Hospitals scheduled 11% (109,915) fewer outpatient appointments during this strike, while patients kept 134,711 (just over 17%) fewer of them. The number of outpatient appointments cancelled by hospitals also rose by almost 67% (43,823). During all four strikes, hospitals cancelled nearly 300,000 outpatient appointments – 52% higher than the volume expected for this period – possibly to protect more critical services, suggest the researchers. -- The number of recorded deaths didn’t change significantly during the strikes and wasn’t higher than expected, due to relatively small numbers. But hospital mortality is likely to be the least sensitive outcome for quality and safety concerns in this context, the -- Foster Unit at Imperial. They accept that they didn’t assess the impact of the strikes on patients who didn’t attend A&E, or the potential impact on the so-called ‘weekend effect,’ or how patients felt about their delayed