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Retrospective analysis of the national impact of industrial action by English junior doctors in 2016.

ABSTRACT: OBJECTIVES:To examine the impacts of the four episodes of industrial action by English junior doctors in early 2016. DESIGN:Descriptive retrospective study of admitted patient care, accident and emergency (A&E) and outpatient activity in English hospitals. SETTING:All hospitals across England. PARTICIPANTS:All patients who attended A&E or outpatient appointments or those who were admitted to hospital during the 3-week period surrounding each of the four strikes (12 January, 10 February, 9-10 March and 26-27 April, excluding weekends). MAIN OUTCOME MEASURES:Raw numbers and percentage changes of outpatient appointments and cancellations, A&E visits, admitted patients and all inhospital mortality on strike days compared with patient activity on the same weekday in the weeks before and after the strikes. RESULTS:There were 3.4?million admissions, 27?million outpatient appointments and 3.4?million A&E attendances over the four 3-week periods analysed. Across the four strikes, there were 31?651 fewer admissions (-9.1%), 23?895 fewer A&E attendances (-6.8%) and 173?462 fewer outpatient appointments (-6.0%) than expected. Additionally, 101?109 more outpatient appointments were cancelled by hospitals than expected (+52%). The 26-27 April strike, where emergency services were also affected, showed the largest impacts on regular service. Mortality did not measurably increase on strike days. Regional analysis showed that services in the Yorkshire and the Humber region were disproportionately more affected by the industrial action. CONCLUSIONS:Industrial action by junior doctors during early 2016 caused a significant impact on the provision of healthcare provided by English hospitals. We also observed regional variations in how these strikes affected providers.

SUBMITTER: Furnivall D

PROVIDER: S-EPMC5855458 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Retrospective analysis of the national impact of industrial action by English junior doctors in 2016.

Furnivall Daniel D Bottle Alex A Aylin Paul P

BMJ open 20180208 1

<h4>Objectives</h4>To examine the impacts of the four episodes of industrial action by English junior doctors in early 2016.<h4>Design</h4>Descriptive retrospective study of admitted patient care, accident and emergency (A&E) and outpatient activity in English hospitals.<h4>Setting</h4>All hospitals across England.<h4>Participants</h4>All patients who attended A&E or outpatient appointments or those who were admitted to hospital during the 3-week period surrounding each of the four strikes (12 J ...[more]

PMID: 29438959

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Project description:ObjectivesSimulation is widely employed to teach a range of skills, across healthcare professions and is most effective when embedded within a standarised curriculum. Although recommended by many governing bodies, establishing a national programme of simulation presents many challenges. Successful implementation requires a clear understanding of the priorities and needs of those it seeks to serve yet there are limited examples of how best to do this. This study aimed to develop an integrated national simulation-based educational programme for junior doctors in Scotland through a structed, multistep prioritisation process.DesignA series of action research cycles were undertaken to develop and evaluate a national simulation programme. This paper describes cycle 1, which employed a six-step structured approach to understand and prioritise learner needs.SettingThe study considered the educational needs of Scottish junior doctors in the UK Foundation Programme (UKFP).ParticipantsMultiple stakeholder groups were involved in each stage of the process including recent Scottish UKFP graduates, clinical educators, UKFP programme directors and postgraduate deans.ResultsKey stakeholders reviewed the 370 competencies in the UKFP curriculum and identified 18 initial competency areas. These 18 areas were subsequently prioritised through the analytical hierarchy process, resulting in a carefully ordered list of 12 competencies from which a targeted simulation-based educational programme could be developed.ConclusionsTo our knowledge, this is the first study to outline the methods of competency prioritisation to create a simulation curriculum that is integrated within a national curriculum in the medical education context. As well as demonstrating the practical steps of such a process, key implications for practice are identified. This robust approach to educational design also resulted in unexpected benefits, including educator and clinician acceptance and programme funding sustainability.

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Dataset Information

Retrospective analysis of the national impact of industrial action by English junior doctors in 2016.

Publications

Retrospective analysis of the national impact of industrial action by English junior doctors in 2016.

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