Junior Doctors strikes

January–March 2016

On 12 January 2016, junior doctors in England took part in the first industrial action of doctors for 40 years. This followed disagreements between the British Medical Association (BMA), NHS Employers and the Conservative government about its proposals for a new junior doctor contract.

The contract was part of plans to deliver a 7-day NHS ‘so we can promise NHS patients the same high quality care every day of the week’, a key policy commitment for Jeremy Hunt, Secretary of State for Health. Hunt argued that this would tackle higher mortality rates for patients admitted to hospital at weekends, though the evidence demonstrating this so-called ‘weekend effect’ was disputed.

Background

The Review Body on Doctor’s and Dentist’s Remuneration (DDRB) recommended a review of junior doctor’s contracts in 2009 and negotiations between NHS Employers and the BMA began in 2013. However, talks stalled in 2014. The BMA were concerned that the NHS Employer’s proposals compromised patient safety and doctors' wellbeing, and meant an effective pay cut for junior doctors. In September 2015, after the government stated it would impose the new contract if a settlement was not reached, the BMA balloted its members for strike action and 98% of junior doctors balloted voted in favour of striking.

Junior doctors general strike

Three strikes went ahead in January, February and March 2016, with junior doctors withholding routine care. This was followed by the first ever withdrawal of routine and emergency care during strike action on 26 April 2016.

According to retrospective analysis by the BMJ, the industrial action ‘caused a significant impact on the provision of healthcare provided by English hospitals’. There were fewer admissions, A&E attendances and outpatient appointments on the days of the strikes than would have been expected. However, mortality did not measurably increase on strike days.

On 18 May 2016, the BMA, NHS Employers and the government agreed upon a modified contract, providing additional safeguards for safe working hours and time out of training. 58% of BMA members voted against the terms of the contract agreement and the chair of the BMA’s junior doctors committee resigned. Despite this, the government announced the phased introduction of the contract between October 2016–October 2017. The BMA ultimately called off four further strikes, which had been scheduled following this.

In 2018, the BMA, NHS Employers and the Department of Health and Social Care reviewed the 2016 contract, agreeing amendments in July 2019.

Source(s)

Powell T.
Briefing paper: Junior doctor contracts in England.
House of Commons Library; 2016.

Hunt J.
NHS 7 day services and the junior doctors' strike.
UK government; 2016.

Bray B and Steventon A.
What have we learnt after 15 years of research into the ‘weekend effect’?
BMJ Quality and Safety. 2016; 2(6): 607-610.

NHS Employers.
Terms and Conditions of Service for NHS Doctors and Dentists in Training 2016.
NHS Employers; 2016.

Furnivall D, Bottle A, Aylin P.
Retrospective analysis of the national impact of industrial action by English Junior Doctors in 2016.
BMJ Open. 2018; 8(1).

NHS Employers.
2018 junior doctor contract refresh: background. [webpage]
NHS Employers; 2019.