Nursing Strikes - The potential impact on patient care and safety

Leonie Millard
Leonie Millard

Published: November 21st, 2022

7 min read

Nursing and healthcare unions have so far rejected the government's pay offer, which will lead to further strike action. The health unions are seeking a pay rise that would at least match inflation, which currently sits at 10.1%. The Royal College of Nursing is seeking a rise that would match inflation plus an additional 5% in pay.

Union officials state that the pay of some experienced nurses has fallen by as much as 20% in real terms since 2010, taking inflation into account. In addition to this, there are also record numbers of nursing vacancies across the NHS, with experts saying that the only way to fill these vacancies being a wage increase with the aim of attracting and retaining nurses.

Which areas will the strikes affect?

The impact of any further strike action will differ depending on whereabouts in the UK you are located. There are legal requirements that must first be met before nurses at each NHS trust or health board are allowed to strike. The requirement is that at least 50% of all Royal College of Nursing members at each NHS Trust or health board must vote that they are in favour before strike action can be taken. Not all NHS employers across England have met this threshold.

Having said this, over half of NHS hospitals and community teams have agreed with the proposed strike action, which is a significant number of nurses on strike. Nurses in every service in Scotland and Northern Ireland voted in favour of strike action. In Wales, all but one health board voted in favour of the strikes.

Click here to visit a BBC News article that sets out which NHS Trusts and health boards will be striking.

What are the possible impacts of the nursing strikes?

The Royal College of Nursing's general secretary, Pat Cullen, said that members would ensure patients did not come to harm by continuing to provide urgent and emergency care throughout the strike action. Services such as intensive care units will remain fully staffed, with other services such as cancer care also likely to be given some form of protection.

However, the strikes will affect routine services. This includes planned operations like hip and knee replacements, district nursing and mental health care. A minority of nurses have voiced concerns that the strike action could leave patients at risk, despite the assurances given by the Royal College of Nursing.

Studies have reached varied conclusions in terms of the affect that clinical strikes have on inpatient care. A 2010 paper from the National Bureau of Economic Research caused many to believe that clinical strikes are dangerous to patients, as it found that inpatient mortalities increased by 20% during strike action. However, recent research has questioned these findings.

A 2022 report by Essex et al found that strikes do not significantly change the rates of inpatient mortality. Although, the factor that has the most impact on patient mortality during strike action is whether or not emergency care is continued. If emergency care is continued, strike action does not tend to affect inpatient mortality rates. This would suggest that the upcoming nursing strikes will not have an impact on the mortality rates at hospitals where the strikes are happening, as emergency care is being protected from strike action.

This is not to say that the care patients receive in hospital is not affected at all by strike action.

Continuity of care

One of the primary ways that the nursing strikes will impact inpatient care is through the sudden lack of continuity of care. Patients will not be able to receive consistent care by the same team of healthcare professionals. Continuity of healthcare allows the medical professionals involved in your care to have better insight into your condition, which can facilitate better decision making.

Studies have shown that more errors happen with patients where continuity of care has been broken, and that this can also lead to an increased rate of rehospitalisation.

Safe staffing

The concept of safe staffing relates to making sure that an adequate number of medical professionals are available to provide care for a certain number of patients. The number of professionals needed per patient will depend on the department that the patient is in the care of, the patient's care needs and the nature of the patient's illness or injuries.

Nursing strikes will pose a clear risk to safe staffing principles, as many hospital and care departments will be without the usual number of nurses. When nurses and medical staff are overloaded, the risk of patient complications increases. Studies have also confirmed that higher rates of medical staffing leads to lower levels of patient mortality, although this is likely to be mitigated during the nursing strikes provided that emergency care settings are adequately staffed.

The nursing strikes in the United Kingdom are unlikely to directly lead to increased patient mortality, although it will seriously undermine the principles of safe staffing and continuity of care. These are two important aspects of patient care, and will lead to the overall quality of care being reduced over the period of time that the strike action is in effect.

Unfortunately, this may cause a rise in medical negligence cases, as the quality of inpatient care is reduced during the nursing strikes. If you would like advice regarding a possible claim for clinical negligence, contact our team of clinical negligence solicitors, and we would be happy to discuss the care you received and whether you may have a claim

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