title: A retrospective study of the impact of the doctors' strike in England on 21 June 2012.
abstract: OBJECTIVE
  To examine the effect of the 24-h doctors' strike on 21 June 2012 on hospital activity in English NHS hospitals.
  
  
  METHODS
  Retrospective descriptive study of inpatient, outpatient and Accident and Emergency (A&E) activity in NHS hospitals over the strike period.
  
  
  METHODS
  All English NHS hospitals.
  
  
  METHODS
  Patients admitted to hospital, patients with outpatient appointments and A&E attendances over a three-week period (from 11 to 29 June 2012), excluding weekends and spanning the strike day.
  
  
  METHODS
  Numbers and percentage change of inpatient admissions (elective and emergency), day surgery cases, outpatient appointments cancellations, A&E attendances and in-hospital deaths on the day of the strike compared with patient activity on the Thursday before and the Thursday after the strike week.
  
  
  RESULTS
  There were a total of 795,267 admissions, 5,602,971 outpatient appointments, 356,645 outpatient cancellations (by NHS provider), 4,470,208 outpatients seen by medical staff, 986,322 A&E attendances and 13,857 in-hospital deaths over the three-week period. Compared with the non-strike period, on the day of the strike, emergency admissions fell by 2.4% while the elective admissions decreased by 12.8%. There was a 7.8% drop in the number of outpatients seen by medical staff on the day of the strike and a 45.5% increase in the number of cancelled appointments by NHS hospitals, while A&E attendances dropped by 4.7%. The impact of the strike across regional Health Authorities in England was varied. The North West Health Authority was affected the most while the least affected Health Authorities were the South West, East of England and South Central.
  
  
  CONCLUSIONS
  The 24-h doctors' strike in England on 21 June 2012 significantly affected the provision of healthcare by NHS hospitals. We observed regional variations on NHS service levels on the day of the strike.
authors.affiliation: Dr Foster Unit, Imperial College, London, UK. m.ruiz@imperial.ac.uk
authors.forename: Milagros
authors.initials: M
authors.lastname: Ruiz
authors.forename: Alex
authors.initials: A
authors.lastname: Bottle
authors.forename: Paul
authors.initials: P
authors.lastname: Aylin
mesh_terms: D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004739:England; D006801:Humans; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010819:Physician's Role; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013222:State Medicine / Q000458:organization & administration; D013317:Strikes, Employee / Q000706:statistics & numerical data*; D016526:Workload
keywords: A&E; NHS; doctors; hospitals; inpatients; outpatients; strikes