Will it be 'business as usual' at surgeries during the doctors' strike?

20 June, 2012 - 12:57 -- Joseph O'Leary

With the planned industrial action by members of the British Medical Association (BMA) to take place tomorrow, the usual raft of estimates on how 'successful' the strike is likely to be have already begun to hit the newspapers.

Organisers of the action may have got a rude awakening this morning, however, to headlines suggesting that few surgeries were willing to participate:

The Sun: "Four in five surgeries to defy strikes and open as normal"

Daily Telegraph: "Doctors' strike: three quarters of surgeries to stay open as usual"

The Guardian: "Fewer than 25% of GP surgeries will join industrial action, survey says"

So can we trust these assertions?

The figures quoted in the headlines come from a survey conducted by the health magazine Pulse, who sent out requests to Primary Care Trusts (PCTs) across England asking if they had figures available for how many practices had confirmed they would be closing during tomorrow's action.

20 PCTs provided figures to Pulse, representing 1,265 practices across England. Pulse kindly provided Full Fact with the response numbers, broken down into 10 PCT 'clusters':

Bedfordshire – 31 out of 87 practices taking action 
Black Country – 9 out of 230
Cheshire, Warrington and Wirral – 57 out of 181
Cornwall – 28 out of 69
Derbyshire  - 37 out of 125
Nottinghamshire – 28 out of 161
Buckinghamshire and Oxfordshire – 32 out of 139
Somerset – 22 out of 76
Suffolk – 22 out of 68
Surrey – 15 out of 129
 
When added together we can see that 281 out of 1,265 practices - or 22 per cent  - were planning to close tomorrow. This provides some justification for the Guardian, Sun and Telegraph's headlines. But there are things to bear in mind before accepting these figures outright.
 
Firstly, it is worth noting the sample: there are 151 PCTs in England, of which 20 provided figures (Pulse told us that others did respond to their request, but couldn't provide data on the number of surgeries participating). In addition, there are just over 8,000 GP practices in England, of which 1,265 are represented.
 
What we don't know is how representative this sample is of doctors' surgeries in general. Respondents were self-selecting, and it could be that those trusts that chose to share their figures did so because they showed particularly low participation rates.
 
Secondly, even though the sample indicates that under a quarter of surgeries plan to close, the data does not show how many will definitely be staying open either. Only Oxfordshire, Buckinghamshire and Suffolk provided figures for those which would definitely be remaining open (137 between them), leaving a number of surgeries in an uncertain category.
 
Given that the data only shows those confirmed to be closed, in some cases the results may actually show the minimum number of closures, with the reality being that several more plan a day of action instead.
 
Finally, Pulse pointed out to Full Fact that, while the figures indicate many surgeries could remain open tomorrow, this is not to say that they will be fully staffed, as individual GPs may still participate in the industrial action. For this reason, it isn't possible to say that those surgeries that do remain open will be operating with a normal service.
 
This is a problem recognised by the BMA too, who told Full Fact: 
 
"Assessing the number of doctors taking part in Thursday's day of industrial action is difficult because doctors will be going to their usual workplaces and GP surgeries will be open as normal." 
 
The BMA claim that their research shows that the action will have an impact nonetheless, estimating that around a third of GPs would participate: 
 
"However, we know from planning with managers that four in every five NHS employers in secondary care have postponed some non-urgent care in advance. We are still estimating GP surgery numbers but our ballot indicated around a third of all UK GPs would take action." 
 
So while this morning's figures may make for grim reading for those doctors backing the industrial action, we will have to wait to see how much of an impact it will have on patients hoping to visit their GP tomorrow.

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