FBLT035 Business Analytics

Introduction: 

The research project has been conducted on the topic “The effects of strikes within the NHS”. The impact of junior doctors’ strikes will be worst than predicted by the government. Junior Doctors is on 5 days Strike due to new contracts for doctors which is unethical, disproportionate and will cause harm to patients (Metcalfe, et. al., 2015). Junior doctors are that who has left the school of medical but has not specialized in any particular field and take training under senior doctors.  This disputes in not begin for the NHS and patient safety; it is entirely about the pay and conditions (Cunningham, et. al., 2008). That is not to belittle the latter, but merely to be factual. Equally there are certain conflicts concerning NHS and social care funding and safety of patient which should be dealt with but cannot be resolved as a contractual issue. Literature review will be reflected in this research for highlighting the key elements. Various kinds of methods and techniques will be described in this research program which will be utilized to gather the data in an appropriate manner. Every activity is carried out with a motive which must be achieved from the execution of the activity (Marchildon and Schrijvers, 2011). Different aspects will be covered under this research program and vital information will be gathered with the help of various articles and journals available over the internet.The research process will be made so as to guide the implementation of the research program in an adequate manner.

Literature review 

The professional of doctors in the view of world are sacred. It has been evaluated that due to strikes of doctors, more than 75,000 patients could be influenced due to cancelation of operations, diagnostic test, and outpatient appointments. On 30 May 2012, the British Medical Association (BMA), which represents almost two-third medical practioners in the UK, has announced the decision to take industrial action because of disagreements over government pension reforms. It has been analyzed that it was done the first time in 37 years that the doctors of the UK had gone out on strike. As per the trade Union and Labor relation act, doctor is protected from the action that puts the public at risk. Therefore it has been announced by British Medical Association that all emergency and urgent cases would be dealt with as usual. All the exact figures are not calculated, 10% of doctors across England had been taken industrial action. The information is given to the department of health from individual NHS trust to disclose a varied picture. In the area of London, 90% hospitals are working as usually and approximately 10% of planned operations were postponed. The general view reported in the national news that there are major impact of strikes on the emergency case and the outpatient appointments and there are number of appointments had to be re-scheduled (Ogunbanjo and Knapp, 2009).

The reason behind striking of juniors doctor is that the government wants to introduce a seven days NHS. Junior doctors have started to argue that amendments in contracts will mean long time working hours and cut to pay as well (Strike, Haller and Soltis, 2005). The British Medical Associations beliefs the contracts are not good for the patients, NHS and for junior doctors as well. This issue has taken a wide face and number of patients has to suffer with difficulties. It has been found that the industrial actions have been taken by doctors who are considered as the complicated by their professional values and ethical framework. It has been analyzed that due to plan of government in changing of contracts will only influence junior doctors in England that is why protest were held in cities all over the country (Goddard, 2016). Most strikes are effective because they harm a third party, who motivated to pressure the employer to consent to demands of strike. Unfortunately, in these of strikes, the third party is concerned as the patient who has to face many difficulties. These kind of behave is inconsistent for many people with the over-riding duty of doctors to advocate for their patients. On the other hand, others have claimed that the strikes of doctor inevitably expose patients to risk of severe harm. The condition might be further difficult by doctors striking to oppose policies that are apparent to threaten the standard of care they are able to deliver (Kuhlmann and Allsop, 2008). It has been evaluated that the strikes of doctors may highlight the conflict between the right of doctors as employee and their duties to patients. However, they are a global phenomenon with strikes which has been already reported in Australia, India, Ghana, Nigeria, the United States, and Venezuela. A junior doctor in England has been voted devastatingly in favor of strike action over the government’s threat to impose a new contract next year (Metcalfe, Chowdhury and Salim, 2015).  

The strikes of junior doctors could hit 57,000 NHS patients. The action which has been taken by junior’s doctors could affect the most unlikely areas of daily life. Due to this reason, the number of staff has gone in the line of shortages and British Museum has warned that areas could be cordoned off. As per the article of “How the public sector strikes will affect services”, that number of patients could get affected due to cancellation of operations, diagnostic tests and outpatient appointments (Ruiz, Bottle and Aylin, 2013). As per the department of health assumes that more than 20% of the workforce of NHS or 260,000 workers will go on strikes, as result, there could be 40,000 fewer outpatients, 5,500 operations and more than 10,000 diagnostic tests. Due to strikes, patient transport services will also be influenced. The blood test will be postponed and the transfer of patients from one hospital to other will be delayed and some inpatients are forced to stay in hospital due to unnecessary reason because no-one is there to care them and tell them that they are alright and can go home and there is another reason of lack of transport services to the patients which will offer only a limited services (McKee, 2015). Hospitals have started to write to patients to warn them that the non-urgent operations schedule will get it at a later date. Along with that the mother and children get also influenced by health visitors and district nurses focusing on only urgent cases like families where someone is injured or sick or there is concern for child protection. The leaders of union are agreed with NHS chiefs that care for emergency and patients who has emergency requirement of treatment regarding health, including Accident and Emergency (A&E) and maternity care, will be not influenced and the safety of patient will be secured. It has been suggested by Union Leaders that services for cancer patients and those on kidney dialysis should also carry on as usual under incidents plan put in place by the employer of NHS organization, union representative and local NHS leaders (Oldham, 2016).

                                         

Figure 2: observed and expected number of inpatient admission, outpatient appointments and A&E Attendances and the rate of death on the day of doctor’s strikes.

Source: (Ruiz, Bottle and Aylin, 2013).

It has been found from the conducted research by New YouGov that strong opposition to the thinking of an indefinite walk-out by junior doctors. 59% people are not in favor with strikes and say that would be the wrong thing to do, on the other hand 23% people are in favor of indefinite doctors’ strike and say it would be right and they should take action against wrong things. While 18% are neutral and they do not have any idea about that (Bovill, 2012).

                                       

Figure 1: indefinite doctor’s strike

Source: (YouGov, 2016).

There are a lot of canceled appointments and operations due to strikes which have been influenced the life of patients. It has reflected that the strikes of junior patients not only influence the patients but also hospital and it has been mentioned by senior government source that they are shameless who think only for themselves by avoiding many of precious lives. The strike is for five days and the Chief Executive of BMA claims that the further strike is essential because the government does not give look to provide detail over seven days services (Taylor, et. al., 2010). They were offered a detailed statement and this was rejected for insertion in the final agreement.

However, the decision of strike by junior doctors is not allover good but they have taken the decision for the benefits of the patients because due to proposal of contracts may harm to the safety of the patients. Along with that, due to amendments in the contracts, juniors doctors have to work more than 100 hours in continuous way which may lad them in to sleep deprivation which is a serious patient safety issues. It has been found that the BMA entered in the contract negotiations with employers of NHS for the purpose of enhancing the safety of the patients and the quality of the life for junior doctors (Duffield, et. al., 2010).

Research methodology

Research methodologies are facilitated to gather the relevant data from the different methods or technique which a researcher applies to the research program. There are various methods and techniques have been used to execute the research program. This section of the research is designed to evaluate the entire factors and techniques which are being utilized by the researcher to collect the data. It is essential to use all methods and techniques so that the target population could get the way with the influence of reliability and authenticity of the Research report could be amplified (Callander and Schofield, 2011). The tuition of rice methodology ensures that the research should move enough proper direction. It will add in providing us at the direction and avail appropriate and systematic set of information to the target population.

Research methods

There are numbers of research method available which can be utilized by the researcher for accumulating information for the research. The qualitative method has been chosen for the collection of the data for this research program. The researcher has chosen this method because this method permits the researcher to evaluate NHS in depth and detail. Furthermore, the way of evaluation and framework of research can be revised in a quick manner as new details appear. Under the qualitative method, the data is accumulated from few respondents. With the help of this method, the researcher can analyze various factors regarding the selected topic. Despite the number of benefits of the methodology, the researcher is well known with the drawbacks of the same.

Research approaches

There are major two approaches that are qualitative and quantitative approaches which have been taken for the execution of this research program. The qualitative approach facilitates in gathering the data by enhancing the knowledge of the emergence factors and opinions which are hidden behind the topic of the research. Quality information is considered an integral component for the execution of this research, primary and secondary sources have been utilized in this research program for gathering the quality information regarding then search topic. The articles, journals and research work of other authors which is available over the Internet are the main contributor to gather the information about the research topic (Munroe, et. al., 2013). The sources have aided in maintaining the quality of the research.

Data collection

Data Collection is the major part of the research. The data is collected from the primary and secondary sources in this research program. The data from the primary sources are those which provide the first-hand information. The data through primary data can be gathered by observation, news, questionnaire, case study and so on. The motive behind a collection of a combination of both resources that are primary and secondary sources is to enhance the proper understanding of the factors of the research topic. The primary source is able to provide the current information. The questionnaire has been made and it will be represented to the junior Doctors of the hospital which are facing this issue. On the other hand, a secondary source provides a data which is already utilized (Tankel, et. al., 2011). It can be accumulated from the articles in the newspaper, research paper, magazines, journals and other available data over the Internet. The advantage of secondary data is that it is not taking too much time together the data and also cost efficient.

 Sampling size and technique

Sampling is considered as the process in which the specific sets of units are chosen from the total population to make an observation. There are a number of the methods for sampling technique. The data is collected in the context of a research topic in a huge quantity and analysis of this large quantity data in the limited span of time act as a challenge. Researcher has chosen the random sampling technique for the analysis of the collected data for coping with this challenge. It is most efficient technique which provides equal opportunity to every sample of the population of involving in the data analysis.

Research strategy

It is vital for the research program to accomplish within the time frame for maintaining the effectiveness of the program. The way of conduct of research program is to be done in an efficient manner. A systematic approach has opted for the research program which will be helpful to execute of every activity of the research in a sequential manner. It has resulted in covering entire activity of tea research program without skipping (Robinson, et. al., 2008). An action plan has been prepared for the reorganization of the various activities of the research program to ensure that every activity is done within the time frame.

Targeted market

It is important to gather the information in an efficient manner and targets need to be set from where information regarding research is to be gathered. It helps in recognition of the sources from where information has to be collected. A primary as well as secondary source has opted for this research. The questionnaire will be presented to the Junior Doctors of the NHS and interviews will be conducted with the patient to gather the information about the effects of strikes within NHS. Apart from that secondary sources have been gathered from the Internet and for ensuring the reliability articles because a reliability of the research is the degree to which the research develops the continuous outcomes. It defines the reliability and the validity of the data to demonstrate the credibility of the research. The use of data in the research is referenced for the purpose of showing is genuine and valid.

Ethical consideration

The nature of ethical consideration in research is critical. Ethics have comprised the norms and Standards two bifurcate the right and wrong. Ethical values and principles have been kept in mind during the implementation of the research program. Ethical Framework is considered in the vital form to accomplish the research program. The data has been collected in a fair manner and maintaining the confidentiality. Integrity has been maintained in the entire research which permits users to use data and information by keeping trust on it.

Result and discussion 

It has been found that for the 3 week that is 11 to 29 June 2012 there were more than (7 lacs inpatient admission and more than 3 lacs emergency admission) and a total of5,602,971 outpatient appointment of this some of them were out patient seen by medical staff. Number of meeting of patients with doctors has been canceled due to strike of a junior doctor. There were 986,322 A&E department attendances and 13,857 in-hospital deaths. An analysis by strategic health authority reflected a varied picture across the country. It has been found that the Northwest health authority was significantly influenced, with numerous cancellation of outpatient appointment north-west strategic health authority. It was considered as the largest drops in the number of outpatients seen on the day on the day of the strike.

There were huge impacts of the strike which has been felt in the inpatient, outpatient and A&E department with a large number of cancelled appointments and decreased number of patients in on the strike day. It has been suggested that the observed reduction in the admission of emergency cases on the day of the strike is not significant on the basis of clinically. It has been concluded that the observed drop on the strike day could be simpler because of daily account variability.

Conclusion:

It has been concluded that the strike of a doctor on 21st June 2012 had an influence on activity within NHS hospitals in England. A significant number of patients were influenced due to strike by Junior Doctors and with a reduction in cancellations of meetings with doctors while with A&E department managed a reduction in total attendance. The reason has been mentioned in this research project behind striking of juniors’ doctor. The discussion has been made in an appropriate manner so that the study on the research topic is done in a good way. It has reflected that the strikes of junior patients not only influence the patients but also hospital and it has been mentioned by senior government source that they are shameless who think only for themselves by avoiding many of precious lives.

References: 

Bovill, D., 2012. Tutorial Therapy: Teaching Neurotics to Treat Themselves. Springer Science & Business Media.

Callander, E.J. and Schofield, D.J., 2011. Emergency department workforce models: what the literature can tell us. Emergency Medicine Australasia, 23(1), pp.84-94.

Cunningham, S.A., Mitchell, K., Narayan, K.V. and Yusuf, S., 2008. Doctors' strikes and mortality: a review. Social Science & Medicine, 67(11), pp.1784-1788.

Duffield, C., Diers, D., O'Brien-Pallas, L., Aisbett, C., Roche, M., King, M. and Aisbett, K., 2011. Nursing staffing, nursing workload, the work environment and patient outcomes. Applied nursing research, 24(4), pp.244-255.

Goddard, A.F., 2016. Lessons to be learned from the UK junior doctors’ strike. Jama, 316(14), pp.1445-1446.

Kuhlmann, E. and Allsop, J., 2008. Professional self-regulation in a changing architecture of governance: comparing health policy in the UK and Germany. Policy & Politics, 36(2), pp.173-189.

Marchildon, G.P. and Schrijvers, K., 2011. Physician resistance and the forging of public healthcare: a comparative analysis of the doctors’ strikes in Canada and Belgium in the 1960s. Medical history, 55(2), pp.203-222.

McKee, M., 2015. Is the UK government right that seven day working in hospitals would save 6000 lives a year?. BMJ (Clinical research ed), 351, p.h4723.

Metcalfe, D., Chowdhury, R. and Salim, A., 2015. What are the consequences when doctors strike?. BMJ: British Medical Journal, 351.

Metcalfe, D., Chowdhury, R. and Salim, A., 2015. What are the consequences when doctors strike?. BMJ: British Medical Journal, 351.

Munroe, B., Curtis, K., Considine, J. and Buckley, T., 2013. The impact structured patient assessment frameworks have on patient care: an integrative review. Journal of clinical nursing, 22(21-22), pp.2991-3005.

Ogunbanjo, G.A. and Knapp van Bogaert, D., 2009. Doctors and strike action: Can this be morally justifiable?. South African Family Practice, 51(4), pp.306-308.

Ogunbanjo, G.A. and Knapp van Bogaert, D., 2009. Doctors and strike action: Can this be morally justifiable?. South African Family Practice, 51(4), pp.306-308.

Oldham, J., 2016. Junior doctors will harm our patients and our NHS if they back the BMA's unethical strikes. Retrieved on 30^th November, 2017 from: http://www.telegraph.co.uk/news/2016/09/05/junior-doctors-will-harm-our-patients-and-our-nhs-if-they-back-t/.

Robinson, G., McCann, K., Freeman, P. and Beasley, R., 2008. The New Zealand national junior doctors' strike: implications for the provision of acute hospital medical services. Clinical Medicine, 8(3), pp.272-275.

Ruiz, M., Bottle, A. and Aylin, P., 2013. A retrospective study of the impact of the doctors’ strike in England on 21 June 2012. Journal of the Royal Society of Medicine, 106(9), pp.362-369.

Ruiz, M., Bottle, A. and Aylin, P., 2013. A retrospective study of the impact of the doctors’ strike in England on 21 June 2012. Journal of the Royal Society of Medicine, 106(9), pp.362-369.

Strike, K.A., Haller, E.J. and Soltis, J.F., 2005. The ethics of school administration. Teachers College Press.

Tankel, A.S., Di Palma, M.J., Kramer, K.M. and Van Der Zwan, R., 2011. Increasing impact of mental health presentations on New South Wales public hospital emergency departments 1999–2006. Emergency Medicine Australasia, 23(6), pp.689-696.

Taylor, C.B., Stevenson, M., Jan, S., Middleton, P.M., Fitzharris, M. and Myburgh, J.A., 2010. A systematic review of the costs and benefits of helicopter emergency medical services. Injury, 41(1), pp.10-20.

YouGov, 2016. Public increasingly blame government in junior doctors dispute. Retrieved on 30^th November, 2016, from: https://yougov.co.uk/news/2016/04/27/public-blame-government-doctor-dispute/.