Industrial action and emergency department attendances in England, 2022-2024: a retrospective multicentre causal mediation analysis.

There were no significant changes to emergency department durations during nurse strikes (-1.7%, 95% CI -1.5% to 4.7%).

Changes in emergency inpatient occupancy explained a proportion of the change in average emergency department durations (resident doctor 10.4%, consultants 53.3%, combined doctors 5.4% and paramedics 14.3%).

During the residents' strikes, patients were more likely to receive treatments in emergency department (adjusted incident risk ratio 1.013, 95% CI 1.008-1.018), but less likely to be admitted (adjusted odds ratio 0.963, 95% CI 0.946-0.980).