Direct and indirect impacts of industrial action on emergency department attendances in England, 2022-2024: A causal mediation analysis with 20 hospitals

Between December 2022 and July 2024, the English National Health Service saw 27 periods of industrial action over 78 days, involving hospital and ambulance staff. In this analysis we estimate the direct and indirect (i.e. causally mediated) impacts of industrial action on the Emergency Department (ED) durations.

The analysis has been summarised in a manuscript that will be submitted to an academic journal for consideration and review.

This repository contains a series of R code files. Each R file has a numnerical prefix indicating the stage of the analysis: (1) data preparation, (2) data checks, (3) creating analysis dataframes, (4) main analysis, (5) sensistivity analysis, (6) additional materials for the manuscript, (7) other outputs not used in the manuscript, (9) preliminary and exploratory scripts.

Some of the R files must be run within the National Commissioning Data Repoistiry (NCDR) data science server. These have the suffix "(ncdr)".