Urgent action needed to tackle burnout endemic in healthcare

NHS organisations, CQC, government and private healthcare must act to tackle the burnout endemic in healthcare, and support doctors to stay in practice, rather than quit or move abroad - according to a leading medical protection organisation.

In its report – “Breaking the burnout cycle” – the Medical Protection Society (MPS) said that only organisation wide interventions will safeguard the wellbeing of doctors and avoid them becoming burnt out and disillusioned in ever greater numbers.

An MPS survey of 275 doctors in the UK revealed that more than one third (35%) of respondents have considered moving abroad due to personal wellbeing concerns, 45% have considered leaving the profession for the same reasons, and 44% said they do not feel encouraged by their line manager/GP partner to discuss wellbeing issues. 

MPS – the world’s leading protection organisation supporting 300,000 healthcare professionals worldwide – is calling for*:

• A named Wellbeing Guardian in every NHS organisation by 2022, with the same principle applied to GP practices, ensuring access to someone who is trained to recognise and support them when they are experiencing difficulties.
• Governments to fund a confidential counselling service for all healthcare professionals across England, Wales, Scotland and the HSC in Northern Ireland
• The CQC to assess the extent to which healthcare providers look after the wellbeing of their doctors as a key line of enquiry.

Professor Dame Jane Dacre, MPS President said: “Medicine is a brilliant career - there are a few other professions with so many possibilities to improve people’s lives. The increasing levels of burnout I encounter as I talk to colleagues is however extremely troubling. It is perhaps one of the great paradoxes of our age, that modern medicine allows doctors to do more for their patients than ever before, yet increasing evidence shows that doctors feel burnt out and disillusioned in ever greater numbers.

“The causes of burnout have been widely debated and include the growing demands and complexity of the job, a faster pace of work and tighter financial constraints.

“The problem is also not unique to the UK, to the NHS or to any one specialty. It is a global phenomenon affecting all clinicians. When we talk to our members around the world about their working environment, sadly they tell us loud and clear about the impact their work is having on their wellbeing. I am proud of the work we do at MPS to support those dealing with burnout, but this support is only part of the solution.

“When doctors feel burnt out it is not only concerning for them but for patients and the wider team. Doctors who are happy and engaged are much more likely to be compassionate and provide safer patient care.

“We simply must not let the environment we work in reduce the sense of value that we get from being a doctor – there is much that can be done, and the healthcare community as whole has a responsibility to act.

“We call on healthcare providers, the CQC, and Governments to take urgent steps to improve the working environment and to truly begin to tackle the endemic of burnout in healthcare. Only with organisational level interventions can the wellbeing of doctors be safeguarded.”

END

Anonymous quotes from healthcare professionals:

“I have recently left the NHS and have gone to work abroad because of burnout.”

“I took early retirement from being a GP principal due to burnout. I am currently working 2 days per week in a different practice as a sessional GP but can see burnout in the GPs in both my former and current practice.”

“This is a challenging time for healthcare in the UK and the NHS. It has always been a demanding career but the emphasis on service provision and targets has eroded what it means to be a doctor and provide good clinical care. It is impersonal, mentally draining, and bad for your physical health”

“I feel burnout. Management has no idea as to the day to day pressures of the job and pile on more and more (unrealistic) targets/expectations.”

*Full list of MPS recommendations:

1. All healthcare organisations should have clear policies and procedures in place to ensure healthcare professionals feel able to take breaks and to take time off when ill.
2. NHS organisations in England should fully commit to the implementation of Wellbeing Guardians. This is a recommendation made by the NHS Staff and Learners’ Mental Wellbeing Commission which was set up by Health Education England (HEE). We believe GPs should not be overlooked and should also have a dedicated person who makes their health and wellbeing a core priority and is trained to recognise and support GPs when they are experiencing difficulties. We think this could be achieved by 2022, and would support similar actions in Scotland, Wales and Northern Ireland.
3. Private sector healthcare should mirror the recommendations for NHS employers, and commit to the implementation of and access to Wellbeing Guardians, preferably one guardian per group or cluster of clinics/practices.
4. Government should offer additional support through financial and other resources to provide confidential counselling service for all healthcare professionals across England, Wales, Scotland and the HSC in Northern Ireland.
5. The CQC should assess the extent to which healthcare providers look after the wellbeing of their doctors and other healthcare professionals. Whilst this is already a publicly reported criterion as part of the ‘well led’ domain, it could be made more specific and should also be made a key line of enquiry. 

References

1. Burnout definition: Burnout is characterised by mental, physical and emotional exhaustion, cynicism, increased detachment and a decline in professional satisfaction caused by multiple factors. These contributing factors can exist at a personal, team and wider system level. Burnout is not the same as depression, they have different diagnostic criteria with different treatment. Burnout improves with a break or time away, depression does not. Burnout is a problem that is specific to the work context, in contrast to depression, which tends to pervade every domain of a person’s life.
2. MPS surveyed 275 UK doctors in April 2019 which was part of a wider international survey of 1,170 doctors across the UK, Ireland, New Zealand and South Africa.
3. Wellbeing Guardians have been recommended by the NHS Staff and Learners’ Mental Wellbeing Commission, which was set up by Health Education England. The Guardians would be a board level role responsible for the mental wellbeing of their staff, they will set organisational expectations, monitor performance and reassure their board that their organisation is a wellbeing organisation and a healthy workplace in which NHS staff and learners can work and thrive. MPS believes this should be achieved by 2022, and that the principle should also be applied in GP practices.

MPS runs a Building resilience, avoiding burnout (BRAB) workshop. This workshop helps to recognise the signs of burnout and gives the knowledge and confidence to manage the symptoms to recover as well as prevent reoccurrence: https://www.medicalprotection.org/uk/articles/building-resilience-and-avoiding-burnout-workshop

For press enquiries, please contact the MPS press office.

About Medical Protection

Medical Protection is a trading name of The Medical Protection Society Limited (“MPS”). MPS is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of more than 300,000 members around the world. Membership provides access to expert advice and support and can also provide, depending on the type of membership required, the right to request indemnity for any complaints or claims arising from professional practice.

Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.

Our philosophy is to support safe practice in medicine and dentistry by helping to avert problems in the first place. We do this by promoting risk management through our workshops, E-learning, clinical risk assessments, publications, conferences, lectures and presentations.

MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.