It’s increasingly recognised that the NHS is chronically understaffed and under-resourced. Ask any doctor currently working in a UK hospital, and they will refer to ‘corridor medicine’ becoming the norm along with 4 hour waits to see a doctor. General Practice is just as bad with GP’s and family doctors reporting waiting times of up to nine weeks for appointments and six times the average number of patients per GP.
In today’s society, we know medics are incredibly busy, working and making the best of a bad situation to ensure the health and wellness of others is at the top of their priorities. What they won’t necessarily tell you is how these working conditions affect their own health and wellbeing and how they are expected to adapt to this new-found ‘normal’ with increased working hours, spiralling workload and lack of support, all while still providing the gold-star standard of care every patient deserves.
With current working conditions as they are, it’s not surprising to read that last year according to findings published in the MBJ Open medical journal, 55% of UK doctors met the criteria for burnout and ‘emotional exhaustion’, with one in five resorting to the use of drugs or alcohol as a ‘coping strategy’. Indeed, a British Medical Association survey of 4,300 medics in April 2019 revealed worrying levels of burnout with junior doctors suffering the highest burnout rate across the medical profession at 91% and GP partners, who co-own surgeries, came second, at 88%.
These findings raise concerns, not only for the health of NHS workers, but also the quality of care patients are being provided with. While it’s through no fault of the doctors (blame extreme workloads and rota gaps), it does show us that work-related stress can no longer be ignored. Not only is it affecting the physical and mental wellbeing of doctors, which could lead to severe health problems, it’s also meaning doctors are leaving their careers early as they simply can’t cope, which in turn adds additional stress to a system that is already operating at maximum capacity.
In 2018, according to the annual United Kingdom Foundation Programme Office (UKFPO) survey, it found just 38% of second year doctors chose to continue their careers in the NHS and enter speciality training (including general practice) – compared to 83% in 2010! This has been compounded by a crisis at the other end of a scale, where up to 69% of consultants have had to cut their hours due to punitive pensions tax.
But, what can we as a society do?
Firstly, we need to realise that if we don’t start looking after our doctors, we won’t have anyone left to look after our patients. Doctors are human beings; they need and should have access to a wide variety of support networks both in their place of work and within the wider medical world. We need to make it easier for them to take decompression breaks, whether it be as simple as giving doctors access to an on-call room where they can get their heads down or allowing time off for personal reasons.
There also needs to be flexibility within the system to allow for career development, not just on a medical skill level, but also on important subjects such as leadership and resilience where medics can engage and come away with the tools they need to thrive and feel better equipped to deal with challenging work settings both at home and across the world. It’s something we personally feel very strongly about here at World Extreme Medicine (WEM). There is nothing more important than our mental health, it’s integral to our physical health and our ability to be the best medics we can be, which is why we set up WEMski – a mini-conference concentrating on mental health and resilience for medical and allied healthcare professionals.
In fact, resilience and mental health are key themes introduced and discussed across all of our WEM courses and feature heavily within the content. Our courses also provide a way in which medics can stay healthy within their job role by providing a reconnection with the type of medicine they signed up to in medical school. Quite often we find by going back to basics, working as a team, problem solving and thinking outside the box without the pressures of everyday life, it means the passion and energy they originally had for medicine is revitalised and they leave not just with new skills, but also with a new sense of purpose and a network of support with like-minded individuals they wouldn’t have otherwise had.
Another great example of this forward thinking is nicely illustrated by the Clinical Fellowships offered by the Royal Devon & Exeter Hospital Foundation. The team have recognised that to attract high quality middle grade doctors for their Emergency Department, they need a more flexible outward looking recruitment policy. They have teamed up with the Exeter University Medical School to offer an exciting 3-year MSc Fellowships in Extreme Medicine as part of a unique post that combines working in the emergency department, whilst completing all of the modules of the Masters Degree in Extreme Medicine.
Has this worked for the department?
The jury is still out, but the initial pilot resulted in 100% retention and students reporting that they were returning to their posts with improved team-working and problem solving skills, alongside a greater understanding of the interplay of complex human factors that is a day-to-day occurance in a busy ED.
WEM Founder, Mark Hannaford says:
“I am dedicated to being part of the future solution to help medical professionals attain a better work/life balance that ultimately encourages them to stay in medicine. It’s important that they do so, that they have the opportunity to escape the pressures of their medical career by changing pace, gaining new knowledge and useful experience, so as well as returning to their team happier people, they are also returning as more effective clinicians.”