Reducing burnout amongst clinicians
Tragically, every three weeks a doctor in the UK commits suicide. Many more opt either to leave the profession altogether during their training, or to take early retirement. Things seem to be deteriorating rather than improving, and this begs the question: what can we do about it?
Many clinicians in training now feel overworked and under-supported. The increasing prevalence of rota gaps results in stressed and exhausted junior doctors working overtime, and this has a negative impact on the continuity and safety of patient care. The breakdown of the firm structure that once offered stability and pastoral support has been replaced by rotations which range across wide geographical areas. This results in nomadic trainees who find it difficult to either integrate with the existing teams or to establish a settled and stable family life.
The observation that clinicians who experience high levels of job satisfaction have better mental health indicates the crucial importance of work-related factors. As a consequence, there is undoubtedly an argument for allocating a portion of the £20 billion per annum extra funding for the NHS specifically to improve the working lives of its doctors, both in hospitals and in general practice. Obvious areas that require urgent attention include improving unsuitable hospital accommodation, increasing study leave allocation and replacement of the sluggish, outdated computer and other communication technology. In addition, now that Theresa May has declared that ‘austerity is over’, a salary rise would certainly boost morale.
Sir William Osler contrasted doctors ‘whose stability of character and devotion to duty make one proud of our profession’ with those who find it difficult to keep ‘the flame alive, smothered as it is apt to be by the dust and ashes of the daily routine’. In this respect, team morale is crucial – but was decimated by the junior doctors’ strike and the eventual imposition of the new contract by Jeremy Hunt. This damaging dispute with trainees centred on weekend working arrangements in relation to the Conservatives’ determination to introduce a ‘7 day NHS’- an aspiration that seems to have been conveniently abandoned as the Conservative party has descended into the morass of internecine struggling over Brexit. Rebuilding and maintaining the morale of the medical profession ought to be a top priority for Matt Hancock, Jeremy Hunt’s successor as Health Secretary, if he truly has the aspiration to reduce burnout amongst clinicians and to keep ‘the flame alive’. One has to hope that he has – for the sake of the many millions of patients who will be cared for by the NHS throughout 2019, and beyond.
What are your thoughts on these matters? Please do add your comments to this blog.