By Dr Anas Nader, medical doctor and founder of Patchwork Health
We must urgently modernise our approach to the health of NHS staff.
The national conversation around mental health and work-life balance has progressed rapidly over recent years. Taken increasingly seriously by policy makers and employers, we are embracing a new era that promotes personal wellbeing. Medical professionals are playing a key role in this, doing their best to support the 1 in 8 British adults who receive mental health care each year, despite the strain on resources
But within this conversation we have forgotten the very clinicians so integral to battling this crisis. Their mental health and wellbeing have been sidelined. This risks tearing the very fabric of the NHS apart.
The number of NHS staff quitting over long hours has tripled in six years. Last year, more junior doctors left the NHS on qualifying than stayed on. A 2018 GMC’s survey found that nearly one in three trainee doctors said they felt ‘exhausted’ even before starting a shift. And two-thirds of doctors responding to a recent BMA survey said their stress levels in the workplace had increased over the previous twelve months.
Our doctors, nurses and the wider clinical community are buckling under the pressure of running a health service that is operating way beyond capacity. This calls for radical rethink of what it means to work on the front line of the NHS.
It was recently reported that a number of hospitals are engaging yoga teachers and masseurs to help relax stressed medics, as well as laying on snacks and hot chocolates to ease the relentlessness of a long shift. Whilst this is laudable, it will barely scratch the surface.
The world of work has moved on since 1948. But if you’re one of the 1.5 million people working for the NHS, it might not feel like that.
With rigid approaches to training, proscriptive rotas, and gruelling shifts, all of which are felt most sharply by junior doctors, working for the NHS is now worlds away from the flexi-time, co-work space reality of most young professionals. These young medics are under strain; dropping out before they burn out.
If we are to stem this tide of talent leaving the profession and improve things for those who stay, we must rapidly evolve employment practices within the NHS. We must embrace clinicians’ desire for more flexible rotas, making it easier to reduce or increase workload in line with energy levels. This will stop medics from having to choose between full-time work or locum life. It’s vital that we invest in the technology needed to enable this, meaning hospitals can attract and retain flexible talent without resorting to extortionate locum agencies.
It’s also incumbent upon the health service to relax the strictures of training programmes, allowing clinicians some time to breathe, sleep and think logically about their next steps. The tighter the constraints we place upon our medics, the more likely they are to want to escape.
Of course, investing in your staff and structures isn’t free. But there are ways that existing funding which is being wasted could be re-allocated. The NHS spends £3bn each year on locum staff and we’re now recruiting more doctors from abroad than those from the UK. We also lose out on huge amounts of investment with each and every medic that steps away from full time practice. If we can reverse these trends by reimagining what life in the NHS looks like, the cost savings stand to be enormous.
We must urgently prioritise the health and wellbeing of our NHS clinicians. We cannot ignore the gaping holes in the system that the clinicians who remain are desperately struggling to fill. It will take a leap of faith and an embrace of modern working if we are to create an institution which allows its staff to thrive, rather than simply survive.