WILL THE NHS BURNOUT?
According to experts, the UK National Health Service (NHS) is at its knees and at risk of succumbing to a humanitarian crisis over the coming winter as homes are being forced to go without heat or food under the pressure of the spiralling costs of living.
But just like it did with Covid, the NHS always comes good, because of the relentless and unparalleled dedication, commitment and goodwill of the very staff that underpin it. ?Did you know that aside from the Indian Railways, Walmart and maybe even Amazon, the NHS is the fourth largest employers in the world, and so surely the NHS will come good again?
If you don’t look after your staff, then there are only two possible outcomes. First is that they become demoralised and burnout. The other option is they look to leave. ?THERE IS NO OTHER OPTION
According to a recent paper in the British Medical Journal, this time, the NHS may not be so lucky, as its previous unrelenting fuse of goodwill appears to be dwindling.
The UK General Medical Council’s latest annual survey based on responses from 67,000 doctors, found that the risk of burnout is now at its worst since it was first tracked in 2018.
Burnout is a state of physical and emotional exhaustion often related to long term stress in the workplace. Common signs of burnout include being tired and drained, feeling helpless, trapped, or defeated.
It’s important to point out that burnout is rarely due to the excess workload. Most doctors are highly skilled and trained to work hard and have done so for most of their working lives. In fact, it’s nothing to do with hard work, more so it’s the failure of support around the clinician to support that excess workload that causes burnout. Other symptoms of burnout include, self-doubt, feeling detached, and cynicism, the very things that colleagues and patients pick up on.
A recent systematic review and meta-analysis published in the BMJ assessed the views and experience of 239,246 doctors around the world and identified that burned-out doctors were twice as likely as their peers to have been involved in patient safety incidents, and to have been rated poorly by patients.
So, what can the NHS do proactively to stop this almost inevitable decline?
Well as with all organisations it comes down to right culture and leadership. Surely if the leaders want high productivity, then they need to create the right culture, environment and setting to enable this. I am sure I can speak for most doctors; in that we all strive for excellence and to be able to deliver the highest quality of standards or care and do the best for our patients. For some of us, our work is our pride and joy, our Ferrari, and for others perhaps just a job, a means to an end, let’s call it their Skoda. ?
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No matter whether you are driving a Ferrari or a Skoda, it’s no fun if you are driving with the hand brake on.?Whether it be a toxic blame culture; equipment being old and dysfunctional; or a lack of space and resources to call their own, the net result will lead to people looking over their shoulder for other opportunities.
If you don’t look after your staff, then there are only two possible outcomes. First is that they become demoralised and burnout. The other option is they look to leave. ?There is no other option, and the net result will be reduced efficiency and productivity.
The NHS is classically a reactive organisation, one that waits for crises and responds accordingly but if the NHS is to survive the coming winter’s crisis, then it needs to act now, or the irony will be that the cold weather will lead to burnout of the very goodwill that keeps it going.
The views expressed here are my personal views and do not in any way express the views of any organisation I am connected to.
References
Thomas C. The Cost of Living Crisis Is a Public Health Emergency. August 2022. https://tribunemag.co.uk/2022/08/the-cost-of-living-crisis-is-a-public-health-emergency
General Medical Council. National Training Survey 2021 results. https://www.gmc-uk.org/-/media/documents/national-training-survey-results-2021-summary-report_pdf-87050829.pdf ??
Hodkinson A, Zhou, A, Johnson J, Geraghty K, Riley R, Zhou A et al. Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis BMJ 2022; 378.
Owner and Founder of NP Physio
2 年Totally agree. I left a few years back for these reasons but I am fully aware things have got a whole lot worse. So much respect for the NHS and you reaching out to emphasise this. ??
Consultant Plastic and Reconstructive Surgeon East and North Hertfordshire NHS Trust, Founder Hawchester London Luxury Timepieces
2 年Chasing my consultant NHS parking permit has on its own burnt me out. 25 emails, dealing with 2 different individuals, filling the same form twice and sending the same 3 attachments twice! ?? I had to then cut and paste all of the information on the submitted forms onto an email cause the individual who I sent the attachment to wasn't bothered to look through it themselves. It's these small things that lead to the greatest frustration and which eventually lead to a feeling of being completely devalued and eventually adds to the burden of burnout.
Ortopediingeni?r (Orthotist) at Sophies Minde Ortopedi
2 年Nicely put. Yes, I left the NHS eight years ago for some of the reasons you identify. I found myself feeling increasingly fatigued and disengaged with my working environment. My CPD time largely involved clearing the backlog of work related to clinic time. My current job gives me enough slack to read journal articles relating to clinical challenges presenting in clinic, and allows suitable breathing space to think creatively with regards problem solving. I'm a much happier (and I think better) clinician as a result.
Emeritus Consultant Orthopaedic in Sheffield
2 年Well said as always Andy, I will watch from the sidelines having already made the gentle leap away from clinical practice. Let's hope the young and enthusiastic managing and working in the NHS can see the problem and resolve to not let this happen.
Orthopaedic Foot and Ankle Surgeon sub-specializing in Athletic Injuries | Investor | Teacher | (aspiring)Surgical Artist | Researcher | Podcaster | Co-founder of "Indications" | "The sole of orthopedics??"
2 年Andy Goldberg OBE eloquently written piece. It is so interesting how burnout has become an international phenomena. The "cure" is no doubt multi-factorial. However, it leaves me wondering what we as physicians, as the leaders in our respective hospital systems can do to combat the current trend. How do we treat our staff? I think there needs to be a grassroots effort. As the book "Leaders eat last says", "So goes the leader, so goes the culture" Some of the most powerful ways I have found to buck the feeling of burnout is to make sure I take a few moments to relate to my staff, residents and co-workers. It isn't easy and requires a different type of discipline, but human connection is powerful. Jeffrey Smith, MD any thoughts?