Nearly 90% of respondents to the MDU's survey say they feel sleep deprived at work, which is a 20% increase compared to a survey carried out three years ago (January 2022) when 75% of doctors felt sleep deprived at work. Of those, 41% experienced sleep deprivation on at least a weekly basis now, compared to 37% in 2022.

Patient safety incidents had also increased with 69 near misses and 17 cases where patients had sustained harm reported, which was an increase on 2022 when there were almost 40 near misses and seven cases where patients sustained harm.

The UK's leading medical defence organisation carried out the survey of 481 doctor members. The proportion saying tiredness has impacted their ability to treat patients safely has increased from a quarter (26%) in 2022 to a third (35%) of doctors responding to the latest survey.

Dr Udvitha Nandasoma, MDU head of advisory services, said:

"The results of this survey are deeply concerning. There has been no let-up in the immense pressures faced by healthcare professionals in the past three years and this is continuing to impact doctor's mental health and affect patient care.

"When patients come to harm as a result of an impaired doctor, tiredness and fatigue are so common that they might not stand out as contributing factors and the focus can unfairly fall on the individual clinician.

"Nearly four in 10 doctors (38%) told us they were rarely or never able to take breaks during the working day, including lunch breaks. This is an unsustainable situation. If the government is to succeed in its 10-year health plan for the NHS, it needs staff to be firing on all cylinders so they can safely care for patients."

Professor Peter Brennan, consultant oral and maxillofacial surgeon and honorary professor of surgery at Portsmouth Hospitals University NHS trust, has published extensively on human factors and minimising medical errors and has a PhD in the subject.

He said: "We should all be concerned that so many doctors and their healthcare colleagues are working while exhausted. Many studies have shown that tiredness and lack of hydration and nutrition can increase the risk of medical errors and affect doctors' health and wellbeing. Staff need to be able to take regular breaks and be provided with the facilities to do so to optimise their professional performance and help maintain wellbeing."

Susannah Basile, interim chief executive of the charity Doctors in Distress, said:

"Doctors who are sleep deprived will struggle to provide the quality of care for patients that they would wish, and this will inevitably impact their mental health. Doctors are leaving work exhausted and feeling insufficiently rested when they return, which can lead to burnout. Adequate rest breaks need to be both prioritised and respected. This means not only enabling access to rest and sleep facilities at work, but also ensuring rotas protect and respect non-working days to give staff sufficient time to reset before their next shift."

The MDU has called on the government and NHS employers to do more to ensure there are adequate resources in place to allow exhausted doctors to take regular breaks. This is part of a package of measures needed to support the health and wellbeing of the NHS workforce including the need to continue funding support services like Practitioner Health for those experiencing burnout.

See more about the MDU's Agenda for Change policy paper.

What doctors told the MDU

"My shift pattern means I'm so tired and there is no down time or time to truly switch off from work. I am often the only doctor looking after 25 patients. It is exhausting" - Foundation doctor
"I feel exhausted and stressed due to an unreasonable workload and relentless shift patterns working long days and night shifts. It has a huge effect on my mental and physical health and my ability to safely and compassionately care for patients. Services like Practitioner Health are vital and I and many others have absolutely relied on their support." - Resident doctor
"I work part time and I have a list of around 1,060 patients. I end up working a minimum of 50% additional hours just to keep on top of administrative tasks. This is only sustainable and safe because I am part time and don’t have another job." - GP
"Shift work really affected my mental health to the extent I had to stop work for a time and get support from Practitioner Health. The absence of a mess and a place to sleep on or after night shifts is really harmful. It would help to have places to store and reheat healthy meals rather than rely on takeaways." - Clinical research fellow

MDU survey findings

89% of doctors felt sleep deprived at work some of the time, 22% said this happened daily and 19% weekly.
35% said tiredness had impaired their ability to treat patients and 34% said tiredness may have played a part.
There were 69 near misses and 17 cases in which a patient sustained harm.
38% were rarely or never able to take breaks during the working day, including lunch breaks with 27% not having a staff room to take a break in.
62% said winter pressures had increased this year and added to tiredness levels.
90% want government to continue funding specialist practitioner support programmes.
The most common reasons for tiredness were high patient demand (67%), being unable to take a break because of work pressures (65%), being unable to switch off outside work (50%) and no opportunity to eat/drink during a shift/session (29%).
The most reported impacts of tiredness included poor concentration (72%) not looking after yourself (70%), difficulty switching off from work (62%), decision making difficulties (53%) and poor mental health (42%).

*The MDU surveyed a sample of doctors in January 2025. The 481 respondents included: consultants and specialists (31%), GPs (30%) specialty/career/ training grade doctors (23%) and foundation doctors (9%).

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