Around nine in 10 (88%) healthcare professionals say that workplace pressures have increased in the past two to three years, a new Medical Defence Union (MDU) survey has revealed. Doctors and dental professionals are turning to coping mechanisms like mindfulness, breathing exercises and fresh air breaks to cope.

The survey of 843 healthcare professionals carried out by the MDU, the UK's leading medical defence organisation, also found four in 10 (40%) said they were likely to retire or leave practice in the next five years. Nearly half of respondents (48%) said they had reduced their hours to cope with workplace pressures.

Dr Caroline Fryar, MDU director of medical services, said:

"Our members are under huge pressure at present as a result of the so-called 'twindemic' of flu and Covid. That, coupled with the long waiting lists for treatment that grew significantly during the pandemic, has meant little opportunity for healthcare professionals to recover from this traumatic period.

"The pressures on the system are not only incredibly frustrating for patients struggling to get easy or quick access to healthcare, but are also extremely difficult for our members. They want to provide patients with the best possible care but tell us they often feel overwhelmed by the many conflicting demands on their time. This is impacting the clinician/patient relationship, and our members often bear the brunt of patient dissatisfaction, which itself can be demoralising.

"We are pleased that the government has committed to publishing a workforce strategy this year as these problems will not solve themselves. It is also key that robust support is put in place at local level to support NHS staff at this incredibly stressful time."

Other findings from the research were:

More than a quarter of respondents (28%) said they used mindfulness and breathing exercises as a coping strategy, up from 16% in an MDU survey conducted a year ago.
Six in 10 respondents (60%) said they took a break by exercising in the fresh air, up from three in 10 (34%) respondents previously.
Nine in 10 (90%) said they felt worn out at the end of a working day and eight in 10 (83%) said they felt burned out.
Six in 10 (63%) said they felt relationships with patients and colleagues had become more strained over the past two to three years.
Around a quarter (23%) had experienced a patient complaint or safety incident with a fifth (20%) experiencing abuse or threats.
Despite this, nine in 10 (92%) said patients and colleagues treated them with respect.

Association of Anaesthetists president Dr Matt Davies said: "We are grateful to the MDU for shining further light on the significant strain being placed on the NHS workforce by the ever more intolerable working conditions. The Association of Anaesthetists have been increasingly hearing this from our members and have also highlighted the problems that fatigue causes in the workplace.

"We are clear that these pressures existed and were growing before the pandemic and have just worsened quicker due to the effects of it. Urgent action is required to address the workforce shortages, workplace conditions and support to staff working in what has been described by many professional organisations as 'unacceptable' environment. The clear link between improving staff health and wellbeing and patient safety cannot be ignored.

"It is no surprise that staff are seeking ways to mitigate the stressful environment but the key is to address the root cause whilst giving staff the time and opportunity to mitigate the effects of the workplace."

What doctors told us

"The system feels broken and patient care is being compromised daily which is very hard to watch with little control over it. It's a constant feeling of not being able to provide the level of care that you want to for your patients." - Anonymous doctor
"Workplace pressures are extreme. I work in A&E it has been bad for years, now the worst ever. Pressures and short staffing are leading to frayed tempers and less tolerance." - Emergency medicine doctor
"I find that increasingly there is a higher level of dissatisfaction from patients. When I see or speak to a patient for the first time at the start of the consultation, I often spend the first few minutes explaining the situation or apologising for delays. This is a necessary conversation, but it reduces the precious time we have to discuss the person's medical complaint. Unfortunately, patient dissatisfaction has also led to increased reports of abuse towards healthcare staff which is upsetting and demoralising at a time when we are working so hard to do the best we can for our patients." - Dr Jenna Fowler, a GP working in Aberdeen and MDU medico-legal fellow
"The stress of working clinically can at times feel unsustainable. Two or three years ago, even on busy on call shifts it was usual to have a short break where you could sit down and grab something to eat. Recently, being on call feels like you are being pulled in a million different directions. Many colleagues I qualified with and worked with in my first two years have taken time out of training or are combining their clinical work with other roles such as teaching and medical writing. Some have reduced their hours to regain a sense of work life balance. It's great to see them feeling happier but illustrates how pressured clinical work is at the moment." - Dr Rachel Stewart, locum hospital doctor and MDU medico-legal fellow

What dental professionals told us:

"Workplace pressures should never be a factor in whether we can treat our patients safely, yet these pressures are increasingly placing barriers in the day-to-day work of dentists around the country." - Anonymous dental professional
"As we couldn't see patients for routine appointments [during the pandemic] they've gone from having stable teeth pre-pandemic to having multiple problems needing treatment or extraction. Understandably some patients are shocked and upset about this and blame us for it. It means that patients who previously were stable now need lots of treatments further adding to the backlog." - Anonymous dental professional
"I use mindfulness in everyday situations to help me be fully aware of where I am and what I'm doing without becoming overwhelmed or overreacting to stressful situations. I use breathing techniques and mindfulness apps. The techniques help me to avoid worrying about things that may or may not happen." - Catherine Hemingway, dentist
"I try to ensure I give myself breaks during the day and avoid the temptation to book patients during lunch breaks or after work. I aim to take a break every couple of hours, take some deep breaths and have a stroll." - Andrew Chandrapal, dentist

Wellbeing resources for MDU members and from the Association of Anaesthetists are available signposting where to get further help.

The MDU surveyed a sample of doctors and other medical professionals (348) and dental professionals (495) in December 2022. The 843 respondents represented a 6% response rate.

Healthcare professionals turn to coping mechanisms to deal with intense workplace pressures, MDU survey finds

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