Dame Denise Coia*, former Chair of Healthcare Improvement Scotland, is co-chairing a UK-wide review into mental health and wellbeing for doctors and medical students alongside Professor Michael West, commissioned by the GMC in 2018. In this blog she outlines the importance of the review and why its co-chairs are still keen to hear more from across the profession.
It’s well known that we are facing pressures in our healthcare system that are having a very significant impact on wellbeing and job satisfaction among UK doctors. In the face of a workload that is ever increasing in both quantity and complexity, the GMC’s annual State of Medical Education and Practice report found over two-thirds of doctors are working beyond their rostered hours on a weekly basis. This has led to 60% of doctors experiencing a worsening work life balance over the past two years.
That is why Michael West and I are co-chairing this review. We want to better understand the circumstances behind poor mental health and wellbeing at work and identify the crucial interventions needed to make a difference, not just for doctors but for medical students as well.
And we are keen to focus on changes that will tackle the root causes of workplace stress, not just the support services that help doctors to manage stress, although of course those can be helpful.
To do this as effectively as possible we have been seeking the views of doctors and medical students across the UK. But if you’ve not given us your view yet then there’s still time.
Medicine is stressful, and has always been stressful, and that stress is felt by doctors at all stages of their careers. However, advances in medicine, increased expectations and an ageing population all mean greater demand and complexity.
The healthcare system is under ever-increasing pressure, that means new challenges for all. Indeed, a recent NHS staff survey found that almost 40% of staff felt unwell due to workplace stress.
We’re looking at whether the causes of stress differ across the four UK countries, at varying stages of a doctor’s career and in different specialties. To do that we need to hear from a wide variety of doctors who are at different stages of their working lives.
We’ve met organisations and individuals, throughout the UK, to gather feedback and hear as wide a range of views as possible on the changes that can improve the wellbeing of doctors and medical students. The conversations have struck a chord with us.
We’ve heard that doctors find it difficult to arrange time off work for important life events, to get proper amounts of sleep and to take breaks. When it comes to breaks and rest, simply making adequate provision of physical space is fundamental to make sure doctors are in the best frame of mind to face the challenges of a highly demanding career.
As well as this we need to look at workload and management. Doctors work in an increasingly regulated environment, many dealing daily with risks that can mean life or death. They need effective inductions, structured supervision and manageable workloads to support them to manage those risks and to safeguard their own wellbeing. Managers need to empower their teams to work with agreed levels of autonomy and make sure that new starters are properly inducted and supported.
In the past, reviews have focused on improving healthcare systems, and many of those changes have brought about important benefits, but some have also introduced increased challenges for the medical professionals who are critical to the delivery of healthcare. It is time to focus on supporting those medical professionals, and our review is doing just that.
There are a number of initiatives in place that are already making a difference, such as the BMA’s fatigue and facilities charter, but more is needed.
We need to make medicine something to aspire to again. To do this, we need to create environments that are constructive and supportive, challenge cultures where people are afraid to speak out due to stigma and perceived career implications, and champion fairness, equality and inclusion.
If you’re a doctor or a medical student reading this I encourage you to take the time to engage with us and make your voice heard. By sharing your experiences you can help us find common themes and areas to target.
Change cannot happen without you. We need examples of the things that have made a difference to your wellbeing at work or in training.
Please send your thoughts to firstname.lastname@example.org and lend your voice. With this review we can care for the doctors that are caring for patients.
* Dame Denise Coia has unfortunately had to step down as Co-Chair of our UK-wide mental health and wellbeing review, due to ill-health. Fellow Co-Chair Professor Michael West will now lead the review until its conclusion.