Tangible positive changes are needed across the NHS to protect the wellbeing of junior doctors and secure the long-term future of the medical workforce, a BMA Scotland report, published today, has revealed.
Junior Doctors in Scotland are working long hours as the NHS attempts to recover from the COVID-19 pandemic, with a lack of rest facilities and a limited approach to flexible working, with concerns raised around personal safety and the safety of their colleagues whilst working long shifts. Many do not feel supported by their employers when it comes to their wellbeing and say a transformational change in workplace culture is desperately required.
A recent snap survey of junior doctors within BMA Scotland found that:
- Almost three quarters - 71% - do not feel supported by their employer in relation to their wellbeing
- 75% said working four or more consecutive long shifts left them feeling exhausted or short of sleep when at work, to a very high or high degree - with long shift being defined as a shift lasting 10 hours or longer in duration.
- Half of those who responded reported their current rota contained four consecutive long shifts - with 18% having more than four consecutive long shifts in their current rota.
- More than 50% stated on a typical shift they "never" or "rarely" get to take at least 30 minutes' continuous rest after approximately four hours duty, without interruption.
- And more than three quarters reported they felt concerned for their personal safety, or that of their colleagues, whilst working long shifts "often" or "sometimes" - with only 5% saying never.
Alisdair Gilmour, chair of the BMA’s Scottish Junior Doctors Committee, said: "Even before the COVID-19 pandemic BMA Scotland had already reported that junior doctors in Scotland were under pressure and concerns were growing for their wellbeing and work-life balance. They were at risk of burnout from very early on in their careers and urgent action was needed to improve their working lives.
"Life during the pandemic has only amplified this and many junior doctors are considering how their work impacts upon their personal lives and whether they are able to achieve the work-life balance they need. Working conditions need to improve and junior doctors need to feel valued by both their employer and the Scottish Government alike. It is deeply concerning that almost three quarters of those who responded to our snap survey do not feel supported by their employer when it comes to their wellbeing, and that must be addressed urgently.
"It can come down to the simplest thing: ensuring juniors receive their rotas on time for example – at least six weeks in advance – which still not does happen consistently across all health boards. Yes, it may seem like a small thing, but a delayed rota has a detrimental impact on juniors who are not able to make plans to see family and friends – something which can hugely affect your mental wellbeing. Ensuring rest facilities are provided for staff, particularly overnight and post-shift for those too tired to drive home, would go a long way towards ensuring better wellbeing and social support among junior doctors.
"By protecting the health and safety of staff, you are in turn protecting the health and safety of patients, by allowing your workforce to adequately rest, reducing fatigue and improving wellbeing.
"Colleagues have told BMA Scotland they are concerned for their health and personal safety, or that of their colleagues, whilst working long shifts – this cannot go on. Working consecutive long shifts further increases the risk of fatigue; the more long shifts you do, the higher the risk – and half of those who responded to our survey currently have at least four consecutive long shifts in their rota.
"In recent years there has been progress made towards safer working hours and patterns for junior doctors in Scotland – however more can, and must, be done to minimise the detrimental effects well evidenced and associated with shift work and fatigue. The recent Scottish Government NHS recovery plan acknowledges that the NHS is struggling and the requirement to put the wellbeing of staff first. However, it does not feature any plan to retain current staff or build the workforce needed for the future – and that is worrying for junior doctors.
"We are asking for tangible changes to working life for junior doctors across Scotland to address this key issue of wellbeing as we recover from this pandemic. To preserve the future medical workforce, we need to evolve – and a transformational change in workplace culture is desperately required."
Notes to editors
We received 185 responses to the snap survey.
Other key issues juniors raised in the survey include:
Addressing the pressing issue of fatigue for junior doctors and managing it effectively through:
- maximum four consecutive long shifts
- protected time off and bleep-free policy during breaks
- better rest areas
- improve awareness of the effects of fatigue
- include doctors' wellbeing in induction programmes
Improving work-life balance by:
- removing barriers to taking annual leave when it is needed
- receiving rotas at least six weeks in advance
- ensure all junior doctors can request leave in advance, with a guarantee it will be acknowledged and honoured unless there are exceptional circumstances
- ensure all junior doctors have adequate time for study, research, clinical/non-clincal admin time etc.
- ensure all junior doctors can work LTFT if they wish
- explore options for junior doctors to work flexibly where appropriate.