Exhausted doctors and nurses feel forced to work overtime in Wales according to unions
BMA Cymru Wales and Royal College of Nursing Wales have raised concerns that hundreds of doctors and nursing staff in Wales say they feel under pressure from employers to work extra shifts, often unpaid
Some doctors say they are already exhausted and despite agreements in place, fear that they will be pressured to doing extra shifts without adequate rest to help reduce the huge backlog of patients needing treatment in NHS hospitals.
The latest BMA ‘tracker’ survey1 revealed that over half of the doctors surveyed in Wales had worked extra hours (53%), with a quarter of them (26%) reporting that these hours were unpaid. Over a third (39%) of the doctors who responded felt pressured by their employer to do extra hours, and over a third (36%) had either skipped taking full breaks altogether or taken them on rare occasions. This has left staff exhausted with over half of doctors reporting a higher than normal level of fatigue or exhaustion.
These experiences are also echoed among registered nurses (RNs) and health care support workers as figures from the Royal College of Nursing’s survey of members’ experience. In the RCN employment survey 2019, 76% of respondents in Wales reported working overtime at least once a week. Of this the majority worked between one and four hours extra a week. Based on working an additional two hours a week, RCN Wales was able to determine nurses give NHS Wales an estimate of 34,732 additional hours of work every week. This equates to 926 full-time nursing posts.
More recently, a 2020 survey noted that 30% of members felt they were working longer hours compared to before the COVID-19 pandemic and 76.6% revealed their stress level had worsened since the beginning of the COVID-19 pandemic. The combination of increased stress levels and rise in additional hours is not sustainable and could have a long lasting negative impact on the retention of the workforce.
Dr David Bailey, BMA Cymru Wales council chair, said: “We are truly concerned to hear that so many doctors are feeling forced into doing extra hours, with many reporting higher levels of fatigue than ever. Not only is this dangerous – putting themselves and their patients at risk – it is also unsustainable.
“The future Welsh Government must address this as a matter of urgency. Staff must have an opportunity to rest and reset - no one should feel pressured to tackle the NHS backlogs on a goodwill basis.”
Royal College of Nursing Wales Board Chair Richard Jones MBE said: ‘Our members are absolutely exhausted. They have been exceptional during this pandemic. They have paused their studies, opted out of retirement and have been retrained and redeployed to help the nation fight coronavirus and stay healthy. They are tired and must be supported physically and mentally.
Nursing professionals are health care’s biggest and best resource. Nurses cannot endure pre-pandemic conditions including increased pressure, understaffing and lack of investment. We want to see an extension to Section 2B of the Nurse Staffing Levels (Wales) Act 2016 to all clinical areas.”
As lockdown restrictions begin to ease across Wales, BMA Cymru Wales and RCN Wales want to ensure that the future Welsh Government does not rely on the goodwill of NHS staff to deal with current backlogs. Instead the new Welsh Government should look to ensure that services resume in a way that is safe for both patients and those providing care. To do so, the Welsh Government and system leaders must start having an honest and open conversation with the public about what the NHS can realistically deliver so that an accurate expectation is set. The future Welsh Government must also commit to developing a robust plan, which addresses actions outlined in the BMA’s Rest, recover, restore report4 and the RCN’s Principles for return to service – staff recovery and patient safety5, including:
- Prioritising protecting the health, safety, and mental wellbeing of the workforce
- Providing the service with additional resourcing dedicated to helping to tackle NHS backlogs
- Ensuring that staff with signs of stress have access to a rapid referral, including self-referral, independent specialist occupational physician-led service
- Expanding the healthcare system’s capacity
- Putting measures in place expand the medical workforce
Notes to editors
The BMA is a trade union and professional association representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- BMA COVID-19 survey April 2021,
57% described higher than normal levels of fatigue or exhaustion from working or studying during this pandemic
53% said they undertook additional hours' work over and above their contractual requirement as part of the response to Covid
26% said these additional hours were unpaid
39% said they felt pressured by their employer to work additional hours
36% said that they took breaks in full either never (14.72%) or rarely (21.30%) - BMA Rest, recover, restore: Getting UK health services back on track
- Royal College of Nursing Principles for return to service – staff recovery and patient safety