Survey of doctors reveals high levels of exhaustion, stress and little confidence to manage the huge backlog of missed patient care

by BMA media team

Press release from the BMA

Published: Sunday 21 June 2020

The latest results in a series of surveys of doctors by the BMA, during the pandemic, reveals a workforce exhausted and with little confidence that the NHS is coping with the huge backlog of missed, cancelled and postponed care.

There are also very real fears that there is neither the capability nor the capacity to manage a second spike in infection levels if that was to occur.

The latest tracker survey from the BMA of more than 7,000 doctors1 found that 64% said there had been a significant increase in demand for non-Covid care and a fifth of doctors said the levels of demand were higher than before the pandemic began.2

Their optimism at the ability to manage patient demand as the NHS tries to manage the backlog is also very low with just 7% having confidence that their local health economy will be able to manage3. Added to that a quarter of doctors said they’d had no engagement whatsoever from their local health economy about how the increased patient demand will be managed as normal NHS services resumed.<sup4

And on the question of how they would cope if there was a second spike in Covid -19 infections, 50% of doctors said they were either not very or not at all confident.<sup5 This comes as the survey shows a slight increase in the numbers of doctors experiencing stress and, exhaustion and burnout. With 45% saying they are feeling stressed, this is a slight increase on previous results.6

Dr Chaand Nagpaul, BMA council chair, said:

"This is the sixth survey of its kind by the BMA during the pandemic, and as a snapshot it’s clear that the NHS is in crisis and doctors are fearful and exhausted. The NHS was an already beleaguered health service with record waits in A&E and hospital waiting lists before this pandemic began. Since then normal services have been put on hold with resources diverted wholesale to the Covid-19 efforts at the expense of large numbers of other patients.

“The Westminster Government has yet to offer any clarity or action plan of how the NHS in England is expected to manage months of cancelled or postponed care; care to be given by already exhausted healthcare staff. We’ve seen the figures showing more than 2 million people waiting for cancer care alone, with overall waiting lists projected to hit 7 million by autumn.

"Meanwhile the reduction in the Covid alert level from 4 to 3 indicates even more the need for honesty about how the surge in non-Covid care is being dealt with. The Government must have meaningful conversations with frontline clinicians about how we can, together, begin to tackle the backlog. This will require transparency around capacity and the workforce crisis, and the need to invest in infrastructure that can meet the healthcare needs of patients.

“The BMA wants the Westminster Government to publish a credible plan for how the millions of patients awaiting NHS treatment in England in the wake of the Covid-19 pandemic, are going to get that care. In addition, the Association also wants the Westminster Government to bring together health leaders and staff groups to ensure frontline clinicians are leading discussions on how to prioritise the most urgent cases and how that will be resourced.”

Ends

Notes to editors

  1. 7,497 (5,955 in England) doctors took part in the survey between 16 and 18 June.
  2. When asked: “Over the last week, what change, if any, have you experienced in the level of demand for non-Covid patient care? 21% said it was back to pre-March level of demand, 43% said there had been a significant increase, but at lower level than pre-March and 19% said a slight increase
  3. How confident are you about your ability to manage patient demand as normal NHS services are resumed?” 20% of respondents said “not at all confident” and 33% said “not very confident” with regard to their own practice or department. For the local health economy, these figures were 22% and 39% respectively, and for community settings 22% and 44%
  4. When asked, “What engagement, if any, has there been with you in your place of work / your local health economy, around how the increased patient demand will be managed as normal NHS services are resumed?” 10% said significant involvement, 40% some involvement and 25% none.
  5. When asked, “How confident are you about your ability to manage patient demand if there is a second peak of Covid-19?” 19% were not at all confident, 31% were not very confident and 36% were slightly confident.
  6. When asked, "During this pandemic, do you consider that you are currently suffering from any of depression, anxiety, stress, burnout, emotional distress or other mental health condition relating to or made worse by your work?" 32% said yes, and worse during this pandemic than before, with another 13% saying yes, but no worse than before the pandemic
  7. Read the recent BMA paper “In the balance: Ten principles for how the NHS should approach restarting ‘non-Covid care’” here.
  8. The BMA believes the following must be priorities for the Government in addressing the NHS backlog:
  • Transparency: Comprehensive data on healthcare demand, population health and workforce must be rapidly collated and published to inform planning in the months ahead. This will include up-to-date data around waiting lists as well as the prevalence of certain conditions and health inequalities.
  • Capacity: The NHS redistributed capacity to care for Covid-19 patients during the peak of the pandemic, but at the expense of other treatments and services. The Government must commit to giving the NHS whatever resources it needs to tackle the backlog as well as the capacity it needs to meet demand in the long-term.
  • Workforce: Additional physical capacity only works if there are staff to provide care – and the system has so far relied on doctors working above and beyond to meet Covid-19 demand. Efforts must be taken to retain, support and protect the valuable staff who have given their all in fighting the pandemic, prioritising their wellbeing and mental health.
  • Learning: Services have been overhauled in the response to the crisis, and the NHS must keep the positive changes for the long-term while ditching unnecessary, outdated systems in other areas. A key element of this will rely on IT functionality.

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