At a time when the NHS is under-resourced, over-stretched and is facing recruitment and retention problems, it is vital that the health and wellbeing of staff is prioritised.
Keeping doctors healthy will have important benefits for the NHS by improving staff engagement, reducing costs associated with absence and turnover and improving patient outcomes.
Our 'Supporting health and wellbeing' report is based on evidence from a BMA member survey looking into doctors' experiences with occupational support services. It focuses on the issues that junior doctors face, while taking a broad view of the challenges confronting the wider NHS workforce and identifying areas of improvement.
Download the report
Quality of care is paramount
The NHS has to ensure that the health and wellbeing of the workforce is supported on an individual and systemic level in order to ensure the highest quality care to patients.
NHS staff sickness absence rates are double the national average
This places major burdens on the NHS and staff in terms of cost, continuity of care and overwork in an environment where long working hours are widespread. On top of which, doctors frequently attend work in ill health.
Equal access to support services is critical to support doctors’ health and wellbeing
Doctors are under very specific pressures and support services across the country are disjointed, giving varied levels of support in different areas. Any good practice is rarely shared. In summary, there is an inequality of access to health and wellbeing services for doctors that must end.
Doctors are not aware of support services available to them
Our research found that only half of doctors were aware of any services that support them with physical and mental health problems. While nearly one in five said that no services were available, a large minority (33%) said that they did not know if they were. In addition, only 27% were very or quite confident that if their physical or mental health was suffering due to work their employer would provide help and support.
Employers can do more to prioritise doctors mental and physical support
Employers should build a supportive culture, tackle the stigma around accessing support services and ensure that services are holistic and comprehensive.
Better access to occupational health services
- Staff should have access to a specialist-led occupational health (OH) service
- Occupational health services should be free, comprehensive and meet the individual needs of doctors working across all settings
- Access to OH services should be consistent across the country and easily accessible for all doctors
- Staff need to have timely access to assessments to prevent delays in training
- OH services need to be adequately funded in order for staff to deliver high-quality services
- It is vital that OH services are confidential to avoid discouraging staff from seeking early help and advice
- There needs to be better funding and support for doctors with disabilities who need specialist equipment to do their jobs
Improving health & wellbeing support services
- Trusts/health boards should review current funding and commissioning of health and wellbeing services to ensure that they meet the needs of the medical workforce
- There needs to be sufficient flexibility in any service to accommodate doctors’ working patterns and rest times (for example, access to gym, canteen, 24 hour access to food)
- Health and wellbeing support services must be more widely promoted by NHS organisations (for example via inductions)
- There are pockets of good practice where trusts have worked with staff to develop and implement health and wellbeing strategies, this learning should be shared across all NHS organisations
Supporting line managers
- Line managers should be supported to handle health and wellbeing issues, through training and education opportunities
Building a culture of care
- Staff health and wellbeing improvement strategies need to be holistic and bring together the provision of OH services, wider non-OH health and wellbeing support services and initiatives that will have a positive impact on staff health
- In order to ensure that health and wellbeing strategies meet their needs, staff should be encouraged to be involved in their design and implementation
- In order to encourage staff to access services at an early stage of their condition, employers should tackle the stigma that surrounds accessing support services and foster a no-blame culture
- Employers must give priority to staff health and wellbeing and provide leadership on the subject
- Trusts/health boards should have appropriate health and wellbeing policies in place, including NICE guidance, and ensure that these are implemented consistently
- NHS organisations would benefit from collecting and analysing information about the extent and causes of staff ill-health in order to monitor improvement
The BMA guide to raising concerns provides practical guidance for all doctors on how to raise concerns and clarifies contractual entitlements.
- Freedom to speak up guardians act as an independent and impartial source of advice to staff who can raise concerns about anything that is harming healthcare services such as unsafe patient care, unsafe working conditions, inadequate induction or training or bullying.
- Local negotiating committees are another mechanism to raise issues at a high level with Medical Directors/Heads of HR. Find out more about how to get involved with your LNC.
- Local medical committees act as a source of support and help with mediation. Find out more about how to get involved with your LMC.
Junior doctor contract 2016
- Exception reporting allows doctors to quickly flag up work that has varied from their agreed work schedule. The BMA has produced a guide for junior doctors on how to raise concerns.
- Junior doctor forums provide advice to the guardian of safe working hours and provide a platform for voicing concerns to management. The BMA has produced a guide on the role of junior doctor forums.
- Guardians of safe working hours help resolve issues related to working hours for the junior doctors employed by it. The BMA has produced guidance for doctors undertaking this role.
Junior doctor contract 2002
- Rota monitoring helps trainees check that they are on the correct banding allocation and that they are complying with regulations on contracted hours, hours worked, and rest requirements. The BMA has produced a guide on rota monitoring.
- There are some national variations in juniors contracts, read more about your nation: England; Scotland; Northern Ireland; Wales