Doctors require respite

by Chaand Nagpaul

Exhausted doctors need to rest and recover to meet the challenges of the backlog crisis in the NHS

Location: UK
Published: Thursday 1 April 2021
Chaand Nagpaul

As the vaccination programme in the UK continues its rapid and successful roll out, with infection rates and hospitalisation reducing, we have been provided with a spark of hope that there may finally be an end to the relentless stranglehold which COVID-19 has had on our nation.

However, while it seems that we may be over the worst of the crisis caused by the virus, the NHS is facing a new crisis of an unprecedented backlog of care accumulating from millions of patients who could not receive care in the past year.

An estimated three million fewer elective treatments occurred last year than usual, while there have been fewer 22.1 million outpatient attendances. There are a record 4.6 million people waiting for operations. 340,000 patients have been waiting more than 12 months for treatment, compared to just 10,000 in August 2019.

These are patients who have already suffered the distress of long delays, and whose health may deteriorate further unless they are given the care they need.

However, the past 13 months have left the medical profession physically and mentally exhausted, and it would be neither sustainable nor realistic to expect doctors to tackle this huge backlog of care without some respite.

Indeed, the latest BMA COVID tracker survey leaves no illusions about this – key findings include that:

  • 41 per cent of doctors are suffering from depression, anxiety or another mental health condition which has worsened since the start of the pandemic
  • 59 per cent say that their current level of fatigue or exhaustion has been higher than normal during the COVID crisis
  • Over half of doctors said that their health and wellbeing is worse now than during the first wave.

This survey also laid bare the reality that doctors who are pushed beyond their limits will see little option but to reduce their hours or leave the NHS:

  • 26 per cent of doctors feel it is ‘more likely’ that will seek to take early retirement in the next 12 months as a result of the pandemic
  • The same number say they are more likely to take a career break
  • Almost a fifth of doctors are considering leaving the NHS for another career altogether.

Such an exodus of experienced doctors could have a catastrophic effect on an NHS already facing extreme workforce shortages and poses a real threat to the nation’s health.

In light of this the BMA  has recently published a report, Rest, recover, restore: Getting UK health services back on track, which sets out five recommendations for UK governments and NHS providers to ensure doctors are given adequate time to recuperate from the tremendous personal toll which the pandemic has taken on them:

All governments and system leaders across the UK to have an honest conversation with the public about the need for a realistic approach to restoring non-COVID care, and support for systems to tackle the backlog

  • Greater clarity must be given on what expectations will be placed on the NHS and public health for restoring services, tackling backlogs and managing waiting times
  • Support must be provided to local systems to develop COVID recovery plans
  • NHS leaders must avoid using crude targets for returning to pre-pandemic levels of activity.

Health, safety, and mental wellbeing of the workforce to remain a top priority

  • All healthcare workers must be permitted to take leave and given sufficient rest breaks and time off between shifts
  • Occupational health assessments must be made available, timely and accessible to all staff working in primary and secondary care, and support must be provided for NHS staff with long-COVID
  • A move away from the use or appearance of the politically charged word “resilience” across NHS organisations.

Additional resourcing to help tackle the backlog

  • A £6.5bn investment to tackle the backlog of maintenance costs across the NHS estate
  • A rapid expansion of diagnostic services in the community for use by both hospital clinicians and GPs
  • Investment in core IT and hardware systems to improve efficiency and enable remote and flexible working.

Measures to expand system capacity

  • A move to rapidly expand diagnostic services within the community, to be accessed by both hospital clinicians and GPs. This must be underpinned by digital interoperability and data sharing across providers
  • Governments must ensure social care packages are in place to enable patients to be discharged safely from hospital
  • Dedicated staff should be employed to prevent doctors being diverted towards administrative duties.

Measures to retain doctors and expand the medical workforce

  • Arrange for a significant pay uplift for all doctors across the UK, and remove punitive rules around pensions taxation
  • Ensure that flexible and remote working is accessible
  • Simplify processes for staff such as retired doctors, refugee doctors and international medical graduates seeking to join or re-join the workforce.

Our report highlights that the NHS is staffed by people, not indestructible and implacable superheroes who only require the encouragement of the occasional round of applause to keep going. It is vital the Government grasps that investing in the wellbeing of doctors is key to tackling the inordinate challenges ahead.

As doctors, we continue to do our duty in caring for and looking after our patients. We only ask that the Government now does its duty to us.

Chaand Nagpaul is BMA council chair