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Launch of new project calls for solutions to NHS challenges amid fears of unsafe care and blame culture

Doctors are increasingly expected to provide patient care in unsafe environments, where a persistent culture of blame stifles learning and discourages innovation. They believe patient services have worsened and national targets are prioritised over the quality of care.

Today, (Thursday 20 September) the BMA publishes the first phase of a major project¹, ‘Caring Supportive, Collaborative,’ aimed at finding solutions to the challenges faced by the NHS.

Launched in early 2018, the project is engaging doctors across the UK in an open conversation about their daily working experiences and what they want the NHS to look like in the future.

Over recent months, almost 8,000 doctors - junior doctors to GPs and hospital doctors - have provided their accounts of working life across the NHS in a major survey conducted by ICM on behalf of the BMA. The results are stark: they show the damaging impact of asking doctors to provide care without enough funding, staff, beds or equipment to meet the needs of patients. Adding to this, the results suggest that poor lines of communication and organisational divisions between general practice and hospitals is undermining patient care. A lack of IT support is holding back efforts to encourage collaboration and greater innovation in our health services.

This, doctors say, is contributing to a vicious cycle of low morale, doctors leaving the NHS, an inability to recruit and widespread vacancies which go unfilled.    

The Project is the brainchild of BMA Chairman, Dr Chaand Nagpaul.

He said: “It is vital that the Government and policy makers heed the views of all doctors who provide care at the coalface; they are in the best place to know the problems the NHS faces on a daily, hourly basis. They know the scale of impoverishment in the NHS is staggering. They are working in a culture which has improved little since the publication of the Francis and Berwick reports following the tragedies in Mid-Staffordshire five years ago.

“Doctors experience challenges of trying to provide safe patient care when there is poor staffing, gaps in rotas, lack of adequate facilities and where a persistent culture of blame stifles learning and improvement. 

 “The BMA’s Caring, Supportive, Collaborative project aims to understand and find solutions to these challenges. “

The survey also reveals that ninety-five per cent of doctors are fearful of making a medical error and that the level of fear has increased over the past five years.  Nine out of ten doctors say one of the main reasons for making errors is pressure and lack of capacity in the workplace.

As well as a culture of fear and blame, the survey also showed that Black and Asian Minority Ethnic doctors remain disadvantaged by the NHS. Only half of BAME doctors feel respected or culturally included in their place of work. They talked of experiencing unconscious racism in everything from job progression to training and patient interaction.

 Dr Nagpaul said: “BAME doctors make up more than a third of the medical workforce and play a vital role, day in day out, delivering care to patients across the country. Yet despite their commitment they’re more likely to face referral to the General Medical Council, are more likely to have their cases investigated and are more likely to face harsh sanctions following an investigation. Only 7 per cent of very senior managers are from BAME backgrounds.

“BAME staff in the NHS workforce as a whole are more likely to experience bullying, harassment or abuse from other staff. Differential achievement in exams and poorer career progression are another worrying factor, and with independent research showing that this is not related to any lack of ability. In the 21st Century, that is not acceptable.”

The purpose of the Caring Supportive and Collaborative project is to ensure that the voices of doctors from all disciplines and backgrounds are heard by the NHS, regulators and the Government as the future sustainability of the NHS is considered and planned for.



The BMA is a trade union 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.

1.       More details about the Caring Supportive and Collaborative project can be found here and the full report will be available on the BMA website at 0900 Thursday 20 September.

2.       You can request a copy from the BMA Press Office - Tel: 0207 383 6448.  Email: [email protected]