Burnout: RCEM calls for urgent increase in staffing levels

The Royal College of Emergency Medicine is calling for UK governments to act now to achieve safe staffing levels in Emergency Departments after a workforce survey found that three in five Emergency Medicine staff say they have experienced high levels of burnout, stress, and exhaustion.

The survey found:

  • 73% of respondents indicated workforce pressures in their Emergency Department impacted patient safety before the pandemic.
  • 59% of respondents experienced burnout during the second wave of the pandemic.
  • 59% described their levels of stress and exhaustion from having worked the second wave as higher than normal.
  • In the next two years, 50% are considering reducing their working hours and 26% are considering taking a career break or sabbatical. When asked what prompted them to make this decision, 32% selected workload pressures and 35% selected burnout.
  • In the next six years, trainee emergency physicians are considering reducing working hours (57%), taking a career break or sabbatical (45%), working abroad (36%), and changing specialty (25%).
  • 69% of clinical leads revealed that locums were being used in their Emergency Department to fill permanent posts.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The workforce survey reveals the scale of the problem in the Emergency Medicine specialty with burnout and retention of staff.

“The fact that half of Emergency Medicine staff are considering reducing their hours in the near future and over one quarter are considering taking a career break, is deeply worrying.

“Emergency Medicine has always been an exciting yet challenging career, but the intensity of the pandemic and the current severity of the pressures has exacerbated these challenges vastly and increased burnout and exhaustion among staff, and ultimately discouraged existing staff from continuing their career in the specialty.

“The response from the survey clearly show that operational pressures are seen by staff as the most significant reason for considering reducing hours, changing careers, or retiring early. Therefore, we must make Emergency Medicine a sustainable career and improve staff retention.

“Demand for urgent and emergency care has increased significantly over the past few years, but the workforce has not grown adequately to keep up with this demand. The result has led to an increase in crowding and corridor care, with more delays and more long stays for patients in Emergency Departments, while staff have been spread more and more thinly trying to cope with intense pressures. These factors put huge strains on staff and put patient safety at risk.

“This is not sustainable for staff, and if Emergency Departments must be the safety-net of the system and the place where people go when they have nowhere else to seek treatment, we must be staffed appropriately to deal with that. Our fear is that we are on the brink of a crisis in urgent and emergency care, and fewer staff will be inclined to work in Emergency Medicine and a depleted workforce will be facing higher demand.”

The College is calling for a workforce plan that achieves safe-staffing levels in Emergency Departments; currently the College estimates there is a shortage of between 2000-2500 Emergency Medicine Whole Time Equivalent consultants across the UK.

Dr Henderson continued: “Governments must acknowledge the data and reports that show Emergency Departments across all four-nations are struggling to cope, struggling with performance, and struggling to deliver quick, effective and high-quality care, and take the necessary action to address it.

“We urgently need decisive action and leadership, we must achieve safe-staffing levels in Emergency Departments across the UK, and this workforce must be formed of staff trained and qualified in Emergency Medicine.

“We must see a long-term Health and Social Care strategy that recognises the value of urgent and emergency care and enables high-quality care and performance – this should be done by funding Same Day Emergency Care and Ambulatory Emergency Care, through expanding capacity, funding local health systems, and rigorously determining the effectiveness of NHS 111 and maximising its potential – all these steps must be taken to address the problems facing emergency care.

“We hope that the new Health Secretary will hear our urgent calls for decisive leadership and take swift action to address the challenges facing the Urgent and Emergency Care system and enact our recommendations.”

RCEM launches public appeal to support A&E staff facing stress and burnout

The Royal College of Emergency Medicine is launching a public appeal  to support the mental health and wellbeing of A&E staff after data show that many have struggled with burnout, distress, and other psychological conditions resulting from the stress of the pandemic, further to the continued pressures of their day-to-day work in Emergency Departments.

The NHS entered the pandemic underfunded, under-resourced and understaffed. This meant the severe demands of the ensuing pandemic were faced by the existing but understaffed workforce.

The shortage of health care workers has meant these existing staff have been continually pushed to their limits and beyond. And throughout the pandemic these health care workers have been physically, mentally, and emotionally challenged. Staff have been working with little or no respite in challenging conditions while facing ever increasing pressures.

The Health and Social Care Committee report “Workforce burnout and resilience in the NHS and social care” cites data from NHS Providers that show 92% of trusts raised “concerns about staff wellbeing, stress and burnout following the pandemic”.

A study published in January 2021 found that nearly half of frontline doctors, including those working in Emergency Medicine, suffered psychological distress during the first wave of the pandemic with others suffering from trauma, PTSD and other psychological conditions.

A study from 2019 found that working as an emergency physician is one of the most fatiguing and stress-inducing professions, a result of regularly working shifts longer than 12-hours, struggling to find work-life balance, and burnout. This was recorded prior to the pandemic, during which the pressures on Emergency Medicine staff significantly increased.

Dr John Heyworth, Consultant in Emergency Medicine in Southampton and Chair of RCEM Fundraising, said: “We know that many Emergency Medicine staff are exhausted and facing burnout.

“After 15 months of this pandemic, with waves of Covid causing intense pressures on our overstretched emergency departments, and now a return to high pre-pandemic levels of hospital activity, added to the stress of the threat of a further wave of covid – this is not surprising. But it is deeply worrying.

“We must do all we can to protect and support our frontline Emergency Department staff. Their hard work and dedication throughout this extremely challenging time has been incredible. As ever, they have been on the frontline throughout the pandemic risking their personal health and dedicating themselves to the care of others.

“The public have shown their remarkable support and respect for the health service. And now, we want to appeal to them to support our A&E staff who work 24/7 in Emergency Departments, ready to treat anyone who seeks care.

“When we know that our Emergency Medicine workforce is struggling with exhaustion, burnout, stress and other psychological conditions then we must take action, and they deserve our support.

“RCEM’s Public Mental Health and Wellbeing Appeal aims to raise money to develop and expand the support services offered to A&E staff who may be struggling with mental health conditions including PTSD, stress, burnout and exhaustion.

“The support offered will be guided and dictated by what A&E staff need most so that we can help them in the best way possible.

“RCEM’s goal is to ensure the services and support provided have a positive and lasting impact on the mental health and wellbeing of our frontline A&E workers.”

RCEM Appeal:

 https://www.rcem.ac.uk/RCEM/Get_Involved/Wellbeing_Appeal.aspx

Donate here:

http://www.rcem.ac.uk/RCEM/Get_Involved/Sign_in_for_donations.aspx?f=SPRW