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Covid-19: Doctors feel under pressure to work extra shifts unpaid, survey shows

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1189 (Published 10 May 2021) Cite this as: BMJ 2021;373:n1189

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  1. Gareth Iacobucci
  1. The BMJ

Thousands of doctors feel under pressure from their employers to work extra shifts, often unpaid, to help tackle the backlog of care caused by the covid pandemic, the BMA has warned.

The warning came after results from the BMA’s latest tracker survey showed that more than half its respondents (58%, 2834 of 4876) had worked extra hours in the previous month as part of the response to the pandemic. Almost a third (29%, 1387) said they were not paid for the additional time they worked.

More than two fifths (44%) of respondents (2086 of 4719) said they felt under pressure from their employer to do extra hours in the last month. And more than a third (36%, 1759) had either skipped taking full breaks altogether or taken them on rare occasions in the past fortnight.

Nearly six in 10 doctors who responded (57%, 2889 of 5059) reported a higher than normal level of fatigue or exhaustion because of working or studying during the pandemic.

Chaand Nagpaul, the BMA’s chair of council, said, “To learn that an already depleted and now exhausted workforce feels forced into doing more and more hours, with many reporting higher levels of fatigue than ever, is extremely worrying. It is putting them and their patients at risk. Working ‘flat out’ without a change to rest and recuperate is simply unsustainable and unsafe.

“Far too many colleagues across the NHS are experiencing unacceptable levels of exhaustion while being pressured to work extra shifts, and this needs to be addressed as a matter of urgency. Governments should be doing all they can to ensure staff have an opportunity to rest and reset—no one should feel pressured to take the NHS backlogs on a goodwill basis.”

The Royal College of Nursing, reporting similar findings from a survey of its nurse members,1 joined the BMA in calling for action.

The college’s acting chief executive and general secretary, Pat Cullen, said, “Exhausted health and care staff, without whom we would not have turned the tide of the pandemic, must be supported to recover. Investment in staffing and pay is about both patient safety and the health of our workers.”

The unions urged governments and NHS leaders to be “honest and open” with the public about what the service could realistically deliver, to prioritise protection of the health, safety, and mental wellbeing of the workforce, and to ensure that staff showing signs of stress were able to access rapid referral to an independent specialist service led by occupational physicians.

Governments should also commit additional resources to help tackle NHS backlogs, increase system capacity, and expand the medical workforce, they added.

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