Intended for healthcare professionals

Practice Practice Pointer:

Supporting healthcare workers with work related stress

BMJ 2022; 379 doi: (Published 16 November 2022) Cite this as: BMJ 2022;379:e070779
  1. Lara Shemtob, academic clinical fellow in general practice and occupational physician12,
  2. Larissa Good, core trainee in anaesthetics3,
  3. Mark Ferris, consultant occupational physician4,
  4. ,
  5. Kaveh Asanati, consultant occupational physician and professor of occupational health12,
  6. Azeem Majeed, GP and professor of primary care and public health12
  1. 1Department of Primary Care and Public Health, Imperial College London, London, UK
  2. 2National Institute for Health Research Applied Research Collaboration Northwest London, Imperial College London, London, UK
  3. 3Southmead Hospital, Bristol, UK
  4. 4Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to: L Shemtob lara.shemtob{at}

What you need to know

  • Work related stress is an important problem in the NHS workforce. Addressing the underlying cause, which may relate to factors such as workplace demand, relationships, and support is necessary for sustained recovery and full engagement with work

  • Healthcare workers may experience guilt or shame due to stigma, preventing them from seeking help if they experience work related mental illness.

  • Time off work and workplace changes to control the triggers may be necessary to allow recovery and sustainable return to work

  • Healthcare workers experiencing work related stress can seek support from colleagues, their own GP, occupational health, and specialised services for healthcare workers such as local mental health and wellbeing hubs and NHS Practitioner Health

A registrar notices that a foundation year two doctor on her team has become withdrawn. He is cynical and hostile in conversation but seems to need more support in basic tasks, frequently asking her to double check his prescribing. Work has been chaotic for everyone, and she is beginning to find his slow pace frustrating.

Two months later, he presents to his GP with sleep disturbance, dreading work, and feeling constantly on edge. He has been this way for weeks but felt afraid to ask for help. He thinks he needs time off work but is worried about letting his team down. He felt exhausted after four months of rota gaps when he couldn’t get enough time off. Demands seem insatiable with a constantly bleeping pager, strained relationships with seniors, and a feeling that he has no control over his workload.

We can all support colleagues with work related mental illness—whether as a colleague, manager, or simply as their GP. Observational studies globally suggest that around 30-50% of the healthcare workforce have experienced work related stress or burnout in the past three years.123 …

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