Rota gaps: a pressure point driving new stresses for NHS staff and managers

Consultant NHS doctors are choosing not to take up extra shifts for fear of the high pension tax bills they will incur and the severe pressures they face at work, leading doctors have warned.

Adrian Boyle, president of the Royal College of Emergency Medicine, told The BMJ that emergency departments throughout the country were seeing an increase in rota gaps as the demand for care outstripped the number of doctors and that staff were reluctant to pick up additional hours. As of September 2022 more than 9000 medical posts in secondary care were vacant in England.1

“The conditions are pretty tough, and people have found clinical work sometimes quite overwhelming, particularly over December,” said Boyle. “It didn’t feel like a nice working environment for lots of reasons, but it was largely the overcrowding and the lack of space in departments that made it very difficult. So, you can understand why people would not want to do extra work or sign up for locum shifts.”

He added that a “lack of joy in work” due to the intense pressure was coupled with the worry that if staff took on extra …