A new survey from the BMA shows that 7 in 10 (71%) junior doctors in England have gone to work despite not being well enough to perform their duties, in the last 3 months alone. The BMA says that this is a sign that junior doctors are not being valued, as junior doctors are currently being balloted on industrial action.
The figures from the BMA's latest survey of junior doctors in England showed that more than three-quarters of respondents (78%) felt unwell as a result of work-related stress in the last year, and that the vast majority of junior doctors (81%) who took part in the survey reported that their health and wellbeing had worsened, or not improved, since December 2021.
Last year a General Medical Council (GMC) study reported that doctors were experiencing workplace burnout at the highest ever levels recorded, with findings from the regulator’s 2022 National Training Survey having revealed that 39% of junior doctors reported experiencing burnout to a high or very high degree because of their work, which was up six percentage points on the previous year’s survey.
One anonymous junior doctor told the BMA: "I became a doctor to help people but the current state of the NHS is preventing staff like me from providing the standard of care we have been trained to give and that we think patients deserve. I have come into work when ill because I know my trust is understaffed and I want to keep patients safe."
A BMA spokesperson said: "The continued decline in junior doctors' wellbeing reflects the BMA’s longstanding concerns that hospital trusts in England are failing in their duty of care to junior doctors."
Trusts Failing to Provide Bare Necessities
In its survey, the BMA identified that trusts were failing to provide some basic necessities - such as proper rest facilities and hot food for junior doctors working out of hours. More than 1 in 4 (27%) junior doctors said that they had no access to any form of rest facilities, while almost 3 in 5 (58%) did not have access to catering facilities with hot food.
"When you're covering so many patients in a day, hungry and with no breaks, you simply can't do a good job by them. The conditions we're working in make it a daily battle to keep patients somewhat safe," said the anonymous junior doctor.
Dr Robert Laurenson and Dr Vivek Trivedi, BMA junior doctors committee co-chairs, said: "No doctor deserves to work in horrendous conditions while not being valued or supported to do their job properly. Continual devaluing of their lifesaving work will drive more junior doctors away, and the vicious cycle of staffing shortages will continue."
The BMA survey of junior doctors in England was carried out between November and December 2022, and part two of the survey focused on wellbeing, workload, culture, and comparators. Other findings included:
- 73% said they 'always or frequently' work in understaffed rotas
- 59.5% said that morale was very low/negative or low
- 51% expressed that their desire to work in the NHS in the next 12 months was very low/negative or low
- 38.1% said they were never or rarely able to take breaks
Previously, the BMA poll of junior doctors last year found that 4 in 10 of those surveyed said that they planned to work outside the NHS, and a third of respondents said they were planning to take their skills abroad in the next 12 months. Of the junior doctors who were thinking about or planning to leave the NHS:
- 85% cited level of current pay
- 83% cited pay erosion since 2008-09
- 79% cited a below inflation pay award in 2022-23
- 83% cited deteriorating working conditions
Pressures Putting Doctors' Health 'at Serious Risk'
The latest findings come as the BMA ballots junior doctors in England for strike action over their pay.
The Government's deadline to meet the BMA's demands expired on 30 September 2022, and consequently on 9 January 2023, the ballot for industrial action opened, and will close on 20 February.
The BMA is calling for full pay restoration to reverse the steep decline in pay faced by junior doctors, which it says "has been cut by 26.1% in real terms since 2008/09", an agreement on a mechanism with the Government to prevent any future declines against the cost of living and inflation, and reformation of the DDRB (Doctors' and Dentists' Review Body) process so pay increases can be recommended independently and fairly to safeguard the recruitment and retention of junior doctors.
If the ballot is successful, junior doctors in England will walk out for 72 hours in March. The 'full walk out' will mean junior doctors in England will not provide emergency care during the strike if a majority of union members vote in favour with at least a 50% turnout.
The BMA said that there is "no option left" than to ballot junior doctors in England for strike action, with patients suffering, staff exhausted, and the Government preferring to treat the public as "fools" with assurances that the NHS has all the resources it needs.
"Without fair pay, the NHS will lose doctors, resulting in longer waits for patients, and even more pressure on the staff that remain," the BMA warned.
"This Government needs to stop pretending that the pressures we're seeing this winter isn't a crisis of their own making,"said Dr Laurenson and Dr Trivedi. "Failure to resource and staff the health service properly is not only threatening patient safety, but is also putting junior doctors’ health at serious risk," they remonstrated.
"Like so many of my colleagues, I do question whether it is worth staying in the NHS, as the current situation is totally unsustainable," said the anonymous doctor despondently.