Doctors buckling under workload warns leader
BMA chief says patients are suffering as pressures lead to stress and burnout
DOcTOrS in Scotland are suffering “stress and burnout” as growing NhS workloads take their toll, medical leaders warned yesterday. The “inexorable rise” of management has also come under fire from Dr Brian Keighley, chairman of the British Medical Association in Scotland, who said doctors had to be listened to more.
he said the NhS was struggling to deal with the pressures of an ageing population, Westminster-led funding cuts and rising expectations from patients which include a shift towards a seven-day-work- ing week in hospitals. Dr Keighley said that despite the Scottish government protecting the NhS in Scotland from the austerity cuts seen south of the Border, doctors still faced growing financial constraints.
he warned that the fall in hospital bed numbers over a period of years was
leading to a rise in waiting lists and more pressure on scotland’s Accident and emergency departments.
the crucial contact between doctors and patients had particularly suffered, Dr Keighley warned in his new Year message. He said: “Reports of stress and burnout amongst all grades of clinical staff are now emerging across the service.
“An ageing population, increasingly sophisticated technology and pharmacology, legitimate rising expectations from patients and their families, the expectation of consistent levels of patient care over all seven days of the week and faster access to treatment are all pressures with which the scottish Government and its 14 health boards have struggled over the past year.”
the “inexorable rise of managerialism” in the nHs had been a “major cause of dysfunction”, he added, and there was a need to return to clinical priorities.
in his message, Dr Keighley said: “i disagree with suggestions that managerial and process change holds the solution to sustaining high quality care and believe instead that it is only by working with doctors and other healthcare professionals that a solution will be found.
“the steady reduction of hospital beds contrary to medical advice and without a wider whole-system approach, has led to the inevitable but predictable assertion that it is an intrinsic lack of capacity which has resulted in rising waiting lists and pressure on accident and emergency over recent years.”
new contracts were now being proposed for doctors, along with “radical” changes to training and greater weekend working and Dr Keighley insisted doctors were ready to look at new ways of working to improve patient care.
But he said any overhaul of the current system should only take place when there was a “clear indication that these changes will produce sustainable benefit and not merely shuffle the deckchairs”.
He added: “there is already a danger that the existing workforce is limited in its ability to generate and deliver solutions because of exhaustion with current arrangements.”
A recent BMA survey of doctors found eight out of ten believed the pressure of their work load was “high” or “very high”.
the doctor’s concerns follow a report by nursing leaders which found many nurses are forced to work unpaid overtime to meet patient needs. A majority of nurses say they think patient care is suffering because of the pressure they are under.
Labour in scotland has called for a review of nHs provision after it emerged that several hospitals operate a skeleton staff cover at weekends, although the scottish Government has set out plans for more of a seven-day operation.
Labour’s health spokesman, neil Findlay, said: “the picture painted by the BMA will be reflected in patient experiences and it is not a good one.”
the nHs in scotland has been protected from the worst of the austerity cuts and still enjoys a record budget of £11.8 billion. Between 2010-11 and 2015-16 the resource budget will have risen by 2.1 per cent in real terms.
Last night, a scottish Government spokesman said waiting times and waiting lists are close to a ten-year low and figures showed 95 per cent of A&e patients are seen within the target of four hours.
He said: “Patients and clinicians are at the heart of achieving excellence in healthcare and that is why, unlike the UK government, we are investing in the nHs and protecting budgets.
“We also are investing £50 million through our unscheduled care action plan to improve the way emergency care is delivered across nHs scotland.
“Having the right number of staff in the right place at the right time is about more than staff numbers.
“We are committed to improving efficiency and freeing up time for clinical care. Management plays an important role in achieving this.”