Survey reveals extent and impact of fatigue on hospital consultants as politicians and healthcare bodies back national campaign

Politicians, healthcare bodies and Medical Royal Colleges from across the UK are backing the national Fight Fatigue Campaignto help raise awareness of the impact of fatigue and shift work on our NHS workforce. Despite growing support for the campaign there is still much to be done, as demonstrated by survey results published today (3 September 2019) which reveals the scale and impact of out-of-hours working on consultant anaesthetists and intensivists. The vast majority of respondents reported work-related fatigue impacting on all areas of life and more than 1 in 10 admitted to having had a car accident or near miss when commuting whilst fatigued in their consultant career, and many more as an anaesthetist in training .

Seven Medical Royal Colleges have joined eleven healthcare organisations and a range of politicians from throughout the UK (alongside official backing by the Labour, Scottish Conservatives and Scottish Green parties) in making a commitment to promoting positive attitudes towards rest and wellbeing across the NHS workforce to help reduce the stigma attached to talking about fatigue.

Today’s survey findings, published in the journal Anaesthesia, highlight the extent and impact of fatigue amongst the 3,847 consultants in anaesthesia and paediatric intensive care medicine in the UK and Ireland who responded to the survey.  The findings follow a 2017 survey of over 2,000 anaesthetic trainees that revealed 57% had experienced an accident or near miss when driving home after a night shift.

The BMA has published its Fatigue and Facilities Charter and the Government has recently announced an allocation of £30,000 per NHS Trust in England to spend on rest facilities, but today’s survey findings demonstrate that more needs to be done to change behaviours and attitudes toward managing fatigue in the workplace.

Commenting on today’s survey findings, Dr Emma Plunkett, fatigue project group lead and consultant anaesthetist, Queen Elizabeth Hospital, Birmingham, said: “The impact of fatigue on our NHS workforce continues to be a major area of concern. Research tells us that sleep is crucial to our health and wellbeing and a lack of sleep in healthcare staff not only affects the professional but will also have an impact on their patients.

“This new survey clearly demonstrates that our senior doctors are simply not getting the rest and sleep they need and much of this is caused by their working pattern and lack of rest facilities at work.

“Our ongoing Fight Fatigue Campaign seeks to change attitudes across the NHS to ensure everyone understands the risks of fatigue and how to mitigate them.  We hope that by collectively taking responsibility for making changes to working practice, we can improve working conditions for staff which will in turn benefit patient care.”

In summary, the survey found that:

• 91% of consultant doctors who responded experience work-related fatigue and 50% of them reported this had a moderate or severe impact on health, wellbeing, work and home life
• 45% of respondents admitted to either having a car accident or near miss when commuting whilst fatigued, with 1 in 10 of these as a consultant
• only a third (34%) said they have access to a private rest facility when on-call
• 84% of respondents contribute to a night on-call rota (including weekends) and 37% also work regular weekend days
• for about one third (32%) the longest period of on-call duty is 48-72 hours and 32% are on call every 8th day or more frequently
• when on-call, about half (52%) of consultants leave work after 10pm or are resident overnight; 55% receive 2 or more phone calls after leaving and just under half (48%) reported taking 30 minutes or more to fall back to sleep after a phone call
• most respondents (62%) did not feel supported by their organisation to maintain their health and wellbeing
• in addition, only 15% always achieve 11 hours rest between finishing one shift and starting the next (the European Working Time Directive requires all doctors to have 11 hours of rest between clinical duties).