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Could a Stitch in Time Save Lives?

Addressing burnout amongst surgeons and anaesthetists is a complex issue. With staff critical to the NHS system run into the ground by ever-lengthening waiting lists and the stress of working within a demoralised system, it is no surprise that 92% of trusts have told NHS providers they have concerns about staff wellbeing, stress and burnout following the pandemic. But how best to support surgeons and healthcare workers in an already pressurised NHS is somewhat of a conundrum.

Even prior to the pandemic, surgeons were suffering from burnout: as far as 2018, the BMJ found that 40% of NHS hospital consultants were scoring worryingly high for emotional exhaustion, depressive symptoms and anxiety symptoms. And in 2020, one-third of doctors who responded to a BMJ survey were described as burned out, a figure surely higher now with the added pressures of having been frontline in a pandemic and managing the subsequent fallout.

Not only does burnout affect the welfare of the healthcare worker but also the wellbeing of the patient, with exhausted doctors twice as likely to be involved in a patient safety incident. Add that to the potential pressure on the NHS when these exhausted surgeons retire early, something that three out of five have stated an intention to do so, citing the strains of workload, job satisfaction, wellbeing, ill-health and bureaucracy. We need to act fast: now is the time to address the issues affecting our valuable workers, and now is the time to mitigate the impact of sick leave, early retirement and burned out staff on the future of the NHS.

Whilst the BMA focuses on pay increases, strike action and early retirement to deal with burnout issues, we propose a more commonsense approach; one which is proven to work and would cost far less than other options explored. We suggest offering a paid, guaranteed, three-month Regular Rest, Reset and Reposition (4R) ‘sabbatical’ every seven years for all nursing, medical and allied healthcare staff, starting with those who took the brunt of the pandemic, e.g. ITU, anaesthetic and respiratory teams. Compared to the patient impact of striking and the cost implications of pay increases, the 4R solution is relatively cost-neutral, equating to a year off, or a 2-3% pay rise over a 30-year career.

This approach isn’t untested. The Harvard Business Review recently lauded the positive effects of ‘free rein’ sabbaticals, referencing a study in the Journal of Applied Psychology which found that following a sabbatical, workers reported a reduction in stress and an increase in overall wellbeing. These positive changes weren’t transient, remaining long after the employees returned to their jobs.

Now is the time to act. It’s time to do something about surgeon burnout and its impact on the NHS, patients, and wellbeing. As our president, Mark Henley, says:

“Offering staff who have effectively been ‘in the trenches’ some cash, and expecting them to go straight back to the front line will categorically not provide the Regular Rest, Reset and Repositioning required to maintain a healthy level of service. A guaranteed 3-month break will, however, provide this. It is a well-established fact in the corporate world that workers who are well-rested and have had time to decompress improve not just their own, but their organisations’ productivity – coming back more motivated and committed. Yet we do not see this consideration in the NHS.”



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