Junior doctors say patient safety is suffering as a result of poor staff morale and excessive stress

A new report outlines the experiences and issues faced by junior doctors on the fronline of the NHS. 

Gaps in rotas, poor access to basic facilities and an ever growing workload means junior doctors are experiencing high levels of stress in their roles – with 80% of junior doctors reporting that their job ‘sometimes’ or ‘often’ causes them excessive stress. However, despite this backdrop, their professionalism and the high quality care they provide mean that nearly all junior doctors feel valued by the patients they treat.

Released today, Being a junior doctor. Experiences from the front line of the NHS, presents a bleak picture of the conditions junior doctors currently face and the impact this is having on the patients they care for every day.

Based on a survey of 498 junior doctors the report found that the current health and wellbeing of the junior doctor workforce is at a harmful and unsustainable level. Findings include:

  • four out of five junior doctors report that their job ‘sometimes’ or ‘often’ causes them excessive stress
  • one in four state that their job has had a serious impact on their mental health
  • over half (54%) report that their job ‘sometimes’ or ‘often’ had a negative impact on their physical health.

Responses from junior doctors on the issue of stress, included:

‘If you’re always being pushed beyond your limit your health suffers, your patient care suffers.’

‘I ignored my own health, as I was more concerned about not missing work and putting colleagues at risk of unmanageable workloads.’

‘[The high workload] puts you under a lot of pressure; you’re stretched, it is difficult to know what to do ...’

Junior doctors were also asked for their perspective on the factors having a negative impact on patient safety. Responses included the well discussed and common factors, such lack of available hospital beds (61%), poor patient access to social care (58%) and nursing rota gaps (51%). One concerning factor was the perception that staff morale (50%) is now so low that it is having a negative impact on patient safety in their place of work.

However, many junior doctors feel valued in the work they do and much of this is down to the contact and support within the medical teams and with patients. According to our report 94% of junior doctors feel valued by their consultant and nearly all respondents (96%) feel that they are valued by the patients they treat for the quality of care they provide.  

The survey also found that the working conditions for many junior doctors falls far short of what is needed - with many reporting limited access to food and water. The findings show that the majority of junior doctors (56.1%) reported going through at least one shift in the last month without eating a meal and nearly three quarters (73.7%) reported working at least one shift in the last month without drinking enough water. This is troubling given that a junior doctors’ shift may last 12 hours or more.

On the report Jane Dacre, president of the RCP said:

Yet again we have more evidence that our NHS is underfunded, underdoctored and overstretched. Junior doctors are the future of medicine and as such we all have duty to ensure that the NHS they work in is a supportive environment, one where they feel like they can learn and grow but ultimately is a place where they can provide high quality patient care.

The findings today show that poor access to even basic facilities, gaps in rotas and the constant pressures of administration, often taking them away from treating patients, is having a stark impact on the mental and physical health of our junior doctors.

Medicine is a brilliant profession with so many possibilities to enhance the lives of the patients we treat. We need to fund our NHS and social care services so that all staff are able to provide safe and effective care, but also have the ability to thrive.

We need to fund our NHS and social care services so that all staff are able to provide safe and effective care, but also have the ability to thrive.

Dr Carol Postlethwaite, chair of the trainees committee of the RCP said:

Being a physician, whether in training or as a consultant can be incredibly rewarding. But, for too long, being a junior doctor has felt like trench warfare. This report exposes trainees' experiences and explains how reccurring institutional failures to care about their health, welfare and training needs have damaged morale and are forcing many away from the front line. We see this in daily rota gaps where there are simply not enough doctors to provide safe patient care.

This report shows what trainees on the front line think.  How concerned they are for their patients, the quality of care they receive and how undervalued and let down junior doctors are feeling currently. They should be heard and listened to - because it also shows how brilliant the job can be and that this urgent situation is fixable.

Being a physician, whether in training or as a consultant can be incredibly rewarding. But, for too long, being a junior doctor has felt like trench warfare. 

Other key findings from the survey include:

  • 41% of junior doctors feel the burden of administrative tasks is so high that it is having a serious impact on the safety of the patients they treat.
  • Only three in 10 believe that they are valued by the chief executive of their hospital or trust.  

To support this work the RCP has also published today a supportive document, Keeping medicine brilliant. This document provides consultants, hospitals, and trusts with in-depth guidance, and a foundation on which to create positive, practical and tangible resources to help trusts and senior NHS leadership improve the working conditions of doctors working in acute settings.

For more information please contact Morgan Evans, senior communications adviser at the RCP. morgan.evans@rcplondon.ac.uk 0203 075 1468.

Notes to editors

This report outlines the views and experiences of junior doctors. Research for this report was undertaken against the backdrop of the junior doctor contract dispute, but it focused on the non-contractual issues that face junior doctors working in the NHS. It is based on a survey of 498 junior doctors that was conducted by the RCP in April 2016. Most of the junior doctors who responded to our survey were higher specialty trainees (71%) and core medical trainees (19%). The majority reported working in a clinical post. On 22 June 2016, over 30 junior doctors attended an RCP roundtable (‘An evening with officers’) to discuss issues related to the working lives of junior doctors: the challenges and the potential solutions. The areas for action (‘treatments’ set out at the start of each chapter) are drawn from their feedback.

Mission health

This report is part of a wider work programme by the RCP named ‘mission health’. The last document of the programme was, Underfunded, underdoctored, overstretched: The NHS in 2016. The report released in September outlined that patients and communities deserve to know the true choice that we face: increase funding or cut care.

RCP response to the autumn statement

Our recent response to the autumn statement also outlined our current concerns around funding for health and social care. Read it in full.