Burnt-out doctors and failed cancer detections show an NHS in need of help
January 28, 2020
A recently published survey of doctors in The British Medical Journal (BMJ) has found that around a third of them are at risk of suffering from burnout, stress and supposed ‘compassion fatigue’.
The survey, the largest published study of its kind according to The BMJ, featured responses from 1,651 doctors and shows that 31% of the doctors surveyed have high levels of burnout with the same number also having compassion fatigue. Furthermore, a quarter of the doctors surveyed said they were experiencing a significant amount of stress. Perhaps unsurprisingly, A&E doctors were considerably more burnt-out and stressed than doctors in other medical areas.
In other news, Cancer Research UK have stated they feel that a shortage of specialist NHS staff is putting more than 1,100 people a year in England at risk at developing terminal bowel cancer.
The charity’s analysis feels that much of this down to the different thresholds that exist between England and Scotland. For example, bowel cancer screening starts in Scotland at the age of 50, whereas as it 55 years old in England. On this point though, it should be said that the NHS in England does screen those in at-risk groups for bowel cancer at an earlier age. For example, those with Inflammatory Bowel Diseases, such as Crohn’s Disease and Ulcerative Colitis, are twice as likely to develop bowel cancer compared to the rest of the population and so, should be screened at least every five years following diagnosis of the condition according to NHS guidelines.
Furthermore, NHS services in Scotland also have a lower threshold for referring a person for further investigation. In Scotland, if a person’s initial Faecal Immunochemical Test (FIT) – an analysis of a poo sample in simple terms – scores 80 or higher, they will be referred for a colonoscopy so a more thorough investigation of their bowel can be done. However, in England, only those with a score of 120 or higher are usually referred for this further investigation. Cancer Research UK estimate that, if NHS England were to adopt NHS Scotland’s thresholds, it would lead to 2,000 extra colonoscopies being conducted each month in England. In turn, Cancer Research UK believe this would lead to 1,100 extra early detections each year.
Therefore, while it is important to clarify the criteria Cancer Research UK have used so that they are able to make the kind of statement that will ensure their research is reported by the likes of The Guardian and The Sun, their analysis does highlight a very important point; there are not enough specialist staff qualified to undertake the further investigations employed by NHS England, as one in ten endoscopy positions – those medically trained to conduct a colonoscopy – are currently unfilled. It may be then that the threshold levels in England are where they are at because of this shortfall in staff.
If this is the case, we have to agree with Cancer Research UK that this is potentially leading to unnecessary deaths; as the charity rightly points out, when bowel cancer is diagnosed at the earliest stage, as it can be through screening, more than 9 in 10 people survive the disease for at least five years. When detection only comes in the late stages of the illness though, the survival rate drops to less than 1 in 10.
If the NHS doesn’t have enough staff and those that do work within it are experiencing the highest-ever events of burnout, stress and ‘compassion fatigue’, serious questions need to start to be asked then.
This is particularly true when you consider other research that has emerged recently. For example, in its report of the BMJ survey, The Guardian also highlights a separate survey conducted by researchers at The University of Liverpool which found that almost one in five doctors who deliver babies have post-traumatic stress disorder (PTSD) from witnessing distressing events in their work, with two-thirds of the 1,095 UK obstetricians and gynaecologists surveyed saying they had encountered traumatic situations during labour and birth.
The survey’s lead, Prof. Pauline Slade, and her colleagues found that PTSD was leading to staffing problems on maternity units because doctors go on sick leave, and is a key factor in three in 10 of the doctors training to specialise in obstetrics giving up before they qualify.
Given the issues at East Kent NHS Trust and the alleged withholding of epidurals by six NHS Trusts in the South East we have written about recently, it is also very interesting to note that the researchers also concluded that PTSD could desensitise obstetricians in how they care for mothers and encourage them to intervene earlier during childbirth if problems arise with the baby.
We have previously called on the Government to do everything it can to help the NHS meet demand and provide the level of service we all rightly expect it to, and we repeat that call.
Otherwise, we have to conclude that there is a serious risk of more cases like the tragic and preventable deaths that occurred at East Kent NHS Trust’s maternity units happening, along with more and more cases of medical negligence taking place in other areas.
While we sympathise with NHS staff and the arguably unrealistic demands that are being placed upon them, instances of medical negligence taking place cannot be accepted under any circumstances and, when they do take place, those affected should be appropriated compensated so that they are not financially harmed and, if needed, can receive the level of ongoing care they require.
At The Medical Negligence Experts, we and the legal firms we work with are experienced at handling instances of medical negligence and so, are well-placed to help you receive the maximum amount of compensation possible if you suffered as a result of negligent medical care, be it at the hands of the NHS or a private healthcare provider.