The doctors’ organisation, BMA Scotland, says conditions for people working in the NHS in Scotland are not sustainable without the injection of ‘proper’ resources of new people and money.

Reporting the findings of a survey of more than 800 doctors and trainees, BMA Scotland says the feedback leaves ‘absolutely no doubt that much better support for doctors is urgently needed’, adding: ‘NHS Scotland needs to be a better place to work, and not one which has the potential to harm its staff’.

Of those that took part in the research carried out earlier this month:

• 71% said they had gone to work when they felt too ill to do so in the last year;
• 45% said they rarely or never get sufficient or prescribed breaks while at work;
• 83% believed the workload pressure in their workplace has increased over the last year;
• 80% often or always worked beyond their daily hours;
• 77% said their work has had a negative impact on their health and wellbeing in the last year;
• 23% had sought help for their mental wellbeing/health within the last two years.

BMA Scotland chair Lewis Morrison says the findings are worrying:

“The survey exposes the reality of escalating workload pressures, with many unable to take the breaks they need and feeling that they must work even when ill themselves. This is clearly bad for doctors’ wellbeing and health, and our survey shows nearly a quarter have sought help in the last two years. And we simply don't know how many more needed help but didn't seek it or couldn't get it.

“Worryingly, our survey also found that two thirds of doctors do not believe their employer provides sufficient support for staff wellbeing. This simply has to change. It is clear that caring for those who care for the people of Scotland must now be a priority. Now, next year and always.

“That is why we are asking Scottish Government and NHS boards to work together to provide improved, effective and accessible support services for staff in both general practice and hospital-based care, who are working in such high-pressure environments.

"Clearly part of the solution is to address the level of pressure in the workplace, but until fundamental changes are made, better support for staff is an urgent need. We are encouraged that the Cabinet Secretary has made positive announcements on this – in particular proposals for a specific health service for doctors in Scotland mirroring that which has been shown to work elsewhere in the UK.

“But that is just treating the symptoms, not the cause. Doctors' work will always be potentially stressful, but current conditions in the NHS simply aren't sustainable and as a result are creating unnecessary levels of pressure on all healthcare workers. We need a properly resourced system – and that means people not just money. Simply saying again and again that we have record staffing doesn't cut it.

"This repeated mantra risks dismissing the concerns of and pressures on those doctors working in services with rising vacancy levels. Let's start talking about how to get and keep the staff we need, not just talk about the number we have, and which clearly isn't enough.

“Political exhortations to meet unobtainable targets only add to the pressure on the medical profession and healthcare services. We need a plan to support those services under most pressure, not just those that are required to deliver on political promises.

“We need action on bullying in the NHS. Those who stepped forward to expose that the behaviours in NHS Highland and elsewhere deserve nothing less than a revolution in NHS culture.

“The unfair and unjustified pension tax issues forcing many doctors to either reduce the work they do, pay thousands of pounds for the "privilege" of their high workload or retire early must be resolved now. It's too urgent to defer it to yet another political year.

“And we need better rest and break facilities so that all doctors can work safely, for themselves and their patients, through their long and stressful shifts.

“The message from doctors is clear. That which is broken must be fixed. We will keep pushing for this 2020. Politicians from all sides have said they are willing to help improve doctors’ working conditions – but now we need to make it happen, because it must. The health service’s biggest asset is its people. Reform and investment might help, but caring for those who care 24/7, 365 days a year is where the real answer lies. Doctors, NHS staff and the patients they care for deserve nothing less.”

The Scottish Government says it is working closely with the profession. A spokesperson told healthandcare.scot work is underway to deliver improvements:

“The welfare of our hard-working doctors is paramount and we are committed to improving their working lives by taking action on issues that are important to them like pay, terms and conditions. We work closely with BMA Scotland to identify and implement changes all doctors want to see.

“Our independent expert group, established to make recommendations on further improvements, is due to report back by the end of the year and the Health Secretary will fully consider the recommendations. This will build on changes already implemented at the request of junior doctors, including banning working seven consecutive night shifts, ensuring no more than seven days or shifts are worked in a row and ensuring all junior doctor rotas should contain a minimum 46-hour rest period following a run of full shifts working nightshift.

“Scotland has an excellent reputation as a place to work and train for doctors – it is why there is a historic number of staff in our NHS, with seven consecutive years of growth. The number of doctors in training has increased by more than 10% since 2007.

“In August, we announced a pay award of 2.5% backdated to 1 April for NHS Scotland medical and dental staff, general medical practitioners and general dental practitioners.

“A proposal for bespoke practitioner support to help doctors suffering from mental illness and addictions is expected in the coming weeks from NHS Education Scotland. This will be fully considered by the Scottish Government, in the context of our ongoing efforts to improve the working lives of staff across our health service.

“The health secretary expects NHS boards to do everything possible to eradicate bullying in the workplace and ensure any reported incidents are robustly investigated.”

In November, the Royal College of Nursing reported findings of a survey of nursing staff showing many were working extra hours and worrying about the impact the pressure on staff was having on patients.

BMA Scotland chair, Lewis Morrison is meanwhile paying tribute to the work of his medical colleagues and other health professionals:

“I want to put on record the thanks of BMA Scotland to them, and how proud we are of the incredible work they do day in day out, but especially at this time of year.

“The year's end is traditionally a chance to pause for thought. To reflect on the demands placed on doctors, and to consider how doctors are being looked after themselves. The survey we publish today can leave absolutely no doubt that much better support for doctors is urgently needed. NHS Scotland needs to be a better place to work, and not one which has the potential to harm its staff.”