On Time to Talk Day 2020, MDDUS encouraged all of its members to reflect on what steps they take to look after their own wellbeing.
A 2019 British Medical Association (BMA) report found that nearly 9 out of 10 GP partners are at high or very high risk of burnout. According to the 2019 Dentistry Confidence Monitor report, 84 per cent of NHS dentists and just over half of private dentists believe their current role has negatively affected their mental health.
NHSX statistics also show that NHS staff sickness absence is on the rise, with the most common reasons for sickness absence identified as anxiety, stress and depression.
Long working hours and intense workload pressures are often regarded as part and parcel of the medical and dental professions. However, in a climate of reducing budgets and increasing demands on clinicians, many struggle to keep up. Working extended hours and cancelling holidays might provide short-term solutions, but such moves can have a negative impact both on a professional’s work-life balance and personal wellbeing.
When wellbeing is neglected, it can leave doctors and dentists vulnerable to fatigue and impaired concentration, both factors which can jeopardise patient safety. Medico- and dento-legal concerns are especially stressful for healthcare professionals, so knowing when and where to turn for support is vital.
How to seek help
It is important that clinicians take a step back to consider whether they (or indeed a colleague) are experiencing symptoms related to burnout or exhaustion, and to ask for help where appropriate. Not only is there no need to “just get on with it”, doing so when experiencing mental health issues can also impact on the ability to practice safely.
If you are unwell, do not rely on your own assessment of your health or even that of a colleague. Seek the independent advice and help of your own GP.
GMC and GDC guidance
Both the General Medical Council (GMC) and General Dental Council (GDC) make it clear in their guidance that doctors and dentists must ensure they are in a fit state of health to practise.
Clinicians also have a duty to take prompt and appropriate action if patient safety is compromised. This includes the risks posed by a colleague who is struggling to cope with stress or ill-health. Those affected should be encouraged to seek help but, if they fail to do so, the regulators are clear that they expect colleagues to intervene.
Good medical practice states: “You must take prompt action if you think that patient safety, dignity or comfort is or may seriously be compromised. If you have concerns that a colleague may not be fit to practise and may be putting patients at risk, you must ask for advice from a colleague, your defence body or us. If you are still concerned you must report this, in line with our guidance and your workplace policy, and make a record of the steps you have taken”.
The GMC has similar advice if you know or suspect your judgement could be affected, in this case by mental health concerns. It says: “You must consult a suitably qualified colleague. You must follow their advice about any changes to your practice they consider necessary. You must not rely on your own assessment of the risk to patients.”
The GDC’s Standards for the dental team takes a similar line, stating: “If you believe that patients might be at risk because of your health, behaviour or professional performance or that of a colleague, or because of any aspect of the clinical environment, you must take prompt and appropriate action.”
Wellbeing - Top tips for healthcare professionals
- Make time to talk: It is important for colleagues to speak to each other about any difficulties they are having at work. This type of direct communication can be very helpful in trying to identify and reduce problems. A simple step could be to start a daily period set aside for an informal meet-up.
- Connect: Try to make time for your family and friends, and for you to feel supported by them. Take time to speak with your colleagues, not just your patients. Get to know those who work in the area around your place of work and be part of your local community. Building connections in this way will support and enrich you every day. For example, linking your practice with the Parkrun initiative can be a good way of extending community connections.
- Take notice: By reflecting on your experiences, you will appreciate what matters to you. Be aware of the world around you, and notice how you are feeling.
- Keep learning: Taking up a new hobby or improving your skills in a pastime you are passionate about can be enjoyable and improve your confidence. Why not consider taking up a hobby you’ve always found yourself putting off up until now?
- Be active: Try to take time away from your desk/work duties at some point during your shift. Why not go for a walk or a run during your lunch break? Regular physical activity has been associated with lower rates of depression and anxiety.
- Consult NHS Employers’ How are you feeling today NHS toolkit. It aims to boost staff wellbeing by encouraging conversation about emotional wellbeing in the workplace.
- Take time for yourself: It’s important (although not always easy) to have a good work-life balance and enjoy home life. Take time to do the things you enjoy, such as reading a favourite book, a meal with family, or exercise.
- Contact local support in your area (see links below) for additional advice and support.
Where to go for support
BMA Wellbeing Support Services
BMA Wellbeing Support Services has a counselling service staffed by professional telephone counsellors 24 hours a day, seven days a week. Counsellors are all members of the British Association for Counselling and Psychotherapy and are bound by strict codes of confidentiality and ethical practice. There is also a peer support service giving doctors and medical students in distress or difficulty the choice of speaking in confidence to another doctor who has experience of supporting colleagues. BMA’s Wellbeing Support Services are open to all doctors and medical students. They are confidential and free of charge.
Call: 0330 123 1245.
Sick Doctors Trust
Provides support and help for doctors, dentists and medical students who are concerned about their use of drugs or alcohol.
Call: 0370 444 5163. This is a confidential helpline which is available 24 hours a day
A telephone helpline service manned by dedicated dentist volunteers who have received training in listening to colleagues who require emotional support.
Freephone: 0333 987 5158, 24 hours a day.
NHS Practitioner Health Programme
A programme focused on early intervention, to support the health of doctors and dentists so that, wherever possible, they can continue providing safe and valued care to their patients. The service is available to any registered doctor or dentist who has a mental health concern (at any level of severity), an addiction problem, or a physical health concern (where that concern has raised a performance issue).
Freephone: 0300 030 3300 (8am – 8pm Monday to Friday & 7.30am to 2.30pm on Saturdays).
Dentists' Health Support Trust
Provides dental professionals with free support and advice on a range of issues affecting mental health and emotional wellbeing
Call: 0207 224 4671. Email: email@example.com
British Doctors and Dentists Group
A mutual / self-help group of doctors and dentists, from all levels within these professions, who are addicted to alcohol and/or drugs and who are living, or who wish to live, in a recovery programme free of alcohol and drugs.
Call: 07792 819 966. Email: firstname.lastname@example.org
BDA Benevolent Fund
A charity which supports all dental students, dentists and their families in financial need.
Call: 020 7486 4994 (9.30-5.30 weekdays). Email: email@example.com
Royal Medical Benevolent Fund
The UK charity for doctors, medical students and their families. The RMBF provides financial support, money advice and information when it is most needed, due to age, ill health, disability and bereavement.
Call: 020 8540 9194 (option 1) Email: firstname.lastname@example.org
The NHS GP Health Service
The national confidential NHS service for GPs and GP trainees in England. The GP Health Service can help doctors with issues relating to a mental health concern, including stress or depression, or an addiction problem, in particular where these might affect.
Email: email@example.com. Call: 0300 0303 300 This service is available 8am – 8pm from Monday to Friday and from 8am – 2pm on Saturdays.
Health for Health Professionals
A face-to-face counselling service for all doctors in Wales.
Call: 0800 058 2738. Lines are open Monday to Friday, 9am to 5pm. Visit www.hpwales.co.uk for more information and out-of-hours support.