David Wrigley: Don’t call us resilient

Health and social care staff have held up a broken system for far too long, writes David Wrigley

I was pleased to see a recent report on workforce burnout and resilience in the NHS and social care caution against the notion of individual staff member resilience. This concept ignores the fact that the system just isn’t working at the moment, and places pressure on doctors and healthcare staff so they feel they have to work even harder to make the broken system work, leading to more burnout.

The report from the Commons Health and Social Care Committee made for difficult reading, and added to the mounting evidence showing that the health and social care system is in desperate need of repair. If we cast our minds back to a time when we weren’t dealing with the covid-19 crisis, long before this pandemic began, the situation across the NHS  wasn’t good at all. Far too many doctors and health and social care staff were experiencing burnout and unnecessary levels of stress, with many identifying workload and pressures at work as the reason. Underfunding and staff shortages meant that doctors and healthcare staff were able to provide patients with care only by persistently going above and beyond, finding innovative ways to stretch limited resources and constantly working overtime. The reality is the NHS has too few doctors and too few beds for our patients.

Then in early 2020, the covid-19 pandemic hit the NHS with such a force that it very nearly toppled the service. I think it’s fair to say that the reason the NHS didn’t become completely overwhelmed was because its staff absorbed the magnitude of the shock and the NHS turned into a covid service. From the start of the pandemic it’s been no secret that doctors and health and social care staff have doubled down and worked harder than ever before, giving rise to the narrative around “NHS heroes”—a term which some do not like.

With this doubling down came an unwanted yet predictable knock-on effect. In absorbing the force of covid-19’s impact on the NHS, collectively, doctors and health and social care staff sacrificed their own wellbeing. This was apparent very early into the pandemic when the BMA’s mental health and wellbeing support services experienced a 40% increase in their use over March, April, and May 2020. It was also around this time that medical organisations began reworking materials that doctors would normally use to treat patients with post-traumatic stress disorder (PTSD) and trauma triggered mental conditions in order to support NHS staff.

Unlike the fictional heroes we see in the movies, “NHS heroes” aren’t superhuman—they’re people just like everyone else. People who, throughout this pandemic, have balanced their own personal traumas—such as the loss of family members, friends, and colleagues—with an unmanageable workload, holding up a broken system, all while being labelled “resilient.” It’s no surprise that today we’re seeing more health and social care staff experiencing burnout, stress, or mental health trauma—including PTSD, which is increasing at an alarming rate.

We know that staff from ethnic minority backgrounds experience worse inequalities than their white colleagues, and many have reported that these inequalities have meant they have felt less able to speak out when things aren’t as they should be at work, raising discrimination as a significant factor in burnout. We also can’t forget figures from the BMA’s regular surveys undertaken during the pandemic, which show that thousands of overworked doctors are planning to leave the NHS due to depression, anxiety, stress, burnout, emotional distress, or another mental health condition.

With this in mind I’d urge any doctor or medical student—regardless of BMA membership—with concerns about their mental wellbeing to use the recently launched BMA national counselling service. By seeking constructive help, you may identify ways of addressing the root causes of your concerns and develop strategies to reduce the impact of the consequences.

It’s fair to say that the Health and Social Care Committee’s report has the potential to go a long way in safeguarding the nation’s health and care staff, but it needs the government to take significant action now. Staff have held up a broken system for far too long; it’s time for the system to take on some of its own weight and begin to support those who work within it. The government must care for those who care for the public to ensure patients get the best possible care—this is in everyone’s interest.

David Wrigley is the BMA’s wellbeing lead. Twitter @davidgwrigley

Competing interests: I am deputy chair of BMA UK Council and a chief officer of the association.