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The Guardian - UK
The Guardian - UK
Politics
Andrew Gregory Health editor

NHS faces ‘alarming’ exodus of doctors and dentists, health chiefs warn

NHS doctor
Intense workloads, soaring demand for healthcare and record backlog of operations are causing burnout among medics, says the MDU. Photograph: Christopher Thomond/The Guardian

The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals four in 10 are likely to quit over “intolerable” pressures.

Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK.

In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”.

Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone.

NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay.

The report comes as the government is due to publish an urgent and emergency care strategy on Monday. It says it will provide tailored support at home to tens of thousands more elderly and vulnerable people, in an effort to shift some NHS care out of hospitals.

However, NHS leaders said the plan had come too late amid a “sluggish” response from ministers to the pressures on the NHS. Further strike action by staff is likely as a row over pay and conditions continues, and the MDU report suggests that as many as four in 10 doctors and dental professionals may have quit the health service by 2028.

“These figures are alarming,” said Eddie Crouch, the chair of the British Dental Association. “NHS dentists are working in a broken system, and many have given up hope of change.”

Matt Davies, the president of the Association of Anaesthetists, said the MDU report exposed how the “significant strain” experienced by staff working in “ever more intolerable working conditions” could lead thousands to quit permanently.

“Doctors come into the profession to make a difference for their patients in the long term,” he said. “It is telling that so many of those responding to the MDU survey say they are thinking of retiring or leaving the profession in the next five years.”

Prof Kamila Hawthorne, the chair of the Royal College of GPs, said the figures chimed with what her members were telling her. Fifteen thousand family doctors alone could leave the NHS altogether in the next five years, according to the college’s own internal data, she added.

“As these survey results show, the overwhelming pressure GPs are working under is leading many to burn out and making many rethink their future working in the NHS,” Hawthorne said.

The MDU report found that 88% of doctors and dental professionals said workplace pressures had increased in the past three years, and 48% said they had reduced their hours in order to cope.

Ninety per cent said they often or occasionally felt completely worn out at the end of a shift, while 83% said their job often or occasionally left them burnt out.

“Our members are under huge pressure,” said Dr Caroline Fryar, the MDU medical services director. “The pressures on the system are not only incredibly frustrating for patients struggling to get easy or quick access to healthcare but are also extremely difficult for our members.”

The MDU report said 63% of doctors and dental professionals felt relationships with patients and colleagues had become more strained in the past three years, with 20% suffering abuse or threats.

“They want to provide patients with the best possible care but tell us they often feel overwhelmed by the many conflicting demands on their time,” Fryar said. “This is impacting the clinician/patient relationship, and our members often bear the brunt of patient dissatisfaction which itself can be demoralising.”

Medical and NHS leaders said that unless action is taken to stop the already dire workforce crisis escalating, the impact on patients will be catastrophic. “Every new vacancy will leave thousands more [patients] unable to secure needed care,” Crouch said.

Matthew Taylor, the chief executive of the NHS Confederation, which represents the whole of the healthcare system in England, Wales and Northern Ireland, said: “The situation will deteriorate without targeted action from the government, which includes investing in the promised NHS workforce plan with additional medical training posts, as well as preparing to negotiate with the unions on pay to avert further damaging strikes.”

Hawthorne called on the government to devise and implement a “bold recruitment and retention strategy” to ensure there are sufficient numbers of doctors to provide patients with “the care they need and deserve”.

“The government must publish its long-term workforce plan without delay – and it must be fully costed and funded,” said Miriam Deakin, the director of policy at NHS Providers, who pointed out that stress was consistently among the most common reasons cited for official staff sickness absences.

The Liberal Democrat MP Daisy Cooper, a health spokesperson for the party, said: “These findings are incredibly alarming and suggest we could see a further exodus of NHS staff unless the government acts now.

“In many parts of the country, people are already struggling to get an appointment with their GP or dentist and this would make matters even worse. This should be a wake-up call for Conservative ministers that they need to end the vicious cycle of staff shortages and burnout.”

The shadow health secretary, Wes Streeting, said: “The NHS doesn’t have enough doctors as it is; it simply cannot afford to lose more.”

A Department of Health and Social Care spokesperson said the NHS was facing “huge challenges” as a result of flu, Covid and the care backlog, adding that there were record numbers of staff working in the health service.

“We are committed to publishing a comprehensive workforce strategy this year to help recruit and retain more staff,” the spokesperson added.

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