Campaign Launched to Give Doctors a Break

Peter Russell

February 07, 2019

A campaign for doctors to be able to take the breaks they need for their own welfare and the safety of patients was launched by The BMJ .

In an editorial in the journal, Cat Chatfield, quality improvement editor, and Abi Rimmer, careers editor, argued that workload in an overstretched health system and a lack of designated rest areas in hospitals have made it harder for doctors to take breaks during shifts.

Similar workload pressures in primary care were also preventing GPs from getting necessary rest, they said.

A Worsening Situation?

The authors acknowledged that medical organisations, trade unions, and Royal Colleges had campaigned on this issue in the past and continued to do so. However, they said the problem persisted and could be getting worse.

In 2016, a report by the Royal College of Physicians, Being a Junior Doctor , found that doctors were unable to take adequate breaks, despite evidence that rest breaks contributed to the provision of safe care.

It found that with a junior doctor's shift lasting 12 hours or more, 56.1% of doctors reported going through at least one shift in a month without eating a meal. It said anecdotal feedback suggested that the situation had been exacerbated by the removal of staff canteen facilities, particularly out of hours.

Junior doctors also reported a shortage of non-clinical facilities – like meeting rooms or seating areas – for staff to share expertise with colleagues. "This contributed to the loss of a sense of community among hospital workers," the report said.

The BMJ editorial said 2 years on, little had changed, with almost 20% of hospitals without a common room or a lounge, according to data from the British Medical Association (BMA).

Due to year-round pressures, doctors had repeatedly told the journal that informal spaces that were vital for learning and building relationships with colleagues were not prioritised by trust managers and were not being incorporated into new hospital buildings.

Give Us a Break Campaign

The BMJ said it was launching its 'Give us a Break' campaign in response to the rising prevalence of burnout in the medical profession. "We will campaign for doctors in secondary care to have access to a doctors' lounge or staff room, and to properly equipped and maintained on-call rooms," the authors wrote.

"We will seek out senior staff who have prompted members of their team to take regular breaks to eat, drink, and rest and ask them to share their expertise.

"In general practice we will explore how teams have found ways to get together for a coffee break or lunch.

"We will promote a culture that encourages doctors to take a few minutes out of their day to pause and regroup."

Although workload and a lack of designated rest areas were largely to blame for the problem, the authors said, doctors also needed to shoulder some of the responsibility by "prioritising self care".

Long Hours, High Pressure, and Fatigue

Commenting on the issue and the campaign, Dr Anthea Mowat, BMA representative body chair, said: "Doctors of all kinds work long hours in incredibly high-pressure environments where decisions often have life or death consequences. Indeed, a recent survey of our members found that more than a third felt fatigue caused by long working hours affected their ability to guarantee safe care to patients.

"Proper breaks are crucial to staff wellbeing, reducing fatigue, and – critically - ensuring doctors can safely, effectively and efficiently care for patients. We therefore wholeheartedly welcome this campaign from The BMJ, which mirrors much of our own work on this important issue."

She said that since the BMA had launched its fatigue and facilities charter in March 2018, 97% of trusts in England had signed up.

"It is in the interests of patients and staff, that employers support measures to ensure doctors take breaks and, even more, guarantee doctors are properly rested," Dr Mowat said.

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