‘NHS staff are exhausted and need a break, but there aren’t enough of us’:

RCP publishes new workforce data showing doctors in Wales are frustrated

As the Royal College of Physicians (RCP) publishes new findings on doctor wellbeing from its 2020-2021 annual census of consultant physicians in Wales, colleagues working in intensive care medicine in Wales have written an open letter (1) to physicians, thanking them for their ‘extraordinary’ contribution to the NHS, and acknowledging that without the efforts of acute medicine, general medicine, respiratory and infectious disease teams, critical care could have been ‘completely overwhelmed’.

But this has come at a cost. Early results from the RCP’s 2020-21 annual census (2) found that in Wales:

38% said they have regularly have problems sleeping.
23% don’t feel healthy.
26% don’t feel as though they have control over their life.
50% tend to dwell on things more than they should.
13% don’t find their work fulfilling.
19% do not feel satisfied with their life.
45% frequently feel frustrated.
36% often get annoyed.

There are fears that the NHS will take years to recover, with backlogs and waiting times exacerbated by workforce shortages and continuing delays for diagnostic testing. In an April 2021 RCP membership survey, 59% of respondents thought it would take at least 18 months for the NHS to recover from the pandemic, while 30% thought it would take over two years. (3)

Many doctors in Wales are exhausted, demoralised and frustrated, which is why the RCP is especially pleased to welcome political commitments from Senedd candidates to increase the medical workforce by establishing a medical school in north Wales and increasing the number of doctors and healthcare professionals in the NHS. This must be an urgent priority for the new Welsh Government in their first few months in office.

Dr Olwen Williams, RCP vice president for Wales said:

‘To put it bluntly, we need more doctors. Waiting lists are getting longer. NHS staff are exhausted and need a break, but there aren’t enough of us to go round. By 2030, older people in Wales will make up a third of the total population (4) and many of them will need support from the NHS and social care. Yet it takes more than 10 years to train a doctor which is why it’s so important that the next Welsh Government increases medical school places as soon as possible. Our recent report, Recover, rebuild, renew, sets out our action plan for the next government.’

Dr Alice Hoole, specialty trainee doctor in acute medicine said:

‘The pandemic changed everything overnight for all of us. To provide medical education for redeployed clinicians, I developed new digital learning tools and an interactive, multi-specialty programme of teaching, which improved our team working skills, wellbeing and morale. As we emerge from the pandemic, I would like to see more of a focus on the wellbeing of healthcare professionals. Staffing pressures as well as the vast and ever-increasing workload at the front door need to be addressed to help us provide the best care for our patients in the future.’

Dr Jack Parry-Jones, Faculty of Intensive Care Medicine lead for Wales said:

‘How did critical care cope with the impact of successive pandemic waves? In short, we couldn’t have coped without help. The Faculty of Intensive Care Medicine would like to draw attention to, and publicly thank, our physician and anaesthesia colleagues for the vital support we have received.

‘Even with increased critical care capacity, we would never have managed without the care physicians provided. The support from acute medicine, general medicine, and more directly respiratory and infectious disease teams in providing care for large numbers of critically ill patients in high respiratory care areas has been extraordinary. These areas are providing high-dependency care usually done in critical care units and have provided a crucial buffer in stopping critical care from being completely overwhelmed.’

He added:

‘In Wales we have been more vulnerable than many to the worst effects of the COVID-19 pandemic. It came as no surprise that chronic social deprivation, poverty, obesity, old age, and close living conditions are all excess risk factors for serious morbidity and death. The medical community in Wales has a long, proud history of highlighting these inequalities, alongside efforts to mitigate them.’

The RCP has previously joined with more than 30 other organisations in Wales to call for a cross-government strategy to tackle health inequalities. (5)