Poor work/life balance driving NHS exodus
As vacancies hit record levels, doctors and nurses want more flexible work arrangements to carry on working in healthcare, study from Deloitte finds.
Poor work-life balance is a key driver of job dissatisfaction for healthcare workers, and improvements are within the power of employers, according to new research from Deloitte’s Centre for Health Solutions.
The findings come from the report, Time to Change: Sustaining the UK’s clinical workforce, which looked at the experience and resilience of front-line clinicians, based on a survey of 1,286 UK public healthcare workers. The study examines how attitudes within the profession have changed since 2017, when a similar piece of research was conducted, and includes input from doctors, nurses and other clinical staff working in primary, community and secondary care.
Having a ‘sense of fulfilment/making a difference’ (42 per cent) and a good ‘work-life balance’ (41 per cent) are the top two drivers of job satisfaction for healthcare workers, the study found. By contrast, pay (60 per cent) and having a poor work-life balance (42 per cent) were found be the two main drivers of job dissatisfaction within the professions.
The high ranking of work-life balance for job satisfaction and dissatisfaction is in stark contrast to five years ago, when work-life balance was the fifth-biggest driver of job satisfaction, according to Deloitte’s 2017 study.
When asked how their feelings on job satisfaction and dissatisfaction has affected career intentions, the most common response, among 53 per cent of all respondents and 59 per cent of doctors, was to reduce hours and move to part-time working in healthcare. In addition, 40 per cent of clinicians overall, including 35 per cent of doctors and half of nurses and midwives had considered leaving the profession and changing career.
The study follows a slew of unwelcome news in recent days, including (now-confirmed) speculation that the government’s long-awaited NHS workforce plan (due to be published Tuesday 30th May) is to be delayed as it is considered too costly and the admission from the Health Secretary, Steve Barclay, that the 40 new hospitals will now not be built by 2030 – in contravention of the Conservative government’s flagship pledge.
Additionally, NHS vacancies remain at record levels as the health service continues to struggle to attract and retain staff. One-fifth of all nursing posts in England are estimated as vacant, and NHS trusts fear that the situation will not change until the government sets out a fully-costed workforce plan.
Karen Taylor, Director and Head of Research at Deloitte Centre for Health Solutions, said: “The problem has worsened over the past few years and our findings mirror recent staff surveys from the industry. There is a clear need to address the physical and mental health needs of staff if employers are to build a resilient workforce.
“Many solutions are in the hands of local health organisations to address and several have implemented effective solutions, just not at the scale needed.”
Sara Siegel, Partner and UK and Global Head of Health at Deloitte, said: “The most vital asset in healthcare is its workforce. Our study shows that the availability, accessibility and quality of care available to patients depend on having the right professionals, with the right skills, in the right place, at the right time.
“Healthcare leaders have a real opportunity to make a long-lasting impact in this crucial area. Those that have adopted new ways of working and technologies, have already realised the benefits to empower their workers. Not only will this help patients, but it will have a positive impact on job satisfaction that supports individuals to build rewarding, long-term careers in healthcare.”
Implications for physical and mental health
The study also revealed that 87 per cent of clinicians had experienced an increase in their workloads since March 2020, including 90 per cent of nurses and midwives and 84 per cent of doctors, with serious mental health and wellbeing implications for those staff affected; 46 per cent of clinical staff reported experiencing a negative impact on their physical health, including 50 per cent of hospital doctors and 45 per cent of hospital nurses. The study also found 57 per cent disclose a negative impact on their mental health, including 58 per cent of hospital doctors and 59 per cent of hospital nurses.
This contrasts with the 2017 study, in which 30 per cent of hospital doctors and 32 per cent of hospital nurses said that their workload had a negative effect on their physical health; and 23 per cent of hospital doctors and 33 per cent of hospital nurses said that it affected their mental health.
Digitisation will help – eventually
Numerous policy documents and reports, including the NHS Long Term plan, have identified the importance of adopting technology across healthcare. Deloitte’s study therefore asked healthcare workers which technologies they think are helping to improve the quality of patient care. The top five technologies included Electronic Health Records (EHR) (87 per cent), e-prescribing (78 per cent), patient apps (73 per cent), at-home diagnostics (70 per cent) and remote consultations (70 per cent).
Adoption remains low, however, and only 64 per cent of clinicians said they are using EHRs, while fewer than half of respondents have adopted e-prescribing (46 per cent), patient apps (33 per cent), at-home diagnostics (22 per cent) and remote consultations (39 per cent). Likewise, automation of human resource and occupational development services is lagging behind other industries and the study points out the crucial need to modernise these areas.
Dr Karen Kirkham, partner and Chief Medical Officer at Deloitte added: “While healthcare workers know that technology-enabled care models, systems and processes can improve outcomes and safety for patients, simplify tasks and reduce the significant administrative burden for clinicians, adoption remains fragmented.
“Healthcare leaders need to modernise and unlock better ways of working that improve the employee – and employer – experience. More efficient HR and people policies that focus on equality, diversity and inclusion, investing in leadership and professional development, and accelerating the digitalisation of healthcare infrastructure, will go a long way towards developing new ways of working that release time to care.”