Written evidence submitted by research team from the Universities of Exeter, Hull, and Oxford (WBR0082)


Workforce burnout in the NHS

Written evidence submitted by the ‘Care Under Pressure’ research team from the Universities of Exeter, Hull, and Oxford, October 2020.






The impact of NHS workforce burnout on service delivery, staff, patients, and service users (before and during COVID-19)



How to improve working life and productivity, and reduce the risk of workforce burnout across the NHS (both now and in the future)

Care Under Pressure findings:

Care Under Pressure recommendations:


Care Under Pressure conclusions and 10 principles

A key conclusion from the Care Under Pressure project was that we do not need MORE interventions, but we need to IMPROVE the ones that we already have. To help those refining/designing interventional strategies to improve and preserve mental health, and tackle doctors’ mental ill-health, we developed 10 principles, by which existing interventions might be refined: 

  1. Be clear about who the intervention is for (given the continuum from full health, to ‘under pressure’, to mental ill-health).
  2. Give options by signposting to a range of interventions (e.g. a ‘one stop shop’ of local, regional and national resources).
  3. Ensure that information about the intervention is readily and rapidly available.
  4. Ensure that interventions are accessible to someone who works long and inflexible hours.
  5. At the initial enquiry stage, invest time in building trust and normalising stigma and struggle.
  6. Provide interventions in groups whenever possible, to prioritise connectedness, relationships and belonging.
  7. Ensure interventions for individuals are endorsed by or embedded in the workplace, where possible.
  8. Encourage and empower individuals to tackle low-level everyday hassles at work, to free up capacity to deal with bigger issues.
  9. Emphasise that prioritising and investing in physical and mental health is essential for optimal patient care.
  10. Evaluate and improve the intervention regularly, using data such as numbers and types of attendee, programme adherence and user perceptions.




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2.              Carrieri D, Pearson M, Mattick K, Papoutsi C, Briscoe S, Wong G, et al. Interventions to minimise doctors’ mental ill-health and its impacts on the workforce and patient care: the Care Under Pressure realist review. Health Services and Delivery Research. 2020;8(19).

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11.              Health Education England. NHS Staff and Learners' Mental Wellbeing Commission. 2019.

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17.              Cheshire A, Ridge D, Hughes J, Peters D, Panagioti M, Simon C, et al. Influences on GP coping and resilience: a qualitative study in primary care. Br J Gen Pract. 2017:bjgp17X690893.

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19.              Gerada C. The wounded healer—why we need to rethink how we support doctors. BMJ. 2015;351:h3526.

20.              Carrieri D, Gerada C, Thistlethwaite J. Health and well-being: time to be strategic. The Clinical Teacher. 2019;16(4):295-7.

November 2020