A&E departments face crisis as staff burn out and consultants move abroad

http://www.theguardian.com/society/2013/oct/08/emergency-departments-face-staff-crisis

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A worryingly high number of A&E doctors is suffering from burnout because of relentless and "intolerable" work pressures, such as routine extra hours and being on-call regularly, emergency unit specialists haved warned.

The future staffing of emergency departments is in question because too few junior doctors are choosing to work within them and growing numbers of A&E consultants are moving abroad, according to a new report by the College of Emergency Medicine, which represents A&E staff.

A CEM survey of 1,077 A&E consultants in UK hospitals found 62 per cent of them believe the job they are doing is unsustainable in its current form, while 94 per cent work overtime in order to ensure high-quality care.

Work-life balance is so difficult for A&E doctors, and the workload so constant and increasingly complex, that existing recruitment problems threaten to become a crisis, the CEM warns.

NHS leaders need to urgently come up with ways to ease the burden on A&E staff through "safe and sustainable working practices for consultants and other senior decision-makers in emergency department" in order to ensure they have "adequate time off for rest and recuperation".

One senior A&E consultant, who did not want to be named, said extra time off or financial incentives to reward doctors for working regularly overnight or at weekends should be considered.

While just two A&E consultants left the NHS to work abroad in 2009, 21 did so last year – "a worrying trend", said the CEM, which warned that highly-trained doctors were being lost to the NHS because too much is expected of them.

The college's report, Stretched to the Limit, comes as Sir Bruce Keogh, NHS England's national medical director, prepares to publish the results of his inquiry into the future of A&E care and amid growing fears that this winter will prove very demanding for the NHS.

Dr Paul Flynn, chair of the British Medical Association's consultants committee, said: "Consultants working in emergency medicine face some of the most challenging, high-pressured and stressful work environments in the NHS, often with limited resources and gruelling workloads.

"Unsurprisingly, the result has been fewer doctors choosing to go into emergency medicine and others leaving to work abroad, meaning existing consultants are working flat out to meet rising demand. We urgently need to look at how we can make working practices in emergency medicine safe and sustainable to address this recruitment and retention crisis."

The Department of Health said it had given an extra £500m to A&E units in England to help them cope with growing pressures and was trying to persuade more junior doctors to choose a career in emergency medicine.

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