BMA quarterly tracker survey Current views from across the medical profession Quarter 3: July 2015
Background The BMA s Health Policy and Economic Research Unit (HPERU) manages an online panel of approximately 3,000 member doctors. The panel is broadly representative of main areas of medical practice and is used for quarterly tracker surveys on topical health questions. The tracker survey also includes recurrent questions on current workload, morale, future intentions and changes in the NHS. The survey also allows for additional questions on other issues if you are a health organisation interested in working with us, contact info.hperu@.
Methodology The quarterly tracker survey was sent to a random sample of 1,031 panel members (excluding students and retired members). Panel members were emailed a link to the online survey between 14 July and 28 July 2015. 486 replies were received, a response rate of 47%. Of these responses, 15 were removed as they were not currently working. The following analysis includes comparisons across branches of medical practice.
Respondents: branch of medical practice Consultants and GPs were the largest groups to respond to the survey: this reflects the composition of the UK medical workforce. Junior doctors are under represented in the survey compared to the workforce. 45% 40% 35% 30% 39% (182) 33% (156) Other doctors includes respondents that were working in medical academia, public health or outside one of the main fields of practice. This group was aggregated due to small sample sizes. 25% 20% 15% 10% 5% 13% (59) 10% (46) 6% (28) 0% Consultant GP Junior doctor in training SAS Other What grade is your current post?
Respondents: working pattern Just over three in ten respondents were working less than full time. This is consistent with previous surveys in the series. 32% (151) 68% (320) Full-time Less than full-time Are you working: full time, less than full time, unemployed, on a career break, on maternity leave, retired?
Current morale
How would you describe your current level of morale? Over 18% of respondents reported morale as high or very high. Conversely 46% reported morale as being low or very low. 40.0% 35.0% 30.0% 33.1% 35.5% On average, morale is slightly lower compared to the last two quarters. 25.0% 20.0% 17.4% 15.0% 13.2% 10.0% 5.0% 0.0% 0.8% Very low Low Neither high nor low High Very high Taking everything into account, how would you describe your current level of morale?
Average morale by branch of practice Using a 5-point scale (1 = very low, 3 = moderate, 5 = very high) the mean morale scores can be compared across branches of practice. Consultant Junior doctor in training 2.6 2.7 All branches of practice morale is below moderate. SAS 2.6 GPs continue to report the lowest morale. Average 2.6 GP 2.4 2.25 2.3 2.35 2.4 2.45 2.5 2.55 2.6 2.65 2.7 2.75 Taking everything into account, how would you describe your current level of morale?
Work-life balance
Overall, how satisfied are you with your work-life balance? On average, satisfaction with work-life balance has stayed the same this quarter. SAS 5.9 GPs again reported being least satisfied with their work-life balance. Consultant 5.2 Average 5.2 Junior doctor in training 5.1 GP 4.5 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 Overall, how satisfied are you with your work-life balance nowadays? (Please give your answer on a scale of nought to 10, where nought is not at all and 10 is completely satisfied )
Current workload
Current workload by branch of practice GPs were much more likely than other groups to report their workload as being unmanageable or unsustainable, however, the percentage has decreased compared to the last quarter (was 73.5%, now 66.0%). 100% 90% 80% 70% 3.4% 2.2% 1.6% 48.4% 4.5% 29.5% Consultants reporting their workload as being unmanageable or unsustainable has increased this quarter (was 38.0%, now 50.0%) with junior doctors decreasing from 29.6% to 20.3%. 60% 50% 40% 76.3% 76.1% I generally have a low workload Generally manageable Unmanageable or unsustainable 30% 66.0% 20% 50.0% 10% 20.3% 21.7% 0% Junior doctor in training SAS Consultant GP Overall, how do you perceive your current level of workload?
Working outside regular hours in the last month by branch of practice Consistent with all previous editions of the Omnibus survey, this quarter shows that GPs are most likely to report always working outside their regular hours. The only craft to show a decrease since the last quarter in those always reporting working outside regular hours was SAS doctors (was 21.1%, now 15.2%). 100% 90% 80% 70% 60% 50% 17.4% 67.4% 11.9% 61.0% 6.6% 45.6% 10.9% 25.6% Never or not applicable Sometimes 40% Always 30% 63.5% 20% 47.8% 10% 15.2% 27.1% 0% SAS Junior doctor in training Consultant GP In the last month, how often have you worked/trained outside your regular hours?
What was the reason for working/training outside of your regular hours? All branches of practice cited too much work as the main reason for working/ training outside their regular hours. SAS and junior doctors are working more outside their regular hours due to vacancies or staff shortages compared to the last quarter. In this quarter SAS doctors showed an increase in pressure from employers (was 15.2%, now 21.1%) and the opportunity of paid overtime (was 12.1%, now 18.4%), with junior doctors reporting an increase in pressure from colleagues (was 14.9%, now 19.2%). 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% Too much work Pressure from employer Pressure from colleagues Due to vacancies or staff shortages Personal development opportunities Opportunity of paid overtime 0% Junior doctor in training SAS Consultant GP In the last month, how often have you worked/trained outside your regular hours? What was the reason(s) for this?
Perception of pay
Perceived fairness of pay by branch of practice More GPs and more junior doctors perceive pay as unfair than fair. Compared to the last quarter fewer SAS doctors perceive pay as fair (was 47.4%, now 23.9%). 100% 90% 80% 70% 45.8% 34.8% 32.4% 40.4% This is the second survey following the publication of the DDRB pay recommendations in March. 60% 50% 40% 18.6% 41.3% 30.2% 28.8% Unfair Neither fair nor unfair Fair 30% 20% 10% 35.6% 23.9% 37.4% 30.8% 0% Junior doctor in training SAS Consultant GP To what extent do you think your current level of pay fairly reflects the work you do?
Job security
Job security by branch of practice Junior doctors in training were the least concerned about the security of their current post. 100% 90% 80% 70% 57.6% 34.8% 47.8% 51.3% 60% 50% 30.4% Unconcerned Neither concerned nor unconcerned 40% 30% 20% 10% 0% 33.9% 5.1 3.4% 30.4% 4.3% 29.7% 18.1% 4.4% 24.4% 17.3% 7.1% Concerned Very concerned Junior doctor in training SAS Consultant GP In the past month, to what extent have you felt concerned about the security of your current post?
NHS changes
Observed changes to the NHS in the last three months Respondents continue to report seeing high levels of waiting times and breaches of A&E targets at their place of work or nearby hospital in the last three months. Increased waiting times for your patients Breaches in A&E targets 39.7% 54.7% Major service reconfiguration 33.9% Formal involvement by regulator Not applicable as do not work for the NHS/have not been impacted by any of the above Black alert implemented 18.6% 17.9% 16.1% Any qualified provider 14.3% New independent sector providers 13.7% 0% 20% 40% 60% Has the hospital or practice where you normally work been directly impacted by any of the following in the last 3 months?
Raising concerns at work
Raising concerns over the standard of patient care Consultants and SAS doctors were the most likely to have voiced concerns over patient safety. 100% 90% 80% 70% 60% 63% 67% 75% 77% No Yes 50% 40% 30% 20% 37% 33% 10% 25% 23% 0% Consultant SAS Junior doctor in training GP Over the last month, have you voiced concerns over the standard of patient care in your workplace?
Employers reaction to voiced concerns Of those doctors who raised concerns over the standard of patient care, 39% believed that no action was taken. To the best of my knowledge, no action was taken 39.3% Conversely 16% of respondents experienced positive action after voicing concerns. My concerns were investigated but the action taken was not satisfactory 22.1% 9% of respondents felt penalised for voicing a concern. This figure has remained consistent over the year. My concerns were investigated and positive action was taken My concerns were investigated and no action was taken 12.9% 16.4% I felt penalised for raising the issue 9.3% 0% 10% 20% 30% 40% 50% Over the last month, have you voiced concerns over the standard of patient care in your workplace? Was any action taken as a result?
Why concerns were not raised Where there were concerns on the standard of patient care, respondents cited the problem was widely known as the primary reason for not raising concerns. The majority of respondents who had not voiced any concerns did not feel the need to raise any concerns over the standard of care. I didn t know how to raise my concerns Other I did not feel sufficiently supported by my superiors I was worried there would be negative consequences for me and my career if I raised concerns My concerns were voiced by other colleagues Not applicable 0.8% 3.4% 4.2% 5.8% 9.9% 10.2% The problem was widely known 15.2% I haven t felt the need to raise any concerns over the standard of care 50.5% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Over the last month, have you voiced concerns over the standard of patient care in your workplace? If no, why not?
Future intentions
In the last year have you ever considered any of the following? Nearly half of respondents were considering retiring early. Retiring early 47.1% Working less than full time 39.9% Working overseas 28.7% Leaving the profession 28.5% None of the above, I am satisfied with my current career 20.6% Retraining in a different specialty 7.9% 0% 10% 20% 30% 40% 50% In the last year have you ever considered any of the following?
Steps taken to change work-life balance Less than half of the respondents have made or are in the process of making changes to their work-life balance. 13.4% (50) 29.9% (112) No, I am still considering my options Yes, I am in the process of making this change Yes, I have made this change 56.7% (212) Have you taken any steps to change your work-life balance?
Influences on career considerations As in the last quarter, over 60% of respondents cited work conditions and hours of work as the top two factors that influenced considerations about their career. Career outside medicine Other Career and promotion prospects 9.1% 10.4% 20.1% Media coverage of the medical profession 33.2% Future financial prospects 35.8% Income 45.5% Domestic circumstances 47.1% Changes to the NHS 59.4% Hours of work 62.6% Work conditions 64.4% 0% 10% 20% 30% 40% 50% 60% 70% Please indicate which factors influenced considerations about your career (please tick as many as apply)
Bullying and harassment
Harassment, bullying or abuse in the last three months On average, doctors reported being harassed most frequently by patients or the public, and least frequently by other clinical professionals. 100% 90% 80% 7.7% 6.9% 30.2% 6.6% 25.7% 70% 60% 50% 40% 45.6% Frequently Infrequently Never 30% 62.8% 67.7% 20% 46.7% 10% 0% Bullied by patients Bullied by managers or team leaders Bullied by other clinical professionals In the last 3 months, how frequently have you personally experienced harassment, bullying or abuse at work? (Please rank where 1=never, 2=infrequently and 3=frequently)
Reporting incidents of harassment, bullying or abuse One-third of respondents indicated they did not report an incident of harassment, bullying or abuse. Yes, I reported it on behalf of a colleague 2.1% Yes, the incident related to myself 6.0% No, I didn t report it 35.6% Not applicable 56.5% 0% 10% 20% 30% 40% 50% 60% In the last three months, have you reported an incident of harassment, bullying or abuse at work?
Type of abuse The most common form of abuse was verbal, followed by psychological or emotional abuse. Verbal 54.1% Psychological or emotional 40.5% Other 2.7% Physical 2.7% 0% 10% 20% 30% 40% 50% 60% What form did this abuse take?