BMJ Open (Nov 2020)
Need for recovery amongst emergency physicians in the UK and Ireland: a cross-sectional survey
- ,
- Jos Latour,
- Daniel Horner,
- Laura Cottey,
- J Leung,
- Doyo Enki,
- Blair Graham,
- Mark David Lyttle,
- J Browning,
- F Cantle,
- J Criddle,
- J Foot,
- S Hartshorn,
- N Mullen,
- R Hughes,
- E Williams,
- S Hall,
- A Ghosh,
- M Morrison,
- S Taylor,
- DSD Ranasinghe,
- A Basu,
- S Gray,
- E Frost,
- Tom Roberts,
- S Lewis,
- P Fitzpatrick,
- G Gardner,
- N Ali,
- Kara Nicola Stevens,
- R Bond,
- J Patel,
- J Thompson,
- S Bailey,
- J Norton,
- C Thomas,
- A Paul,
- K Thomas,
- H Cooper,
- L McKechnie,
- A Knight,
- E Walton,
- C Kennedy,
- L Kane,
- S Richter,
- J Selway,
- C Rimmer,
- M Ayres,
- C Ponami,
- A Quartermain,
- K Kaur,
- K McGregor,
- T Clingo,
- R Stewart,
- K Mirza,
- T Hussan,
- P Cuthbert,
- M Alex,
- F Barham,
- A Bayston,
- K Veeramuthu,
- R Macfarlane,
- G Lipton,
- K New,
- M Jee Poh Hock,
- E Umana,
- C Ward,
- V Agosti,
- M Connelly,
- C Weegenaar,
- J Kerr,
- SJ Dhutia,
- T Owens,
- B Cherian,
- U Basit,
- D Hartin,
- O Williams,
- C Lindsay,
- S Manou,
- MH Elwan,
- C Nunn,
- R Fuller,
- S Stevenson,
- C Reynard,
- J Daly,
- A Da’Costa,
- L How,
- G Boggaram,
- D McConnell,
- R Hirst,
- R Campbell,
- J Muller,
- H Chatha,
- R Grimwood,
- F Fadhlillah,
- S Ojo,
- S Ramsundar,
- A Blackwell,
- I Traiforos,
- T Sparkes,
- L Barrett,
- M Sheikh,
- J Driessen,
- S Meredith,
- C Newbury,
- H Grimsmo-Powney,
- H Malik,
- L Gwatkin,
- R Blackburn,
- F Gillies,
- TF McLoughlin,
- SM Rahman,
- K Hopping,
- M Broyde,
- K Challen,
- M Macdonald,
- A Randle,
- E Timony-Nolan,
- H Fairbairn,
- G Gracey,
- K Clayton,
- C Magee,
- G Hartshorne,
- J Foley,
- S Gardner,
- S Pintus,
- K Scott,
- K Brammer,
- A Raghunathan,
- S Langston,
- S Saunder,
- C Szekeres,
- L Kehler,
- B O’Hare,
- A Arumugam,
- C Leech,
- Y Moulds,
- DL Thom,
- A Mackay,
- R Wright,
- CE Davies,
- A Hanks,
- E Murray,
- A Saunders,
- KI Malik,
- IMV Asif,
- S Manouchehri,
- A Fatkin,
- S Naeem,
- N Cherian,
- O Hill,
- C Boulind,
- P Williams,
- S Hardwick,
- C Gandolfi,
- E Everitt,
- G Hampton,
- D McKeever,
- D Purdy,
- L Savage,
- L Brown,
- P Harris,
- R Sharr,
- R Loffhagen,
- V Rivers,
- HD Khan,
- K Vincent,
- H Baird,
- S Bury,
- E Grocholski,
- G Kamalatharan,
- J Gaiawyn,
- G Johnson,
- A Tabner,
- L Abraham,
- N Sexton,
- A Akhtar,
- C de Buitleir,
- B Clarke,
- M Colmar,
- Z Haslam,
- K Veermuthu,
- D Raffo,
- J Stafford,
- S Mclintock,
- OR Griffiths,
- B McIlwham,
- K Cunningham,
- E Clegg
Affiliations
- Antimicrobial Resistance Research Group, Centre for Neonatal and Paediatric Infection, St George`s University of London, London, UK
- Jos Latour
- Faculty of Health, University of Plymouth, Plymouth, UK
- Daniel Horner
- Emergency Department, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, UK
- Laura Cottey
- Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
- J Leung
- Doyo Enki
- 2Plymouth University, Medical Statistics, Plymouth, United Kingdom
- Blair Graham
- 1 Nursing and Midwifery, University of Plymouth, Plymouth, UK
- Mark David Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
- J Browning
- F Cantle
- J Criddle
- J Foot
- S Hartshorn
- N Mullen
- R Hughes
- 3Research and Early Development, Respiratory and Immunology, Clinical, AstraZeneca, Cambridge, UK
- E Williams
- 1Translational Healthcare Technologies Group, Centre for Inflammation Research, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- S Hall
- 2Cabrini Health and Monash University, Melbourne, Australia
- A Ghosh
- Department of Rheumatology, IPGMER, KOLKATA, INDIA, Institute of Post Graduate Medical Education and Research, Kolkata, India
- M Morrison
- S Taylor
- 1The Christie NHS Foundation Trust, Manchester, UK
- DSD Ranasinghe
- A Basu
- S Gray
- E Frost
- Tom Roberts
- 1 Trainee Emergency Research Network (TERN), The Royal College of Emergency Medicine, London, UK
- S Lewis
- 4 Defence Medical Rehabilitation Centre Stanford Hall, Loughborough, UK
- P Fitzpatrick
- G Gardner
- 2Primary Care, Birmingham Medical School, Birmingham, UK
- N Ali
- Kara Nicola Stevens
- Medical Statistics Group, Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK
- R Bond
- 2Faculty of Computing, Engineering and the Built Environment, Ulster University, Belfast, UK
- J Patel
- 2Trudell Medical UK Limited, Basingstoke, UK
- J Thompson
- 1Neurosurgery, University of Miami Health System, Miami, FL, USA
- S Bailey
- J Norton
- C Thomas
- 1University of Derby, Derby, UK
- A Paul
- Neurosurgery, Albany Medical Center, Albany, NY, USA
- K Thomas
- Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens School of Medicine, Hippokration General Hospital, Athens, Greece
- H Cooper
- L McKechnie
- A Knight
- 6Rheumatology, Department of Medical Sciences, Uppsala university, Uppsala, Sweden
- E Walton
- C Kennedy
- Royal Canadian Medical Service, Canadian Armed Forces, Ottawa, Ontario, Canada
- L Kane
- S Richter
- J Selway
- C Rimmer
- M Ayres
- C Ponami
- A Quartermain
- K Kaur
- 2Medical Student, Keele University, Keele, United Kingdom
- K McGregor
- T Clingo
- R Stewart
- K Mirza
- T Hussan
- P Cuthbert
- M Alex
- F Barham
- A Bayston
- K Veeramuthu
- R Macfarlane
- G Lipton
- K New
- M Jee Poh Hock
- E Umana
- C Ward
- 2Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- V Agosti
- M Connelly
- C Weegenaar
- J Kerr
- SJ Dhutia
- T Owens
- B Cherian
- U Basit
- D Hartin
- O Williams
- C Lindsay
- S Manou
- MH Elwan
- C Nunn
- R Fuller
- S Stevenson
- C Reynard
- 1Pfizer UK, Tadworth, UK
- J Daly
- A Da’Costa
- L How
- G Boggaram
- D McConnell
- Emergency Department, Derriford Hospital, Plymouth, UK
- R Hirst
- R Campbell
- Galway University Hospital
- J Muller
- 2University of Basel, Switzerland, Basel., Switzerland
- H Chatha
- R Grimwood
- F Fadhlillah
- S Ojo
- S Ramsundar
- A Blackwell
- I Traiforos
- T Sparkes
- L Barrett
- M Sheikh
- J Driessen
- S Meredith
- C Newbury
- H Grimsmo-Powney
- H Malik
- L Gwatkin
- R Blackburn
- F Gillies
- TF McLoughlin
- SM Rahman
- K Hopping
- M Broyde
- K Challen
- M Macdonald
- A Randle
- 20SWAG Cancer Alliance, Somerset, Wiltshire, Avon and Gloucestershire, UK
- E Timony-Nolan
- H Fairbairn
- G Gracey
- K Clayton
- C Magee
- G Hartshorne
- J Foley
- S Gardner
- S Pintus
- K Scott
- K Brammer
- A Raghunathan
- S Langston
- S Saunder
- C Szekeres
- L Kehler
- B O’Hare
- A Arumugam
- C Leech
- Y Moulds
- DL Thom
- A Mackay
- R Wright
- CE Davies
- A Hanks
- E Murray
- A Saunders
- KI Malik
- IMV Asif
- S Manouchehri
- A Fatkin
- S Naeem
- 4 Emergency Department, Barts Health NHS Trust, London, UK
- N Cherian
- O Hill
- Specialist Rehabilitation, Defence Medical Rehabilitation Centre, Loughborough, UK
- C Boulind
- P Williams
- S Hardwick
- C Gandolfi
- E Everitt
- G Hampton
- D McKeever
- D Purdy
- L Savage
- 1Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds
- L Brown
- 7 Emergency Department, Brighton and Sussex University Hospitals NHS Trust, Worthing, UK
- P Harris
- R Sharr
- R Loffhagen
- V Rivers
- HD Khan
- K Vincent
- H Baird
- S Bury
- E Grocholski
- G Kamalatharan
- J Gaiawyn
- G Johnson
- Neurosurgery, Washington University, St. Louis, MO, USA
- A Tabner
- L Abraham
- N Sexton
- A Akhtar
- C de Buitleir
- B Clarke
- M Colmar
- Z Haslam
- K Veermuthu
- D Raffo
- J Stafford
- S Mclintock
- OR Griffiths
- B McIlwham
- K Cunningham
- E Clegg
- DOI
- https://doi.org/10.1136/bmjopen-2020-041485
- Journal volume & issue
-
Vol. 10,
no. 11
Abstract
Objectives To determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores.Design Cross-sectional electronic survey.Setting Emergency departments (EDs) (n=112) in the UK and Ireland.Participants Emergency physicians, defined as any registered physician working principally within the ED, responding between June and July 2019.Main outcome measure NFR Scale, an 11-item self-administered questionnaire that assesses how work demands affect intershift recovery.Results The median NFR Score for all 4247 eligible, consented participants with a valid NFR Score was 70.0 (95% CI: 65.5 to 74.5), with an IQR of 45.5–90.0. A linear regression model indicated statistically significant associations between gender, health conditions, type of ED, clinical grade, access to annual and study leave, and time spent working out-of-hours. Groups including male physicians, consultants, general practitioners (GPs) within the ED, those working in paediatric EDs and those with no long-term health condition or disability had a lower NFR Score. After adjusting for these characteristics, the NFR Score increased by 3.7 (95% CI: 0.3 to 7.1) and 6.43 (95% CI: 2.0 to 10.8) for those with difficulty accessing annual and study leave, respectively. Increased percentage of out-of-hours work increased NFR Score almost linearly: 26%–50% out-of-hours work=5.7 (95% CI: 3.1 to 8.4); 51%–75% out-of-hours work=10.3 (95% CI: 7.6 to 13.0); 76%–100% out-of-hours work=14.5 (95% CI: 11.0 to 17.9).Conclusion Higher NFR scores were observed among emergency physicians than reported in any other profession or population to date. While out-of-hours working is unavoidable, the linear relationship observed suggests that any reduction may result in NFR improvement. Evidence-based strategies to improve well-being such as proportional out-of-hours working and improved access to annual and study leave should be carefully considered and implemented where feasible.
