BMJ Open (Nov 2020)
Need for recovery amongst emergency physicians in the UK and Ireland: a cross-sectional survey
- Jos Latour,
- J Leung,
- Doyo Enki,
- Mark David Lyttle,
- J Browning,
- F Cantle,
- J Criddle,
- J Foot,
- S Hartshorn,
- N Mullen,
- E Williams,
- A Ghosh,
- M Morrison,
- S Taylor,
- DSD Ranasinghe,
- A Basu,
- S Gray,
- E Frost,
- Tom Roberts,
- 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
- Jos Latour
- Faculty of Health, University of Plymouth, Plymouth, UK
- J Leung
- University of Queensland, Brisbane, Australia
- Doyo Enki
- Research Design Service East Midlands, University of Nottingham, Nottingham, UK
- Mark David Lyttle
- 5 Emergency Department, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- J Browning
- Ludwig Institute for Cancer Research, Melbourne Centre for Clinical Sciences, Austin Health, Heidelberg, Victoria, Australia
- F Cantle
- Paediatric Emergency Department, Kings College Hospital, London, UK
- J Criddle
- Paediatric Emergency Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- J Foot
- S Hartshorn
- Paediatric Audit and Research (RAM Network), West Midlands, UK
- N Mullen
- 2Simulation in the North-East, Sunderland Royal Hospital, City Hospitals Sunderland Foundation NHS Trust, Sunderland, UK
- E Williams
- 1Women and Children’s Health, Faculty of Life Sciences and Medicine, King’s College London, London, UK
- A Ghosh
- 1Neonates, Princess Royal Maternity Hospital, Glasgow, UK
- M Morrison
- Information Services Division, Scotland, Edinburgh, United Kingdom
- S Taylor
- 1Paediatrics, West Middlesex University Hospital, London, UK
- DSD Ranasinghe
- 1Paediatric Emergency Department, Portsmouth Hospitals NHS Trust, Portsmouth, UK
- A Basu
- 3Neurology, Sir James Spence Institute, Newcastle upon Tyne, UK
- S Gray
- 4Department of Anaesthesia, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
- E Frost
- Centre for International Health, University of Sherbrooke, Canada
- Tom Roberts
- The Royal College of Emergency Medicine, London, UK
- P Fitzpatrick
- 2Paediatric Emergency Medicine, Royal Children’s Hospital, Melbourne, Australia
- G Gardner
- 1Memorial Sloan Kettering Cancer Center, Department of Surgery, New York, USA
- N Ali
- Tan Tock Seng Hospital, Singapore, Singapore
- Kara Nicola Stevens
- 3 Medical Statistics Group, University of Plymouth, Plymouth, UK
- R Bond
- Department of Cardiology, Musgrove Park Hospital, Somerset, UK
- J Patel
- 1Emergency Medicine, University Hospitals Leicester, Leicester, UK
- J Thompson
- 1Imperial College London, London, UK
- S Bailey
- 6 East and North Hertfordshire NHS Trust
- J Norton
- 4Imperial Patient Safety Translational Research Centre, Medical School, London, UK
- C Thomas
- Division of Community Health Sciences, St George's University of London, London, UK
- A Paul
- Staffordshire Rheumatology Centre, The Haywood, Stoke on Trent, ST6 7AG, UK
- K Thomas
- 1Marie Curie Palliative Care Research Centre, Cardiff University, Cardiff
- H Cooper
- 4General Paediatrics, Worcestershire Acute Hospitals NHS Trust, Worcester, UK
- L McKechnie
- 2Neonatal unit, Leeds Teaching Hospitals Trust, Leeds, UK
- A Knight
- 3Management Team, Taunton and Somerset NHS Trust, Taunton, UK
- E Walton
- 3PERUKI, UK
- C Kennedy
- Paeds AandE, North Middlesex University Hospital, London, UK
- L Kane
- Paediatrics, Bwindi Community Hospital, Uganda
- S Richter
- 1Cambridge University Hospitals Foundation Trust, Cambridge, UK
- J Selway
- C Rimmer
- 1FINCH Unit, Sandwell and West Birmingham NHS Trust, Birmingham, UK
- M Ayres
- C Ponami
- A Quartermain
- K Kaur
- School of Clinical and Experimental Medicine, Institute of Biomedical Research, University of Birmingham, Birmingham, UK
- K McGregor
- T Clingo
- R Stewart
- King's College London, Institute of Psychiatry, London, UK
- K Mirza
- Eye Clinic, University College Hospital, Galway, Ireland
- T Hussan
- P Cuthbert
- M Alex
- F Barham
- A Bayston
- K Veeramuthu
- R Macfarlane
- G Lipton
- K New
- The University of Queensland, School of Nursing & Midwifery, Brisbane, Australia
- M Jee Poh Hock
- E Umana
- C Ward
- Retired, Liverpool, UK
- V Agosti
- M Connelly
- 1Marie Curie Cancer Care, UK
- C Weegenaar
- J Kerr
- Department of Microbiology, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, UK
- SJ Dhutia
- T Owens
- Department of Economics, University of Nottingham, UK
- B Cherian
- U Basit
- D Hartin
- Emergency Department, Addenbrooke’s Hospital, Cambridge, UK
- O Williams
- Children Nationwide Regional Neonatal Intensive Care Centre, King’s College Hospital, London SE5 9RS, UK
- C Lindsay
- 2Amgen, Thousand Oaks, USA
- S Manou
- MH Elwan
- C Nunn
- R Fuller
- Medical Department for the Elderly, The General Infirmary at Leeds, Leeds, UK
- S Stevenson
- Department of Rheumatology (Floor 7), Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK
- C Reynard
- 1 University of Manchester, Manchester, UK
- J Daly
- Royal Liverpool Children’s Hospital NHS Trust, Alder Hey, Liverpool, UK
- A Da’Costa
- L How
- G Boggaram
- D McConnell
- R Hirst
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
- R Campbell
- 1School of Social and Community Medicine, University of Bristol, Bristol, UK
- J Muller
- Department of Clinical Genetics and Department of Growth and Reproduction, University Hospital Rigshospitalet, Copenhagen, Denmark
- H Chatha
- R Grimwood
- F Fadhlillah
- S Ojo
- S Ramsundar
- A Blackwell
- I Traiforos
- T Sparkes
- L Barrett
- 2School of Medicine, University of Leeds, Leeds, UK
- M Sheikh
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- J Driessen
- S Meredith
- MRC Clinical Trials Unit at UCL, London, UK
- C Newbury
- Department of Paediatrics, University of Auckland, Auckland, New Zealand
- H Grimsmo-Powney
- H Malik
- 2Liverpool Hepatobiliary Unit, University Hospital Aintree, Liverpool
- L Gwatkin
- R Blackburn
- 1Institute for Health Informatics, UCL, London, UK
- F Gillies
- Royal Brompton Hospital, London, UK
- TF McLoughlin
- SM Rahman
- K Hopping
- M Broyde
- K Challen
- Northwest Deanery, Manchester, UK
- M Macdonald
- Fife Acute Hospitals Trust, Fife, UK
- A Randle
- E Timony-Nolan
- H Fairbairn
- G Gracey
- K Clayton
- C Magee
- 1Marie Curie Hospice West Midlands, UK
- G Hartshorne
- J Foley
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9JT UK
- S Gardner
- Paediatric A&E, Ormskirk DGH, Ormskirk, UK
- S Pintus
- K Scott
- School of Biological Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
- K Brammer
- A Raghunathan
- S Langston
- S Saunder
- C Szekeres
- L Kehler
- Emergency Department, Birmingham Children's Hospital, Birmingham, UK
- B O’Hare
- Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi
- A Arumugam
- C Leech
- Y Moulds
- DL Thom
- A Mackay
- The Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London, UK
- R Wright
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK
- CE Davies
- A Hanks
- E Murray
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
- A Saunders
- 1University of Manchester, Manchester, UK
- KI Malik
- Department of Surgery, Macclesfield District General Hospital, Macclesfield, UK
- IMV Asif
- S Manouchehri
- A Fatkin
- S Naeem
- N Cherian
- O Hill
- 1Military Performance Division, Natick, MA, USA
- C Boulind
- P Williams
- Department of Mathematics and Statistics, University of Surrey, Guildford, Surrey, GU2 7XH, UK
- S Hardwick
- C Gandolfi
- E Everitt
- G Hampton
- D McKeever
- D Purdy
- L Savage
- L Brown
- 5Health Protection Agency, HCAI and AMR Programme Team, London, UK
- P Harris
- 9 Royal Prince Alfred Hospital, Sydney, Australia
- R Sharr
- R Loffhagen
- V Rivers
- HD Khan
- K Vincent
- 1University of Texas Medical Branch, Galveston, USA
- H Baird
- S Bury
- E Grocholski
- G Kamalatharan
- 1University of Manchester, Manchester, UK
- J Gaiawyn
- G Johnson
- 1 Emergency Department, Royal Derby Hospital, Derby, Derbyshire, UK
- A Tabner
- 1 Emergency Department, Royal Derby Hospital, Derby, Derbyshire, UK
- L Abraham
- Department of Ophthalmology and Visual Sciences, South Australian Institute of Ophthalmology, Adelaide University, Adelaide, South Australia, Australia
- N Sexton
- A Akhtar
- Accident and Emergency Department, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK
- C de Buitleir
- B Clarke
- Department of Pathology, University Health Network/University of Toronto, Ontario, Canada
- M Colmar
- Z Haslam
- K Veermuthu
- D Raffo
- J Stafford
- S Mclintock
- OR Griffiths
- B McIlwham
- K Cunningham
- Whiston Hospital, Prescot, Merseyside L35 5DR: Department of Accident and Emergency Medicine
- 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.
