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Take a look at a selection of our recent media coverage:
14th October 2024
Recommendations to mitigate burnout among the oncology workforce have been shared by the European Society for Medical Oncology (ESMO). The paper outlines how to manage psychosocial risks, optimise wellbeing, and reduce burnout among oncology healthcare professionals (HCP) to support staff, improve efficiencies and help maintain the delivery of optimal cancer care.
The series of 11 recommendations targets improvements in three areas: information and training to support HCPs development and practice, resources to safeguard HCPs psychological and physical health, and activism and advocacy to support the wellbeing of the oncology workforce. The proposals are aimed at individual healthcare professionals, institutions and national and international societies.
A diverse, multinational panel of interprofessional experts developed the evidence-based plan designed to address the growing pressures placed on the profession and mitigate the threat they pose to the quality and equity of cancer care. The recommendations are based on the key findings from three previously reported ESMO Resilience Task Force (RTF) surveys, which included more than 3,700 responses from professionals in over 100 countries.
The measures include providing more training and individualised mentoring to support HCPs, allowing them to restore control over their career development. In addition, plans to ensure manageable workloads and offer more flexible working conditions are suggested, as well as the need to create more pleasant working environments with suitable equipment and the time and space to communicate with colleagues and reduce isolation.
ESMO stated that the recommendations are ‘fundamental’ for the future of cancer care. They warned that failing to make the necessary changes would cause the quality of cancer care to deteriorate across Europe, whilst global health inequalities would increase as high-income countries deplete the medical workforces of low- and middle-income countries to try to meet their labour needs.
For each area of action, the paper highlights various initiatives that ESMO is undertaking to help address the issue and provide tangible support to practitioners, including efforts to push for necessary political measures to protect the oncology workforce.
Commenting on the recommendations, Dr Jonathan Lim, member of the ESMO RTF and consultant medical oncologist in advanced immunotherapy and cell therapy at the Christie NHS Foundation Trust in Manchester, UK, said: ‘As oncologists on the ground, we see every day that morale is low and that the workforce is in crisis. Our hope is that this work will now serve as an evidence basis that individuals can use as leverage to advocate for change within their institutions, taking from the recommendations what is most valuable and feasible within their respective countries, cultures and working environments.’
In June, the Royal College of Radiologists warned that escalating workforce shortages were causing ‘growing delays’ in cancer diagnosis and treatment in the UK and ‘putting patients’ lives at risk’.
19th August 2024
A study by German researchers shows that despite differences in healthcare systems in Europe, strategies that address everyday external stressors in emergency departments (EDs) can improve working conditions and increase sustainability.
The European Society for Emergency Medicine (EUSEM)-initiated, Europe-wide consensus survey sought to identify unequivocal major factors for good and poor working conditions in EDs and determine their retrospective effects on healthcare providers. The findings provide a scientific framework for future interventions to improve ED provider work lives.
An overview of previously reported ED working conditions and improvement interventions across Europe was attained from a literature search and informed a two-round mixed-method Delphi survey, covering key factors for ED providers’ work life, wellbeing, and associated patient care outcomes. The researchers surveyed 18 clinicians with emergency medicine leadership roles across large (>600 beds), middle-sized (200–600 beds) and small hospitals (<200 beds) in six European countries: Belgium, Finland, Germany, Italy, Romania and the UK.
There was almost unanimous consensus amongst the participants on four categories of working conditions in EDs. These categories included both positive aspects, such as ‘job challenges’, encompassing variation and interdisciplinary interaction, which had an average rating of 4.7/5 in the survey response and 100% consensus, ‘job intellectuality’ (mean = 4.6, 94%) and ‘job control’ (mean = 4.4, 100%), which included participation in decision-making.
The highest ratings for negative conditions were for ‘overcrowding’ (mean = 4.7, 94%), ‘workflow interruptions and/or multitasking’ (mean = 4.6, 94%), ‘time pressure and/or lack of breaks’ (mean = 4.4, 89%), and ‘employee turnover and understaffing’ (mean = 4.4, 83%). Additionally, ‘medical errors’ (mean = 4.1, 83%) were deemed to be highly relevant among clinicians.
The highest-rated work-life improvement practice was ‘emergency care as autonomous specialty’ (mean = 4.4, 94%), while skills training, debriefings after critical events and regular feedback from mentors were also deemed crucial at a team level.
Whilst the positive aspects of ED life were attributed to personality aspects, such as high individual motivation and team orientation, the negative effects were shown to depend on external and structural factors caused by the healthcare system. The authors noted that the latter can lead to exhaustion and burnout and are ubiquitous across European healthcare systems.
The authors hope the findings can help decision-makers develop targeted strategies to improve working conditions in the field of emergency medicine, as well as laying the ‘scientific groundwork for future intervention studies at the local and systemic levels to improve ED provider work life’.
Weigl, M et al. Key factors for sustainable working conditions in emergency departments: an EUSEM-initiated, Europe-wide consensus survey. European Journal of Emergency Medicine 2024; Jul 19: DOI: 10.1097/MEJ.0000000000001159.
18th April 2024
Over a third of patients are in favour of clinicians using artificial intelligence (AI) in consultations to improve documentation processes such as clinical letters, according to a recent white paper from the Microsoft company Nuance.
Analysing survey responses from 13,500 participants from nine European countries plus the UK and Australia, the white paper explored patients’ recent interactions with clinicians and whether they believed AI would have helped to improve their experience.
The responses highlighted five main challenges that patients felt contributed to an unsatisfactory experience with their clinician: ineffective communication, excessive waiting times, lack of personalisation, insufficient continuity of care and limited accessibility to healthcare information.
An average of 40% of respondents felt that they didn’t receive their physician’s full attention during consultations because they were focused on their computer screens. Of those, 40% said that led to feelings of frustration. In the UK, this frustration peaked at 50% of respondents.
In order to improve this interaction, an average of 34% of respondents said they felt using AI to assist in the clinical documentation process would be a good idea, ranging from 27% in Norway to 48% in Spain.
When considering the age breakdown, respondents from younger age groups were more likely to agree AI would be beneficial. The percentage decreased with each age category from 43% of 18-to-24-year-olds to 26% of those aged 65 and over.
Although the patients surveyed had not yet had any personal experience with AI in healthcare, respondents chose freeing up time for the clinician as the most compelling reason to use AI, with an average of 45% and peaking at 55% for German respondents.
While the survey respondents broadly supported the use of AI, they also raised concerns about the use of AI in clinical settings, with 50% saying they were ‘somewhat concerned’. A further 32% were ‘not very concerned’ and 10% were ‘not concerned’.
The main cause for this concern was a lack of AI regulation at 34%, which increased to 46% in Germany and 48% in the UK. Medical information being recorded was also highlighted, with 17% recording this as a concern.
In response to this, the white paper stated: ‘The regulatory aspect of AI is changing all the time, with most governing bodies in our surveyed countries working on AI roadmaps and specific legislation.
‘Healthcare organisations should ensure they implement tools that are purpose-built for clinical environments to guarantee quality and safety, and that they clearly communicate the benefits to clinicians and patients.’
Writing in the white paper, Dr David Rhew, global chief medical officer and vice president of healthcare, at Microsoft, said: ‘With AI, we can pull together more information than ever before, extracting deeper insights into patient health and treatment options. We can accelerate and automate the workflows clinicians follow, and simplify the tasks that can draw their focus away from the patient. And we can tailor care pathways and treatments to the individual patient’s unique needs.’
The white paper also stated that ‘this total focus on the most meaningful part of their role – working directly with patients – supports clinicians’ professional satisfaction and reduces the likelihood of burnout’.
Earlier this year, the EU-funded METEOR Project highlighted widespread retention issues in Europe with 9% of doctors and nearly 14% of nurses declaring an intention to leave their profession, citing low job satisfaction, growing depersonalisation and emotional exhaustion as the primary factors.
And the recent NHS staff survey revealed that 65.56% of medical and dental staff were unable to meet all the conflicting demands on their time at work.
Previous research from Nuance in 2022 revealed that NHS healthcare professionals in acute, mental and community health settings were spending an average of 13.5 hours per week generating clinical documentation – a 25% increase since 2015.
Consultants were found to spend the longest on clinical documentation at 15.1 hours per week.
A further 3.2 hours per week were spent out-of-hours by healthcare professionals on this task, according to the research.
Some 68% of respondents said they felt it likely or very likely that their notes would be more complete if they had more time to complete them.
In an attempt to help free up doctors’ time to treat more patients and reduce waiting times, the NHS has recently announced the rollout of AI software at 10 trusts in England that aims to reduce missed appointments.
13th March 2024
Almost one in 10 doctors across the European Union (EU) intend to leave their profession, according to a new cross-sectional study from the EU-funded METEOR Project, highlighting widespread retention issues.
Researchers from the METEOR Project – which collects scientific knowledge on job retention of healthcare workers in Europe to develop policy recommendations to increase job retention – asked 381 physicians and 1,351 nurses at hospitals in Belgium, the Netherlands, Italy and Poland about their intention to exit the profession or leave their current hospital, and the factors influencing their decisions to quit.
The results showed 9% of doctors and nearly 14% of nurses declaring an intention to leave their profession, citing low job satisfaction, growing depersonalisation and emotional exhaustion as the primary factors.
The survey also revealed 16.3% of doctors and 8.4% of nurses are considering leaving their current jobs. Factors impacting nurse and physician retention in hospitals highlighted job dissatisfaction, lack of career development and poor work-life balance as the main determinants of intention to leave,, which the researchers suggested can ‘help governments and hospital administrators combat the trend’.
Laura Maniscalco, co-author of the study and research fellow at the University of Palermo (UNIPA), said: ‘Many doctors want to leave their current workplaces because of the management and personal issues. In the high-stress environment of a hospital, they can face challenges in terms of work-life balance or conflicts that can result in bullying.
‘Additionally, the ineffectiveness of the management system and understaffing can force them to work in areas outside of their expertise, leading to role conflicts and reducing opportunities for career advancement.”
Domenica Matranga, a professor at the UNIPA and co-author of the study, added: ‘Our research suggests that nurses may [also] no longer find their job rewarding or valued. This issue is connected with relatively low salaries, tough working conditions and, of course, the physical and emotional pressure caused by the pandemic.‘
This latest study adds to ongoing research highlighting and addressing the pressures on clinical workforces across the EU and UK.
Recommendations to enhance the wellbeing of doctors in Europe were published in November 2023 as part of a new policy from the Standing Committee of European Doctors. These aimed to improve patient care, professional excellence and overall job satisfaction and included focusing on adequate staffing and workload management, embracing a people-focused working culture, championing mentoring and peer support networks and supporting doctors as parents and carers.
Staff retention and mental health issues have also been noted amongst UK clinicians in recent months. A survey of 1,958 NHS health professionals from across the UK in September highlighted understaffing as a main factor pushing healthcare workers to leave the NHS.
A UK surgical workforce census report published in January 2024 found that 61% of respondents cited burnout and stress as the main challenge in surgery due to excessive workloads, and 50% of respondents across all career grades indicated that they considered leaving the workforce in the past year.
And last summer NHS chief executive Amanda Pritchard acknowledged that the NHS was seeing higher levels of sickness among staff compared to pre-pandemic, particularly due to poor mental health and anxiety, some of which she said was ‘directly related to what people have been through over what was an extraordinarily difficult few years’.
The turnover crisis comes as the healthcare sector struggles with an existing shortage of medical personnel. Projections from the World Health Organization indicate that in six years Europe will need 18.2 million healthcare workers to meet the growing demand for healthcare services driven by an ageing population and increased prevalence of chronic diseases.
As a result, the authors of this latest METEOR Project study are urging healthcare managers across the EU to ‘devise effective retention strategies, taking into account job satisfaction, work engagement, and a positive working climate’, adding that ‘such internal policies are crucial, given the difficulty of finding replacements for departing professionals’.
28th April 2023
Dr Urmas Sule, HOPE president, details how Estonia has weathered the significant challenges of 2022 and his hopes and expectations for 2023.
In 2022, we moved from Covid-19 to an energy crisis and the uncertainty of war. Unfortunately, Covid is still very much present. Managing one crisis after another, and sometimes doing it simultaneously, proves a challenge for maintaining a reasonable balance of healthcare services for Covid and non-Covid patients. In my opinion, we have succeeded in guarding the patients’ interests and safety the best way.
During these difficult times, we saw how important it was to have smooth cooperation between hospitals and healthcare providers. An effective distribution of tasks and responsibilities was developed to protect patients’ interests in the best possible way.
We as hospital managers cooperate well with the Health Board, the Health Insurance Fund and the Government of Estonia. Continuous negotiations with the Government and the Health Insurance Fund about adequate financing of services and support for the health sector were necessary and proved very fruitful.
Our partnership with the Estonian Medical Association, the Medical Faculty of the University and the Health Care Colleges has been a big help in involving medical and nursing students.
Our main focus for 2022 was, and will always be, to protect our healthcare workers from burnout. This is not an easy task and needs good cooperation between all partners.
Similar to other European countries, Estonia also faces the problem of a shortage of healthcare workers. Healthcare specialists are working for multiple employers. This is good for knowledge exchange, but is difficult to organise in a pandemic situation. Shortages have been a problem in Estonia for a long time, not just during Covid. The pandemic intensified the problem. Ensuring a reasonable division of labour and responsibilities between hospitals and other healthcare institutions has been a challenge.
But there are also other barriers, too. Political priorities have shifted from solving the healthcare crisis to an energy crisis and the effects of war. The primary focus has been improving readiness for emergencies in all areas. Helping Ukrainian refugees, providing them with social security and healthcare services is one of the important and ongoing challenges.
The Estonian Government created a new crisis staff structure during Covid. This structure was adapted for the healthcare sector together with the Estonian Hospitals Association network. We have collaborated with the Estonian Health Insurance Fund to guarantee the best possible availability of healthcare services to all patients. This has been possible due to the prudent and flexible planning and financing of services.
To motivate employees, we have negotiated collective agreements in two-year increments. This has been a good opportunity to hear the needs and expectations of healthcare workers so we can do our best to try to meet those expectations and improve working conditions. Negotiations for the coming years are currently underway, and we will make all efforts to find a balanced agreement and retain the effective and trusting relationships among our social partners.
The Health Insurance Fund measures the need for health services to lessen the treatment deficit. In collaboration, we have negotiated and agreed on the measures to reduce treatment deficits for non-Covid patients. We planned and introduced new services to prepare for Ukrainian refugees entering the healthcare system. But the biggest challenge for hospitals is the rapid and continuous rising costs of energy and other services.
We have monitored hospitals’ workloads and cooperated to ensure best use of all resources – especially the healthcare workforce – to create a flexible system that is prepared for new challenges.
We have seen a rapid growth of the development and use of e-services and remote services and consultations in the healthcare sector in Estonia. There has been great development across many specialities – psychiatry, for example – during the pandemic. This has been possible due to the collaboration between hospitals, other healthcare providers and the Health Insurance Fund.
Because of the health crisis, we have increased infection control capacity and knowledge, not only in the healthcare sector, but also in society. A nationwide vaccination campaign has also alleviated the effects of Covid and the burden on the healthcare system.
We are negotiating the 2023/24 collective agreement with the Medical Association, Nurses Association and other trade unions. It is a challenge to achieve a balance between reasonable salaries and general pricing principles that include all input prices and guarantee adequate availability of patient services.
At the same time, our healthcare system has to achieve the best possible flexibility to be prepared for any possible crises. This seems like an endless and boundless task!
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