Care Under Pressure


Care Under Pressure 3: Optimising the delivery and impacts of interventions to reduce hospital doctors’ mental ill-health in the NHS

The NHS needs motivated doctors to provide the best care for patients. However, doctors experience high levels of stress, anxiety, and other mental illnesses due to very challenging demands and pressurised work environments. They worry about patient safety, the consequences of letting patients and colleagues down, and their professional reputation. Many work while unwell or choose to leave the profession. This has contributed to shortages of doctors. Existing workplace support for doctors seems to be having limited effect. In the 2020 NHS staff survey, around 40% of doctors reported to have felt unwell because of work-related pressure. Around a third of staff said that they were considering quitting their job. With COVID-19, the need to address mental ill-health in doctors is even more important to the future of the NHS. Existing approaches to workplace support do not take into account the different factors contributing to mental ill-health in doctors (e.g. individual, organisational, social); nor how existing approaches to preventing/supporting mental ill-health might interact within the workplace. Our previous NIHR project, Care Under Pressure 1 (CUP1), brought together evidence, and produced guidance and recommendations to reduce doctors’ mental ill-health in the workplace. One conclusion from CUP1 was that we do not need MORE initiatives, but we need to IMPROVE the ones that we already have. The proposed project, CUP3, transforms the principles and recommendations established by CUP1 into practice in eight carefully-selected NHS Trusts. It addresses the lack of practical guidance on how to apply existing recommendations for preventing or reducing doctors’ mental ill-health in the workplace so that they work as intended. Our aim is to work with and learn from eight NHS Trusts to minimise doctors’ mental ill-health and its impacts on the workforce and patient care, providing guidance for all NHS Trusts.
1. Map existing interventions to reduce doctors’ mental ill-health in the NHS; and use this to select eight different NHS Trusts
2. Work with these Trusts to understand their existing strategies to reduce doctors’ mental ill-health
3. Develop guidance for all NHS Trusts to help them evaluate and implement strategies to reduce doctors’ mental ill-health


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Care under Pressure programme of research

Care Under Pressure is an interdisciplinary research programme that aims to understand the causes of mental ill-health in health professionals, across specialties and career stages, and make informed recommendations to tackle this problem.

Care Under Pressure was born in November 2015