Barometer 2024: Deep dive on managing workloads
Why we commissioned this research:
To better understand the Barometer survey 2024 results relating to actions doctors had taken in response to pressure on their workload and capacity. The survey found the most common action doctors had taken was refusing to undertake extra workload. Almost two in five having done this in the past year (39%). One in five doctors had also reduced their contracted hours (20%).
The interviews explored what actions doctors had taken to manage their workload. The types of work they were refusing to undertake and why. And how these actions had affected themselves, their colleagues and patient care.
Evidence from this research has informed, The state of medical education and practice in the UK: Workplace experiences 2025 report.
What did the research involve?
It involved 40 in-depth interviews with doctors who had taken part in the 2024 Barometer survey. They had indicated they had refused additional workload due to pressures on workload and capacity. Interviews were conducted between October and November 2024.
The sample represented a mix of roles, career stages, and backgrounds. It included GPs, specialists, doctors in training, specialty and associate specialist (SAS) and locally employed (LE) doctors. The sample also included doctors who had reduced their contracted hours in the past year.
Key findings:
Refusing additional workload took many forms, including:
- prioritising tasks within shifts (e.g., refusing or delaying ad hoc tasks such as adding patient information)
- saying no to, or not volunteering for, different types of extra work (e.g., work not included in contractual hours such as covering shifts/taking on additional shifts)
- reducing current hours or roles (e.g., reducing or stopping “non-essential” roles in leadership or education)
Reasons for refusing additional work included:
- avoiding burnout and exhaustion
- prioritising family and caring responsibilities
- seeking better work life balance
- prioritising training
- poor remuneration for extra work
Catalysts to taking action included systemic issues (such as staffing shortages and administrative burden). And feelings of being under-appreciation and experience of moral injury.
Positive impacts of taking action included improved wellbeing, better family life, and greater job satisfaction. Many doctors felt they could deliver better patient care as a result in the long term.
Challenges and trade-offs included feelings of guilt. Concerns about career progression and the potential short-term impact on patient care or colleagues. Doctors felt the positives of taking action to manage workload outweighed the negatives.
Despite taking these actions, some doctors are still at risk of leaving the UK workforce due to workload pressures. Some plan on a career change, moving abroad, or early retirement.
Doctors suggested improvements to help manage their workload pressures. Ideas such as better IT systems, more mental health support, greater input into rota planning, and improved pay for additional work.
