The NHS is facing an exodus of senior hospital doctors as new figures show that more than 80% may retire early because work-related stress is causing them sleepless nights, marital breakups and illness such as ulcers, anxiety and even strokes.

A survey of NHS consultants shows that huge numbers are becoming burned out and having their lives damaged as a result of the escalating pressures at the service’s frontline, including rising demand, long hours and the need to meet targets.

In a survey of 817 experienced hospital doctors by the Hospital Consultants and Specialists Association (HCSA), 81% said they had thought about retiring earlier than planned as a direct result of work pressures. Burnout, low morale and increasing stress meant many would quit before reaching their retirement age, leaving hospitals overstretched and putting the care of patients at risk, the association warned.

“The number of consultants that are considering retiring early is staggeringly high and a big worry for the NHS. The NHS could be left without enough consultants and the remaining consultants would then be spread too thinly,” said Eddie Saville, the HCSA’s general secretary.

“If experienced consultants are bringing forward their retirement age because they are burned out, the loss of that amount of skill and expertise will have an impact on recruitment and retention of existing staff, and inescapably an impact on patient care,” added Saville. The HCSA represents 3,500 of the 48,000 consultants in the NHS across the UK.

Consultants told the HCSA how stress and routine extra hours are leaving them depressed, unable to sleep properly, and irritable with their partners or children. Asked how their health and wellbeing had been affected by work-related stress, one consultant replied: “For the first time in my life I’m on antidepressants and it affected my sleep. Not very tolerant with kids and unable to support them through GCSEs and A-levels, which I would have liked to do, due to stresses at work.”

Another said: “Have gone home in tears on several occasions. Have been on cusp of taking stress-related time off work, but don’t want to make it worse for my colleagues.” Another said he got stressed even when on holiday, thinking about coming back to work. “I deeply regret my choice of career,” he added.

The findings also show that:

83% of consultants said work-related stress – long shifts, working beyond their contracted hours, extra work at home to keep up – had taken a toll on their family life. They cited relationship tension, breakups and divorce, and said it also made them feel guilty that they were neglecting their parental responsibilities.



80% work beyond their contracted hours, with 40% doing so “always” and 39% doing so “often”.

73% sometimes have sleepless nights thinking about work.



71% said work-related stress had taken a toll on their own health and contributed to them getting illnesses such as clinical depression, type 2 diabetes, high blood pressure, stomach ulcers and fatigue.

68% say they face unreasonable levels of work stress for about half the week or more and 33% say they face it for the entire week.

65% singled out their workload as the single biggest cause of their stress.

Facebook Twitter Pinterest The health secretary, Jeremy Hunt, wants the NHS to become a seven-day service Photograph: Neil Hall/PA

A separate study by researchers at Southampton University published in the online journal BMJ Open found that nurses working long shifts are also facing burnout, which is driving them out of the job. Working 12-hour shifts leaves 40% of nurses fed up with their jobs and a third wanting to leave their position, according to the survey of more than 30,000 nurses in almost 500 hospitals in 12 countries across Europe between 2009 and 2010.

The latest findings come just a week after the NHS England boss, Simon Stevens, launched an occupational health scheme for GPs in response to growing concern that NHS staff’s welfare was suffering as the service faced rising demand for care despite severe budgetconstraints.

The rising, widespread stress levels reported by consultants also raise doubts about the viability of David Cameron and the pledge by the health secretary, Jeremy Hunt, that the NHS will have become a fully fledged seven-day service by 2020.

Medical bodies such as the British Medical Association (BMA) and Royal College of GPs have warned that there are too few doctors to fulfil that ambition, and that services during the week will suffer if consultants work more overnight and at weekends.

Hunt’s ultimatum to the BMA to accept routine weekend work by consultants – or he would force them to do so by imposing a new contract – was due to expire on Friday. However, on Thursday night the doctors’ union said it would reopen discussions over the issue. Talks had broken down last October without agreement after two and a half years of negotiations. The vast majority of consultants already do at least some shifts outside of normal working hours.

Prof Jane Dacre, president of the Royal College of Physicians, which represents most hospital doctors, said that some consultant jobs in some medical specialties were becoming harder to fill.

“We have an increasing number of unfilled consultant posts in some of the specialties that patients need the most. These posts are becoming less attractive due to their high workload and stress affecting our ability to provide high-quality care”, said Dacre.

“While physicians still really enjoy diagnosing and treating patients, the systems in which they are working are becoming increasingly difficult. Our fellows and members also want to provide seven-day services for patients, but are concerned about the implications of initiatives like this for their working and family lives, particularly as there have been no detailed plans on how seven-day services could be provided.”

Prof Sir Bruce Keogh, the NHS’s medical director, said: “This survey illustrates just how hard people are working across the NHS. Day in, day out, thousands of our doctors and nurses are going the extra mile to save and improve lives around the clock.

“We need to get on with redesigning our NHS to make it easier for doctors, nurses and other NHS staff to provide the care their patients deserve – including at weekends.”

A spokesperson for NHS Employers said: “The biggest annual survey of NHS staff showed managers are doing more to support workforce health and wellbeing. There are over 50% more programmes supporting staff health and wellbeing now compared to 2010. NHS staff are now more confident than ever in reporting stress and mental health problems.”

But, he added: “We cannot be complacent. As demand on the NHS grows, efforts to improve the health and wellbeing of staff are very important, not only for staff but also to improve patient outcomes.”

The Department of Health said: “NHS staff are our greatest asset and it’s vital that employers make sure staff get the care they need. We are committed to making sure we have enough staff to meet patient needs seven days a week.”

The stresses and strains of working on the NHS’s frontline

I don’t recognise the person I was before I became a consultant. I’ve lost many friends who cannot understand the pressure that I am under. I am considering resignation before I lose my family.

My wife of 28 years has had enough. I am seriously considering getting out of the NHS.

I’m tired all the time. When I get home the kids are full of beans and I am just unreasonably grumpy. I can hear myself yelling at them and I just can’t stop.

My wife has had to take me aside and reflect on my worsening temper at home. At the age of 51 I don’t seem to be able to shrug off the stresses from work as easily as I did.

I spend a lot of time at home doing work and worrying about work. Rarely able to switch off completely. I often think about resigning.

Stress is affecting me physically. Because I get home very late, I eat and go straight to bed, which makes it harder to control my cholesterol, weight etc. I am also constantly tired, although when I have caught up with sleep during the holidays I am very energetic. I wake up early worrying about work stuff, and the stress and sleep deprivation definitely contribute to a permanent state of anxiety, which can be quite debilitating.

(Source: Responses to the survey undertaken by the Hospital Consultants and Specialists Association)