More support needed for the well being of cancer consultants
Cancer Research UK today (Friday) called for more support for cancer specialists as research shows the risk of poor mental health among hospital consultants has increased in the period 1994 to 2002.
In the study, published in today's (Friday's) Lancet, the research team suggests the increases in psychiatric morbidity and emotional exhaustion are likely to be due to the changes in cancer services since 1994. These have greatly benefited patients but may have increased levels of job stress without comparably increasing job satisfaction, for some cancer specialists.
The study led by Cath Taylor at Cancer Research UK's London Psychosocial Group at the Institute of Psychiatry, King's College London, examined consultants in two surveys in 1994 (880 consultants) and 2002 (1308 consultants). Over the eight years, the proportion of consultants reporting distress that is clinically significant increased from 27 per cent to 32 per cent. The number of consultants experiencing emotional exhaustion also climbed from 32 per cent to 41 per cent.
The study shows the decline in mental health among hospital consultants is significant for two types of cancer specialists - surgical and clinical oncologists.
Among surgeons, rates of mental distress rose from 22 per cent to 33 per cent and emotional exhaustion from 27 per cent to 41 per cent, while among radiotherapists (clinical oncologists) the rates were 28 per cent to 38 per cent and 39 per cent to 52 per cent, respectively. The researchers also studied gastroenterologists, radiologists and medical oncologists among whom significant changes were not found.
Cath Taylor, says: "There seem to be several underlying reasons for this worrying development. It appears to be in part due to increased stress from being poorly resourced and having responsibility for the quality of the work of other staff, together with trying to meet the expectations of relatives. On top of this, these consultants have an enormous workload coupled with insufficient levels of satisfaction from some areas of their work."
Appointments of all types of consultants increased across the board between 1994 and 2002. For example, the number of medical oncologists being appointed increased by 147 per cent. However, the research shows there was only a 45 per cent increase in the numbers of surgical oncologists and a 33 per cent increase in clinical oncologists - the two groups which suffered the biggest decline in mental health.
Professor Amanda Ramirez, Director of the Cancer Research UK London Psychosocial Group says: "The increase in numbers of doctors becoming surgical and clinical oncologists is much lower than for other specialties such as gastroenterology, so those currently in post are over-burdened by their work. Engaging consultants more directly in managing their workload and improving their clinical services may increase their job satisfaction. More openings for consultants to teach or carry out research are also likely to boost morale."
Professor Alex Markham, Chief Executive of Cancer Research UK, says: "The NHS Cancer Plan has been a great success for patients - death rates are falling and patients' experiences of care are improving, but cancer specialists are under enormous pressure and need support. Many seem to be 'running on empty' - they're delivering high quality care to patients, but somewhere along the line it's been forgotten that we need to care for the doctors as well.
"There now needs to be a closer look at consultants' roles and solutions need to be found for their work-related problems. The period of the study coincides with the introduction of challenging targets for NHS cancer services. Perhaps the impact of these on some groups of clinicians have been greater than anticipated.
"Further expansion of consultant numbers should remain a priority to improve the working lives of existing doctors. Since 2002 the number of clinical oncologists has climbed by a further 22 per cent - from 315 to 385. So the job of attracting and training more into the speciality is under way - but the NHS must ensure this continues."
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