CUP3
Research type
Research Study
Full title
Care Under Pressure 3: Optimising the delivery and impacts of interventions to reduce hospital doctors’ mental ill-health in the NHS
IRAS ID
314025
Contact name
Daniele Carrieri
Contact email
Sponsor organisation
University of Exeter
Duration of Study in the UK
1 years, 0 months, 29 days
Research summary
Summary of Research:
Doctors experience high levels of stress, anxiety, and other mental illnesses due to very challenging demands and pressurised work environments. COVID-19 has exacerbated these issues and the need to address mental ill-health in doctors is even more important to the future of the NHS. However, existing workplace support interventions for doctors are having limited effect and do not take into account the different factors contributing to the problem, nor how existing approaches to preventing/supporting mental ill-health might interact within the workplace.This NIHR-funded project, Care Under Pressure 3 (CUP3), seeks to address these gaps. It builds on the principles and recommendations from our previous realist review Care Under Pressure 1 (CUP1), applying these to current practice to understand how to improve existing interventions.
The research aim of CUP3 is to work with and learn from eight purposively selected NHS Trusts in England to develop an implementation toolkit for all NHS Trusts to optimise their strategies to reduce doctors’ mental ill-health and its impacts on the workforce and patient care. CUP3 involves three sequential phases over 24 months:
- Phase 1: developing a typology of interventions.
- Phase 2: realist evaluation of current interventions, primarily involving 160 interviews each lasting approximately one hour. Participants will be NHS staff recruited due to their professional role, either hospital doctors, or staff involved with initiatives and strategies to support doctors (e.g. service managers, well-being champions, occupational health).
- Phase 3: developing an implementation toolkit.CUP3 will produce guidance to optimise their strategies to reduce doctors’ mental ill-health through an implementation toolkit for use across all NHS Trusts, and tailored recommendations for the NHS Trusts involved in the research.
This HRA application relates primarily to Phase 2 (realist evaluation) as this is the only phase collecting data from participants.
While research with NHS staff does not necessarily require NHS REC approval, the topic and nature of the research make it seem suitable for NHS REC ethical approval, so this will be sought alongside the HRA application.
Summary of Findings:
What is the problem?
Doctors experience high levels of stress affecting their physical, mental and emotional wellbeing due to the volume of patients needing healthcare services and the fact that there are not enough staff and other resources to provide this care. Patients and doctors are very anxious about patient safety and doctors also feel frustrated at being overworked, undervalued and not listened to. Workplace support for doctors is not always effective and there is little reliable guidance on how to improve it.What did we do?
We worked with hospitals to understand how to improve their strategies to support doctors' wellbeing. The project had three parts:
1. Develop a tool to map existing support.
2. Interview doctors and other staff in eight hospitals in England to understand how to improve their wellbeing.
3. Develop guidance for all hospitals to help them improve their strategies to support doctors' wellbeing.What did we find?
Using our tool to map existing support promoted clear thinking about how to best improve doctors' wellbeing and reduce effects of workplace stress.
Interviews showed that much of the support provided is not addressing the real problems affecting doctors' wellbeing. For example, problems of overwork and poor IT systems were not addressed by 'solutions' such as gifts of tea bags, yoga, and animal visits.
We distilled our results into guidance for hospitals to plan and implement support for doctors more effectively.We are a team of expert researchers and clinicians with nearly a decade of successful work in this area. An advisory group including patients, policy makers, and doctors helped us to design feasible guidance and communicate our results. As well as reports and publications, we have used cartoons and other innovative approaches to make our work more accessible.
Patients have contributed to this summary.REC name
Wales REC 6
REC reference
22/WA/0352
Date of REC Opinion
22 Dec 2022
REC opinion
Further Information Favourable Opinion