A quarter of doctors and surgeons and one in three nurses in the NHS have been bullied or put under excessive pressure over the last  two years, a new report says today.

Of 1,000 healthcare workers in the United Kingdom polled in the  survey, 43 per cent were also so  concerned about patient care that they thought their organisation could be at the centre of new scandal such as the one that hit the Mid Staffordshire NHS Foundation Trust.

Just one in four respondents said they have confidence in their senior managers, the research, carried out by the Chartered Institute of Personnel and Development (CIPD), found.

Titled Focus on Culture Change and Patient Care in the NHS, the  survey was commissioned to assess working conditions in the health sector following Robert Francis QC’s damning report into poor patient care at the Mid Staffordshire  Trust. It was also set up to see how organisations can identify problems before they escalate.

A public inquiry was launched in 2010 in the wake of the abuse  scandal at Stafford Hospital where hundreds of patients died because of poor care. In February this year it concluded and recommended  wide-ranging reforms to the  NHS, including making it illegal  to hide information about  sub-standard care, with staff  and senior managers held more  accountable for malpractice and mistakes.

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MORBIDITY AND MORTALITY IN DOCTORS VISITED BY MEDICAL MISFORTUNE. by Dr M Donnelly

The purpose of this paper is to raise further concerns about medical practitioners visited by medical misfortune.

The paper describes how social medicine focuses on the social determinants of health but it rarely focuses on the social determinants of the health of medical practitioners who may be visited by ill health or medical misfortune leading to disciplinary processes and ill health.

There is little written formally about the epidemiology of medical misfortune but we know that it may occur unexpectedly challenging the practitioner and demonstrating that in these situations the practitioner may well be on his or her own, frequently deserted by colleagues.

In 2004, in the United Kingdom, sanctions were made against 315 doctors; 82 erasures, 116 suspensions (64 on health grounds) and 117 conditions on registration (64 on health grounds). In 2003, of 214 doctors subject to GMC supervision, nine died, giving a case fatality rate of 4.2%, twice the death rate from coronary artery by-pass surgery. After the deaths of four soldiers at Deepcut Barracks in Surrey, a mortality of 0.03 per cent (throughput of 12,000 soldiers), Amnesty International called for a Public Inquiry. The trend has been downward since the National Audit Office documented the £40m spent on suspensions (the most frequent challenge) to the Public Accounts Committee..

If the morbidity and mortality amongst such medical practitioners is not addressed, more health service resources will be wasted, morale amongst medical practitioners will continue to fall and recruitment to the medical profession may adversely be affected.

1. General Medical Council . Annual Report 2004. General Medical Council . London, 2004.