Irish hospitals failing to meet the core needs of doctors

The core needs of hospital doctors in Ireland are not being met, which will have implications for workforce wellbeing and retention, according to Dr Niamh Humphries (PhD), Senior Lecturer at the RCSI Graduate School of Healthcare Management.

Dr Humphries, who has published a number of key studies on doctor workforce issues in Ireland, presented her latest research on medical workplace needs in the ‘Lifestyle and doctors wellbeing’ session at the College of Psychiatrists of Ireland 2023 Spring Meeting on 30 March.

These findings are from a 2021 dataset, collected remotely with mobile instant messaging ethnography, which included initial interviews via Zoom or over the phone and a 12-week ‘back-and-forth’ conversation over WhatsApp with interviewees.

The research, based on previous work conducted on behalf of the General Medical Council in the UK, looks at the ‘ABC core needs at work’: Autonomy and control, which concerns having a ‘voice’ or ‘influence’; Belonging, which is being part of an effective inclusive team; and Competence, concerning safe and manageable workloads with effective line management.

Autonomy and control in the workplace were found to be “challenging”. Doctors felt they could not speak-up in the workplace for fear of being seen as “difficult”. Both senior and trainee doctors felt they faced barriers initiating improvement, and thus had low influence over the workplace.

Findings also showed doctors felt they had little control over work patterns and hours, and this was related to staff shortages.

Respondents said they felt a sense of belonging among peers and teammates, but at hospital level, they felt a sense of “not-belonging”. This was particularly an issue for NCHDs.

NCHDs also felt undervalued because of issues with hospital administration or HR departments, and NCHDs and consultants felt underappreciated and “expendable” by hospitals and the HSE.

The study also found safe and manageable workloads, which are key to competence, “appear to be lacking in many instances”. Staff shortages again impacted competence in the workplace as supervision and management were absent.

Speaking to the Medical Independent, Dr Humphries said: “The way people are working in hospitals at the moment just isn’t really good enough…. It’s unsustainable the way things are and the way things have been going.”

She added that “lack of hope is a real issue” among hospital doctors. “They need more hope that things will change in the future. And we need to start moving towards something more positive in order to give some hope.”

According to Dr Humphries, there are some positives in that these issues “are being aired” and “spoken about [on] panels like today”.

The study, ‘That’s just how medicine is: How Ireland is failing to meet the core work needs of its hospital doctors,’ is set to be published in the near future.