A BMA report on mental health and wellbeing in the medical profession - published alongside a charter setting out steps employers must take to support staff - warns that the medical profession has 'arguably less capacity than ever before'.
Doctors who took part in research carried out for the report identified 'the contradiction between the increase in responsibility and scope, and decrease in capacity and empowerment' for modern-day clinicians as the 'most significant difficulty facing the profession'.
The report found: 'This was said to impact doctors in a number of ways, principally a critical lack of time, increased pressure and expectations, which can increase the risk to wellbeing and potentially mental health.'
Burnout risk
The research by the BMA follows findings from a huge poll of doctors published earlier this year that showed nine out of 10 doctors face a high risk of burnout.
GPs have been shown to be at particularly high risk of burnout, as an increasing number of primary care doctors drop out of partnership roles and move to part-time working in the face of rising pressure.
The GP Health Service - an NHS service set up to help doctors facing mental health, burnout or addiction problems - has seen up to 100 doctors a month come forward to seek support.
Doctors in the latest BMA report said they had 'more to consider and more to do' than in the past - but often with 'less focus on direct patient care' and with less support and reduced resources.
Complex patients
An ageing, more complex population along with increased expectations on the part of patients have contributed to rising workload, doctors warned. Primary care, meanwhile, has been expected to take on more and more work as hospitals push patients out faster and social care and community nursing services have been eroded.
GPs have repeatedly warned that the 10-minute consultation is not enough to handle the complexity of the average patient consultation - and GPs responding to the BMA research highlighted time pressure as a key concern.
They also pointed to a rise in administrative demands on primary care at a time when funding had been squeezed, forcing practices to cut back on ancillary staff to take on this workload.
The report warned: 'In some cases, doctors report being forced to work harder and longer to compensate and plug the gaps, sometimes leading to symptoms of exhaustion and burnout.'
Lack of support
It added that limited time had meant 'opportunities for doctors to interact with each other through meetings, handovers or even social events are vastly reduced'. The report said: 'A lack of collaboration and ensuing sense of professional isolation was highlighted as a growing trend in all care environments, but especially common in general practice and for locums.'
Many doctors highlighted arrangements to protect their time and resources, flexible working, and openness and awareness of mental health risks as factors that had helped them maintain good mental health. They warned that doctors struggling with their mental health who were denied the chance to reduce working hours 'often took extended periods of sickness and absence and in some cases ultimately resigned, retired or retrained'.
Mental health expert and former BMA president Professor Dinesh Bhugra said: 'Employers have a duty to implement a safe and a healthy work environment and we hope that the launch of the BMA Mental Wellbeing Charter will serve as an important guideline to help them improve working conditions.
'While employers have a practical role to play in improving the situation for staff, they cannot go it alone. The Government must provide the right investment and resources to address wider systemic pressures.'
