Expert advice

NHS People Plan is refreshingly honest about the causes and extent of nurse burnout

The interim plan’s promise must now be backed up by funding and action

The interim plan’s promise must now be backed up by funding and action


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Burnout has been included in the new revision of the International Classification of Diseases (ICD-11), the World Health Organization (WHO) announced in May. It is an ‘occupational phenomenon’, and WHO will develop evidence-based guidelines on mental well-being in the workplace.

WHO has defined burnout as a ‘syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy’.

Contributing factors that are all too familiar

Type ‘nurse’ and ‘burnout’ into the world’s favourite academic research search engine and you will get about 120,000 results in 0.7 seconds. The two words, unfortunately, go together. Stressful and demanding work, long hours, shifts, and understaffing all contribute to making nurses prone to burnout. Factor in poor management or uncaring employers, and this in turn can lead to what WHO terms ‘reduced professional efficiency’: fatigue, absenteeism, turnover.

The interim People Plan, just published by NHS England, has a refreshingly honest take on this issue. It acknowledges that ‘our people report growing pressure, frustration with not having enough time with patients’. It admits the NHS is riven with nursing shortages, and it makes the link between these shortages, burnout, and compromised care.

Acknowledging this system-wide problem is a necessary starting point. What we now need is focused and funded action. The interim plan is light on detail and there is no word on budget. This is because decisions on funding will not be made until the autumn, at the earliest. The plan promises ‘a new offer’ to nurses based on creating a healthy, inclusive and compassionate culture where everyone feels they have influence.

Wide consultation is promised over the summer months. Nurses need to get fully engaged to ensure this promise becomes a sustained reality.


James Buchan is professor in the faculty of health and social sciences, Queen Margaret University, Edinburgh

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