AAGBI RCoA and FICM logos

Joint statement: tackling the effects of fatigue on the NHS workforce

Following the tragic death of an anaesthetic trainee who fell asleep at the wheel while driving home after a night shift, the Association of Anaesthetists of Great Britain and Ireland (AAGBI), the Royal College of Anaesthetists (RCoA) and the Faculty of Intensive Care Medicine (FICM) have come together to launch an agenda for action to address the impact of fatigue and shift working on the NHS workforce. 

Evidence about the issue
Anaesthesia is the single largest hospital-based medical specialty. Issues raised by both anaesthetists and intensivists are indicative of the challenges facing the profession, and the wider NHS. A recent national survey of anaesthetic trainees published in the scientific journal Anaesthesia  found:

  • Nearly three quarters of respondents reported that fatigue had a negative effect on their physical health or psychological well-being
  • 84% had felt too tired to drive home safely after a night shift
  • 57% had experienced an accident or near miss when driving home after a night shift.

The problem
Lengthy shifts continue to be a reality for many doctors in training: a report from the RCoA found that 95% of anaesthetic trainees were regularly staying beyond the end of their shift to work. Despite guidance on rest breaks outlined in the New Deal contract, self-assessment of tiredness and fatigue risk management are not yet part of routine practice.

The abolition of 24-hour resident on calls has seen rest facilities removed from many hospitals. Less than a third of anaesthetic trainees who responded to the AAGBI-led survey had access to a suitable rest facility, and of those who did, approximately 10% had to pay between £5 - £65 per shift to use them.

The solution
The AAGBI, RCoA and FICM have developed and distributed educational resources to all NHS Trusts in England, and Health Boards in Scotland and Wales. The resource packs contain a ‘traffic light’ coding system to evaluate existing rest facilities, and outline ways for hospital management, doctors and other staff to work together to establish, improve or promote those facilities. In tandem, a #FightFatigue campaign on social media will aim to raise awareness and a positive change in culture by:

  • Educating doctors, nurses, allied health professionals and managers about the benefits of good sleep hygiene and how to reduce fatigue and embedding this learning as part of all staff induction programmes.
  • Changing attitudes across the workforce to ensure that people understand the importance of  guarding against fatigue in maintaining patient safety and staff well-being.
  • Establishing a minimum provision for free rest facilities within hospitals for ‘power naps’ at night when the demands of patient care allow and for rest before travelling home after a night shift.

Take action to #FightFatigue
The AAGBI, RCoA and FICM are committed to supporting healthcare leaders and managers with practical solutions to help fight fatigue in the workforce. We are calling on NHS Trusts and Health Boards to take three simple actions to #FightFatigue:

  1. Download the educational resources and ensure they are used as part of the induction programmes for staff working in all departments by visiting: bit.ly/howtofightfatigue
  2. Adopt the minimum standards for rest facilities, and follow guidelines published at: bit.ly/FatigueGuidelines
  3. Promote positive attitudes towards rest across the workforce and help reduce the stigma attached to talking about fatigue by joining the #FightFatigue Twibbon campaign: bit.ly/LetsFightFatigue

Make a commitment
To become a signatory to the #FightFatigue campaign, or offer feedback on how to enhance this initiative, email fatigue@aagbi.org.

Signed by:

Download a copy of the joint statement here.