91% of doctors who responded to a Medical Protection Society (MPS) survey believe staff shortages pose a “significant threat” to patient safety, with 89% saying the impact on patients is harming their own mental wellbeing.
In the MPS survey of more than 660 healthcare practitioners, many respondents indicated that medication shortages (66%) and equipment shortages (45%) are also impacting on patient safety, with more than 90% saying these shortages are affecting their mental wellbeing.
Respondents from state healthcare facilities commenting anonymously in the survey spoke of their distress at seeing patients suffer due to the continually dwindling supply of staff, medication, and equipment.
One healthcare practitioner said, “It leads to sleepless nights knowing that the service that you have rendered was not to best standard.”
Another commented: “You feel powerless, you want to do your job but some of the things that you need to do it effectively are just not available.”
Another doctor said: “No gloves or appropriate size. No proper suture material, no stock at times to place a cast. As a clinician working, who will take the fall if something goes wrong due to shortages? I will and that is a worry.”
Others also spoke of the stress of having to substitute or use medication that is not as effective, and the impact on their patient.
MPS, which protects the professional interests of over 300,000 healthcare professionals around the world, including more than 30,000 in South Africa, said more needed to be done to address the worrying impact of severely under resourced environments on both patients and doctors.
Dr Volker Hitzeroth, Medicolegal Consultant at MPS, said: “The critical shortage of doctors and the medicine stock outs in public health facilities, are long standing, multidimensional issues in South Africa. While we recognise the difficulties in resolving these problems, it must be noted that the impact on patient safety and on the doctors who are trying to do their best for their patients, is worrying.
“The effect of not being able to provide safe patient care on a doctor’s mental wellbeing – due to reasons beyond a doctors control - cannot be overstated. When patient safety is at risk, doctors also feel vulnerable to complaints, regulatory investigations, clinical negligence claims and even criminal charges which creates additional stress and pressure.
“When mental wellbeing is poor, it is worrying for the individual practitioner, but can also jeopardise patient care.
“We need to see more local mental wellbeing resources established so those healthcare practitioners struggling with moral distress and other wellbeing issues can access appropriate support. We also need measures to ensure those needing time off to recuperate can take it without adding to staff shortages or detracting from patient care.
“If the damaging effects of under resourced environments on both patients and doctors are not addressed, I fear South Africa may face an exodus of healthcare practitioners at a time when we can least afford it. Indeed, our survey shows that around two in five of those doctors who are considering leaving the healthcare profession, cite staff, equipment or medicine shortages as a major influence in their decision.
“At MPS our focus remains on advising our members on steps which may help to prevent foreseeable risks caused by staff, medicine and equipment shortages, and being there for members to request support and assistance if something does go wrong. We also provide a 24/7 independent counselling service as a benefit of membership for those who need wellbeing support.”
Doctors who participated in the MPS survey commented anonymously:
“A lot of patients complain directly to me and see the poor treatment at hospitals due to lack of staff as a reflection on my caring for them. It is emotionally and mentally draining trying to assist patients and relatives every time they are admitted and unhappy with service.”
“It leads to sleepless nights knowing that the service that you have rendered was not to best standard.”
“No gloves or appropriate size. No proper suture material, no stock at times to place a cast. As a clinician working, who will take the fall if something goes wrong due to shortages? I will and that is a worry.”
“When there is not enough staff… it impacts on the quality of health care the sector provides. Patient management is delayed unintentionally, and further care is compromised.”
“You feel powerless, you want to do your job but some of the things that you need to do it effectively are just not available.”
“The stress of having to substitute or use drugs that are not as effective.”
“Shortage of equipment and broken equipment not being fixed has a massive impact on my daily service delivery.”
“I cannot comfortably take time off to deal with my mental health because I always have to cover shifts at work. When we are extremely short staffed, I cannot do procedures for patients which leads to sub-standard care (as opposed to what happens when we are fully staffed). I am forced to treat patients less than adequately just because we do not have the time or staff to treat them properly.”
“I cannot do my job correctly and safely in a way that is best for the patient. We are always "making a plan" because of these shortages and patient safety and care unfortunately bears the brunt.”
“Stress persists and suppression has now become second nature, with a price to pay eventually. At times I just feel like giving up.”
ENDS
Key findings
- 91% of doctors in South Africa believe staff shortages pose a “significant threat” to patient safety
- 89% of doctors said that staff shortages and their impact on patient safety, was affecting their own mental wellbeing
- 45% said shortages of medical equipment were impacting patient safety
- 96% said shortages of medical equipment was affecting their own mental wellbeing
- 66% said shortages of medications were impacting patient safety
- 91% said shortages of medications were affecting their own mental wellbeing
- 82% said staff shortages make it difficult to take time off to deal with mental wellbeing issues
- 87% said that they cannot see staffing levels improving in the foreseeable future
- 47% of doctors considering leaving the medical profession cited staff shortages as a major influence for their decision
- 43% of doctors considering leaving the medical profession cited shortages of medication and the impact on patient safety as a major influence for their decision
- 36% of doctors considering leaving the medical profession cited medical equipment shortages and the impact on patient safety as a major influence for their decision
About MPS
The Medical Protection Society Limited (“MPS”) is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of more than 300,000 members around the world. Membership provides access to expert advice and support and can also provide, depending on the type of membership required, the right to request indemnity for any complaints or claims arising from professional practice.
Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.
Our philosophy is to support safe practice in medicine and dentistry by helping to avert problems in the first place. We do this by promoting risk management through our workshops, E-learning, clinical risk assessments, publications, conferences, lectures and presentations.
MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.