We’ve signed an open letter to Dr Michael McBride, Chief Medical Officer for Northern Ireland, and Professor Sir Chris Whitty KCB FRS, Chief Medical Officer for England.

It urges them to work with NHS Practitioner Health and the Northern Ireland Executive to commission an extension of the service to doctors and dentists in Northern Ireland.

The open letter has been coordinated by the charity Doctors in Distress and signed by a coalition of leading UK medical organisations, including DAUK.

NHS Practitioner Health

It points out that doctors working in England, Scotland, Wales, the Isle of Man, Jersey and Guernsey can all access confidential, expert mental health and addiction care designed for the profession.

Northern Ireland’s 5,200 whole-time-equivalent doctors and dentists are alone in the United Kingdom in having no equivalent dedicated provision.

The signatories draw on published evidence to set out the scale of unmet need:

• A 2024 British Medical Association member survey found that 44% of doctors reported suffering from depression, anxiety, stress, burnout or other mental health conditions related to or made worse by their work.
• Northern Ireland records the highest prevalence of common mental health conditions of any UK region, affecting at least one in five adults.
• HSC trusts recorded a sickness absence rate of 7.1% in 2024 – the highest of any UK
• health system – alongside a 5.6% medical and dental vacancy rate and the longest waiting lists in the United Kingdom.
• Applying NISRA benchmarks to the Northern Ireland medical and dental workforce produces a conservative estimate that mental-health-related absence accounts for between 25,000 and 31,000 lost working days each year, the equivalent of removing between 110 and 140 full-time doctors and dentists from the system annually.

Mental health support

Dr Matt Kneale, DAUK co-chair, said: “Doctors in Northern Ireland should not be left behind when it comes to accessing confidential mental health support.

“The pressures facing the workforce are immense, and dedicated services like NHS Practitioner Health make a real difference.

“Extending this support to Northern Ireland is essential for the wellbeing of clinicians and the safety and sustainability of patient care.”

Mary Jane Roberts, chief executive of Doctors in Distress, said: “It is an outrageous inequality that Northern Irish doctors are being treated like this.

Proven service

“It is so easily solved: NHS Practitioner Health is an expert, proven service, ready to provide the care that is needed. This is an ethical, speedy win. I am sure the CMOs as leaders of the medical profession will act to resolve the issue.”

Professor Baroness Gerada DBE FRCGP FRCPsych, patron of Doctors in Distress and founder of NHS Practitioner Health, said: “Now, more than ever, support for doctors is needed. There is so much distress and pain out there in the general public and our patients.

“We have to keep our healthcare professionals working, resilient, able to support the people that are really desperate.”

Read the letter in full.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

The episode has been recorded to mark Mental Health Awareness Week.

Hosted by Dr Steve Taylor, GP co-lead at the Doctors Association UK (DAUK), it features Samantha Watham, chief operating officer of Frontline 19, and psychotherapist Claire Goodwin-Fee, who discuss the urgent realities facing frontline staff.

The episode highlights the startling data behind rising stress, burnout, and suicide risk, especially among nurses and women, and why the stigma around seeking support persists.

Frontline 19, a non-profit organisation delivering psychological support and counselling to the NHS and UK frontline workers, reveals that on average, one nurse takes their life every week, and a doctor every three weeks.

The episode explores the startling data behind rising stress, burnout, and suicide risk, especially among nurses and women, and why the stigma around seeking support persists.

It breaks down tangible solutions that are surprisingly simple and cost-effective. From debrief spaces to changing workplace culture, the guests share strategies that can save lives and rebuild resilience.

Dr Taylor said: “This episode is an urgent call to action for healthcare workers, policymakers, and anyone who cares about a healthier, more compassionate system.

Mental health support

“If you believe mental health support should be a right, not a privilege, this conversation is essential listening.”

Watch the full episode here: Not the NHS Again – Mental Health Awareness Week special

The Not the NHS Again podcast is a collaboration between Keep Our NHS Public and DAUK.

Watch all previous episodes here: Not the NHS Again podcast.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Mental health provision

The survey also found that 640 GPs felt the provision for children with mental health issues in their area was not good enough. Some 508 GPs felt the same about adult provision. Dr Shire spoke to BBC News and LBC about the results. She told the BBC: “It’s not a surprise to anybody that the number of people seeking help for mental health conditions has increased. “There’s been an increase in mental health conditions since Covid.

Anxiety and depression

“Quite a lot of people said the first time they experienced anxiety or depression was during the pandemic. “I think we need to celebrate the fact people feel able to ask for help, rather than criticising them for asking for help. “And then look at why they are asking for help and what help is available for them?” Asked whether neurodivergent conditions such as ADHD were over-diagnosed, Dr Shire said it was more likely that diagnosis was ‘catching up’ with the number of neurodivergent people. She said: “Adults, especially, often can’t access reasonable adjustments in the workplace, or help and support without a diagnosis.

Support people

“There’s no availability for things like CBT and coaching. They are mentioned in the NICE guidelines as a way to support people with ADHD, but they can’t get access to that unless they’ve got this diagnosis. “(Being diagnosed can be) very validating for somebody to understand why they’ve struggled, or why they’re struggling. Is it just me, or is it something else?” Watch Dr Shire’s BBC News interview again on the DAUK Instagram. In an interview with LBC, Dr Shire stressed the need to avoid stigmatising people who seek help for their mental health. She said: “Life is difficult at the moment.

Struggling

“If you’re struggling to find work, you can’t afford food, then you’re not going to feel great about things. “I think it’s about looking at what support is available.” Dr Shire highlighted the lack of timely access to talking therapies, with long waits leaving many people getting worse before treatment begins. In response to a question about people not working because of their mental health, she said that, if someone was able to, then working could be helpful in recovery from any health condition.

Bigger picture

She added ‘people needed to be supported to work’, including being allowed time off to attend medical and therapy appointments. “We need to look at the bigger picture,” she said. “Why are people coming forward and how can we help them?” Listen again to her LBC interview on the DAUK Instagram. The most recent NHS survey on mental health showed more people have common mental health conditions now, with a 45% increase since 1993. It found that and 20% of NHS activity is related to mental health.

Mental health funding

However, mental health services only received 8.7% of the NHS budget in 2024/25. This is set to fall in 2025/26. Dr Shire said: “Without adequate funding and support for people, it’s hard to see how we can expect people to overcome their mental health conditions.” All of our committee members are volunteers. They speak to the media and campaign on the issues facing doctors in their own time. Please support their work by joining DAUK or donating to our GoFundMe.

Dr Jacques, a member of the Doctors’ Association UK’s (DAUK) GP committee, was interviewed for a BBC Breakfast feature about mental health support for doctors.

She told viewers there was still ‘a stigma’ around mental health in the profession.

“With health care professionals, we don’t consider ourselves to be human,” Dr Jacques said. “To admit we’re struggling is quite a hard thing to do, so I think people tend to hide it a lot and keep it to themselves.”

Support the work of the Doctors’ Association UK by becoming a member.

Each year, millions of people take part to focus on getting good mental health, and this year the theme is Movement: moving more for our mental health.

Everyone can get the mental health benefits of moving more, it’s all about finding what works for you.

Get involved by sharing your moments for movement for your mental health using the trends #MentalHealthAwarenessWeek and #MomentsForMovement

Find out more with the Mental Health Foundation.

If you’re struggling with your mental health and wellbeing it can be daunting to ask for help. You might not know where to turn or who to contact.

It’s important to remember that you are not alone and that support is there for you.

We have brought together mental health and wellbeing resources to support our members and medical professionals.

Click here to access them now through our website.

NHS England (NHSE) today announced that the Practitioner Health service for secondary care doctors, dentists and senior NHS staff would be extended by another 12 months.

DAUK reported how Practitioner Health had been due to have its funding cut from Monday – meaning no new referrals would be accepted leaving vulnerable doctors without access to its support – while a review into the service was carried out.

It led to a social media storm, with the decision criticised by doctors, healthcare professionals, and groups and associations.

Now NHSE has announced Practitioner Health will be extended by 12 months whole the wider review is carried out.

Ms Fernandes said: “We’re delighted that NHSE has reversed its decision to cut NHS Practitioner Health for hospital doctors.

Thank you DAUK members

“Thank you to our members and to everyone who made their voices heard.

“It is disappointing that NHSE felt able to cut this lifeline of a service without proper consultation and provision of an alternative.

“Everyone understands the need to ensure value for money within the NHS, but DAUK feels that the mental health of the doctors that provide healthcare for our patients is about as important as it gets.

“NHSE needs to reflect on its decision to stop Practitioner Health, reflect on the response that this generated, and consider an alternative way to treat and communicate with its workforce.”

What is NHS Practitioner Health?

NHS Practitioner Health is a free, confidential service for doctors and dentists across England with mental illness and addiction problems, who are working or looking to return to clinical practice. This service is a commitment as part of the NHS Long Term Plan.

Announcing the reverse, Dr Navina Evans, NHSE’s chief workforce officer, said: “Following discussions with Practitioner Health on their current service for secondary care doctors, dentists, and NHS senior staff, we have jointly agreed to extend the service by 12 months, for both existing and new service users, while we carry out a wider review to ensure that all NHS staff groups have the mental health support they need.”

NHS Practitioner Health has been given just days’ notice that its funding for secondary care will be paused from this Monday (15 April).

This is while a period of consultation is carried out on the service, which is currently treating more than 6,000 doctors and healthcare professionals, 60 per cent of whom are hospital staff.

It means that no new referrals will be accepted from Monday, leaving vulnerable doctors experiencing anxiety, depression, suicidal ideation, and addiction without access to support. Current clients will continue to be seen.

Ms Helen Fernandes, co-chair of DAUK, said: “This service is so important and given the pressure that our secondary care doctors and healthcare professionals are under, it’s needed more than ever.

“To turn off the funding just like that, with no warning and nothing in place is absolutely outrageous.

“These are real people who are in trouble and distress. They will need some support somewhere, so where do they go?

“The commissioners that fund the service want to do a piece of work to find out if it’s value for money, so rather than do that piece of work and keep the service running at the same time they’re going to stop it, which seems a really bizarre thing to do.”

NHS Practitioner Health

NHS Practitioner Health is a free, confidential service for doctors and dentists across England with mental illness and addiction problems, who are working or looking to return to clinical practice. This service is a commitment as part of the NHS Long Term Plan.

Dr Peter Bailey, who qualified as a GP in 1984 and has worked for NHS Practitioner Health for five years, said: “I feel incredibly passionate about the decision that’s been made – it’s wrong-headed and stupid.

“I can’t imagine anybody working for workforce wellbeing in the whole of the world who will think this is a good idea, to cancel a service that’s working perfectly well while you have a think about whether you want to continue funding it.

“It’s ludicrous.”

Dr Bailey said the service was originally set up following the tragic death of a hospital doctor who was unable to access confidential help for her mental illness.

He said: “If someone like her were to call Practitioner Health on Monday, she would be turned away.”

Support for doctors

Another doctor who works for NHS Practitioner Health but wanted to remain anonymous said: “For six months it’s likely there will be no support via Practitioner Health for addicted or suicidal hospital doctors.

“It’s clear people will be rejected from Monday

“This is due to new commissioners, lack of funding, and poor awareness of the importance of supporting clinicians, not only for their own health but for patient safety issues.”

More than 32,000 doctors and healthcare professionals have been treated by the service since it was founded in 2008.

Ms Fernandes said: “To pull out a major support service for hospital-based doctors seems rather cruel. We’re calling on the commissioners to reverse the decision.

“The funding of this service will be tiny in comparison to the NHS budget but the work it does is huge.”

We’ve contacted the GMC for help on the issue.

In a statement, Practitioner Health said: “We have been in discussion with NHS England over arrangements for the service from 1 April 2024 and want to reassure all patients who are already registered with the service that this does not alter your situation. We will continue to support all existing patients to complete their treatment.

“NHS England are undertaking a review of the staff support offer for mental health across all staff groups to consider long term sustainable options. We will contribute to the review.

“On this basis we have agreed with NHS England to halt new registrations for secondary care staff from 15 April 2024 onwards. New secondary care patients will be signposted to alternative sources of support, including your GP, occupational health departments and organisational employee assistance programmes.

“The arrangements for the primary care element of Practitioner Health have been extended for a further 12 months to 31 March 2025.”

Amid claims that GPs are “hiding” from patients behind telephone triage and e-consultations, I feel compelled to show you a glimpse of “The Other Pandemic”. Falling squarely at our feet overspilling our appointments: mental health.

In March a survey of over 4,000 people in the UK established that “there is a genuine, wide and profound mental health crisis.” The appointment list for my day’s surgery supports the assertion.

GPs have always managed the majority of mental ill-health in the UK. One surprising positive to come from the pandemic, is that talking about mental health is losing its stigma.

At the start of the pandemic, even the worst affected tried to hang on, to give us the time and space we needed to deal with Covid. Those who did come were already in crisis, desperate, having held their breath for too long.

After the first lockdown the floodgates opened, and over a year and a half into a pandemic that seems destined to continue indefinitely, every day brings more new patients.

Mental health services were already creaking pre-pandemic. Community mental health teams provide good, if slightly slower, access to talking therapies for those too ill to access the voluntary sector service, and a crisis team that can react to offer support in a timely way to patients at risk of suicide. 

But what they can’t offer, is medication. That needs a psychiatrist; the adult psychiatrist for my particular area has been unfilled for months. If I think patients need more than an anti-depressant, or an adjustment of anti-psychotics, then we must wait until the situation becomes urgent enough to warrant a review by the psychiatrist from a neighbouring area.

With clear evidence that severe mental illness is best nipped in the bud, preventing both long term illness and recurrence, that can’t possibly be an adequate service for our patients.

Child mental health services fare no better. Child and Adolescent Mental Health Services (CAMHS) have a reputation for being impossible to access at the best of times. They are the only service GPs refer to who routinely “bounce” referrals back, without even seeing or assessing the patient. With disruption to schooling, uncertainty about exam formats, isolation from friends, fear of illness and loss of loved ones, the mental health of our children is suffering, and the service has been overwhelmed.

Even those children who clearly meet the referral criteria are waiting months to be seen. As a GP there is little I can offer here, except monitoring and general support. 

I find myself seeing a child and her clinically vulnerable parent monthly, tracking her increasing anxiety, her flattening mood, the total insomnia worsening to the point of hallucinations. A change that means I can write a letter to expedite the appointment, and six weeks or so later, an assessment happens. I continue to check in with her while she waits again, this time for therapy.

I know just enough about this highly specialised area to be aware that my inexpert input could cause more harm than good; regularly opening a box of unhappiness she may have naturally put a lid on, without being able to help her make sense of the contents, balanced against the risk of not knowing whether she is deteriorating, or how deep that deterioration has gone.

Other regulars include a small cohort of new mums, mostly presenting too late after the birth for the narrow referral window of our perinatal mental health service. Isolation and lack of support has hit hard at a time when sleep deprivation, hormones, traumatic experiences, pain and disillusionment coincide to create a perfect psychological storm. I do my best, but notice that those who can afford private therapy seem to recover faster and more fully.

Another, larger cohort, are the patients with health anxiety. Something that has affected almost all of us to some extent, during the biggest health crisis of our time.

Amongst the onslaught of unmet need, we must sift through those whose anxieties about their health are irrational, and identity those who may have been sitting on a serious physical problem for too long. Both need addressing and often both can occur within the same patient. With delays in secondary care diagnostics, and now a national shortage of blood test tubes, we are working in a minefield.

Working at this intensity, among so much distress and without an end in sight, is starting to take its toll on our profession. In April mental health service NHS Practitioner Health announced they were taking 22 per cent more self-referrals from GPs than pre-Covid – myself included.

Mental health care and general practice are in deeper crisis than ever before, and this needs a political solution. There is an opportunity here to open a conversation and with investment, to create something outstanding. We just need to demand it – please write to your MP to do this.

In the meantime, keep trying if you need to see us, and remember that GPs are human too, so please be kind.

Dr Louise Hyde is a GP and member of the Doctors’ Association U.K.

Healthcare staff who have worked through the coronavirus crisis should have a similar mental health service as that offered to war veterans, a group of leading medical organisations, including DAUK, has said.

Read the full article here.

The volume of patients, the complexity of illnesses, and the unrelenting nature of the covid pandemic are having a huge impact on morale among our junior doctors, many of whom are experiencing their first winter in the NHS, write Nikki Nabavi and Clara Munro

A winter surge in hospital admissions is not unfamiliar. However, Public Health England’s annual flu and covid reports1 show that the current pressure on hospitals is not comparable to the usual winter influx. The difference in healthcare staff’s morale between the start of the pandemic and now is palpable, not least among those who are experiencing their first winter in post.

The nervous energy that characterised last spring has been replaced by chronic exhaustion. Natalie Ashburner, vice chair of the Doctors’ Association UK, says that doctors feel “battered by the unrelenting experience of caring for those with the virus.” And the idea of “just a bad day on call” is replayed without any opportunity for recovery.

Pushpo Hossain, a junior doctor in London, says, “When you are doing everything you can and you reach the ceiling day after day, morale falters.”

Alone

One major difference is that, during the first wave, doctors weren’t also providing routine care. This has now changed, and in addition there are long backlogs of patients, some of whom have had their treatment delayed for over eight months. It’s created an additional pressure on the NHS that wasn’t there during the first wave.

The Faculty of Intensive Care Medicine surveyed its members in November 2020, before the peak of the second wave, and reported that only 18% of respondents agreed that staffing levels in intensive care units were adequate.2At the peak of the second wave in January, junior doctors and medical students were being asked to volunteer in intensive care, sometimes through call-outs on social media.3

The BMJ heard concerns about staffing levels from several junior doctors around the country. “Staff are constantly having to isolate, which leaves us so understaffed,” says Amelia Seifalian, a foundation doctor in Watford. “Often at 9 pm we are asked on our hospital’s foundation year 1s’ WhatsApp group if anyone can go in and cover a night shift, as they are short of around four doctors.

“These shortages mean that juniors are left with more responsibility than usual, and things that you would usually ask your senior house officer for support on or double check with them, you are unable to, which makes us feel less confident.”

In a 2019 study published in the Journal of the Royal College of Physicians, 66.4% of doctors reported “feeling part of a team” as being the most important factor affecting their morale.4 Bethan Markall, a junior doctor based in Birmingham, told The BMJ that rota gaps also affected doctors’ sense of team support and camaraderie: “Juniors no longer have a team—it’s not unusual to work four different shifts, each with completely different teams.” This leads to a lack of team identity and reduced support.

Markall adds, “First year foundation programme teaching has only been online, meaning we have had less of a chance to meet our cohort or socialise with them, which can be quite isolating.”

This trend of isolation is highlighted by the stark contrast between the culture of free team meals and social support, as seen during the first wave of the pandemic, and the new socially distanced canteen booths that Seifalian describes, allowing for little to no mealtime debriefs with colleagues after difficult days. She emphasises the importance of reflections with colleagues. “I don’t want to talk about it to my family or housemates,” she says. “I don’t want to share the burden.”

Infantilised and ignored

Morale may be further eroded by feeling “infantilised” by colleagues. Freddie Stourton, a foundation doctor in the south of England, says that it can feel frustrating and exhausting to be thrown in at the deep end and then be “told off” for things that are out of your control. Senior staff can expect juniors to be familiar with their surroundings or a ward’s logistical practices, even though they are sometimes working with completely different teams on different shifts. Some reported being shouted at for “standing in the wrong place” five minutes after arriving at a new ward and while trying to help a patient.

While all doctors will be familiar with the “bad shift,” those who spoke to The BMJ said that the covid pandemic had brought an increasing frequency of these shifts among junior staff who lack the experience to contextualise these encounters.

The Doctors’ Association UK is among those who have called for greater provision of accessible mental health services for doctors. A spokesperson told The BMJ, “We have grave concerns about the effect that this pandemic is having on the mental health of NHS workers. We urgently need more specialist mental health services that are well funded, adequately resourced, and accessible to those who need them.”

The BMA, meanwhile, has called for medical staff to be prioritised for covid-19 vaccination to help reduce the absences that are leaving rotas short5 and subsequently affecting junior doctors’ ability to attend vaccination appointments themselves, while changes to shift patterns and night shifts6 make this challenging.

Stourton says that, in some ways, the shunting of junior doctors reflects an attitude that’s persisted throughout the recruitment process: doctors who have undergone years of training being “treated like numbers on a page, with patchy communication and changes in the process with little or no notice.”

Partha Kar, consultant in diabetes and endocrinology and a BMJ columnist, says that “what junior doctors have taken on in this pandemic has been nothing short of astonishing. Stepping into areas way outside their comfort zone, with specialties not being a barrier or given a second thought—their desire and determination to help without any hesitation has been fabulous to see and be part of, as well as inspiring.”

He concludes, “The least as seniors we can do is to find some time, if possible, to have a kind or caring word, or even a simple thank you, for their efforts in these extraordinary times.”

Read the article in the bmj