Authors:

• Dr Ramai Santhirapala, Wellbeing Lead, Council Member and Trustee, Royal College of Anaesthetists
• Dr Robert Self, Wellbeing Board Lead and Vice-President, Association of Anaesthetists

Wellbeing refers to the overall state of being healthy, happy, and content with various aspects of life – physical, emotional, and mental, alongside social connection and purpose. 

Regrettably, many anaesthetists and other healthcare professionals experience the opposite of wellbeing in their working lives – for example, more than 6,000 patients (50% of these are secondary care doctors) are registered each year with NHS Practitioner Health. In healthcare, however, responsibility for workforce wellbeing should not rest solely on individual anaesthetists. Instead, we must look to systemic change and improved working conditions. With wellbeing problems, including burnout, continuing to impact our profession, RCoA and the Association of Anaesthetists are working collaboratively to address this complex issue.

In 2023, RCoA, in partnership with the Association of Anaesthetists, formed a workforce wellbeing task and finish group, which included national bodies such as the BMA, GMC, and NHS England. Major outputs of this group were the development of a centralised digital hub of existing wellbeing resources, greater promotion of the ‘Good Department’ chapter in the College’s Guidelines for the Provision of Anaesthetic Services (GPAS), and the inclusion of wellbeing in job approvals and the Advisory Appointment Committee process.

A significant step forward was the joint creation of a job description for wellbeing leads – which were a formal recommendation for all hospitals. This role, suitable for any autonomously practising anaesthetist (eg, consultant or SAS), is intended to champion the health and wellbeing of anaesthetists at departmental level. We stress the importance of alignment with trust or board wellbeing leads, and the necessity of allocated programmed-activity (PA) time in job planning, scaled to department size, to enable delivery of meaningful interventions. A recent study has highlighted the point that potential solutions for wellbeing problems must align with what doctors themselves perceive to be the problem.

The wellbeing-lead role is not entirely new, but its implementation is gaining traction. Data from the Anaesthesia Clinical Services Accreditation (ACSA) process show that, while 4% of departments still lack rest facilities, many are acting on recommendations made during reviews, whether or not they fully meet wellbeing standards. This demonstrates a growing commitment to workforce wellbeing at the departmental level. The NAP 7 study reports that only half of departments have a wellbeing lead so there is still some way to go.

To build on this momentum, we are hosting the first national Wellbeing Leads Day later this year, jointly organised by both our organisations. This inaugural event will bring together wellbeing leads and clinical leaders from across the UK to share initiatives, discuss challenges, and provide a psychologically safe environment for learning and connection. The day will address wellbeing issues affecting all career stages – consultants, SAS doctors, and residents alike. If you’re a wellbeing lead or clinical leader, we encourage you to attend.

As we consider the broader picture, there are additional, often less-discussed aspects of workforce wellbeing. Incivility in the operating theatre is known to affect performance, increase complication rates, and reduce organisational commitment. By extension, sexual misconduct is being addressed through the RCoA’s involvement in the Working Party on Sexual Misconduct in Surgery, part of the effort to ‘break the silence’.

Wellbeing overlaps significantly with patient safety – it is particularly striking how incidents, complaints and dealing with coroners or the GMC can have profound effects on clinicians. This is well described with respect to perioperative cardiac arrests in the NAP7 study and in the Association’s Catastrophe Handbook.

Equally important is fostering inclusivity – creating a sense of belonging has a profound impact on wellbeing. As our specialties work to improve demographic representation and tackle differential attainment, we must maintain a whole-person, holistic approach. True wellbeing comes from systems that support everyone through a deeper understanding of lived experiences and challenges.

We hope this update has shown the strength of the coordinated, collaborative efforts underway to address the complex issue of workforce wellbeing. We have seen an encouraging rise in local wellbeing initiatives, some of which have been published in this Bulletin. Our commitment is ongoing, and together we hope to ensure a more supportive and sustainable future for all anaesthetists.