Fatigue and sleep deprivation

Being a doctor typically involves high-intensity, time-pressured working patterns. These can lead to sleep deprivation and fatigue, effecting doctors' health, well-being and performance, their safety and that of their patients.

This BMA briefing highlights why doctors are at risk of fatigue and the acute and long-term impacts this can have. It also presents a framework for how Government, organisations and doctors themselves can manage this risk.

Factors increasing the risk of fatigue

Doctors and other clinical staff are at an increased risk of fatigue due to specific factors, including:

long working hours

high intensity workloads

increasing numbers of patient consultations, leading to 'decision fatigue'

unplanned and unpredictable interruptions associating with providing patient care advice while on call

the disruptive effects of shift working on the natural sleep cycle

Other factors which can contribute to fatigue include having to take annual leave at fixed times, being bullied or harassed at work, and additional responsibilities such as running a GP practice.

Impact of fatigue on doctors and patients

Fatigue and sleep deprivation, associated with long working hours and shift work, impacts on doctors' personal safety, increasing the likelihood of occupational accidents, road traffic crashes and needlestick injuries. It also increases risks to patient safety through clinical errors.

In the long-term, working long hours and shift or night work carries significantly health risks - including cardiovascular disease, primary sleep disorders, becoming overweight or obese, and developing type 2 diabetes.

Managing fatigue in the medical profession

While the risks of long working hours and shift work are well-recognised and managed in other safety-critical industries, such as for flight crew, working hours for doctors and other clinical staff are significantly less regulated.

A more comprehensive approach to managing the risks of fatigue in the medical profession is urgently required.

The BMA's framework outlines measures for Government, health departments and national bodies, for employers and for doctors to better anticipate and manage these risks.

Watch our animation on managing fatigue

Guidance for doctors and other clinical staff

Alongside this briefing, the BMA has produced guidance for doctors and other clinical staff on how best to manage the risks of fatigue associated with current working patterns.

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