Healthcare staff in Guardian survey say increasing workloads, unreasonable expectations, cuts and long hours are damaging their lives
“Reduced budgets, reduced staff members, higher caseloads and more red tape … You are always struggling just to keep up.” That is one heartfelt comment from a survey by the Guardian that reveals the huge toll government cuts are taking on staff in public services and the voluntary sector.
The Clockoff survey, conducted last month, asked about the wellbeing of employees across the voluntary sector and public services. More than 3,700 people, in jobs ranging from social work to police and probation, from social housing to the NHS, charities and NGOs, took part online via the Guardian’s professional networks.
A clear picture emerges of staff working long hours, with few breaks, and a workforce that has become wearily resigned to this way of working. When asked, do you think stress is a fact of life for employees in the public or voluntary sector, 85% of respondents say they agree. For respondents working in probation services the figure rises to 100%.
Some 93% of respondents say they are stressed at work either all, some, or a lot of the time. Of the 9% who say they are stressed all of the time at work, almost all report working beyond their contracted hours. On average, respondents put in an extra seven hours a week. Close on one in five say they don’t take any break during their working day, with less than a quarter (24%) enjoying a main break of at least 30 minutes.
It is clear that cuts are having a sustained impact on workloads. Social workers, for instance, report having more work to do, but not only are there fewer staff to deal with cases, cuts to voluntary bodies also mean there are fewer external support services for children and families. “The phrase ‘doing more with less’ is not only an offence against physics, it is the frontline workers who bear this ever-increasing load,” says one social worker. “When the captain says faster the oarsmen are the ones whose labour is increased.” She adds: “I suffer with insomnia caused by my employer and I am being treated for anxiety and depression.”
NHS staff are the most likely of all public sector workers to feel stressed because of their job, according to the survey results. More than 60% say they feel stressed all or most of the time, and 59% say they feel more stressed this year than last year.
The survey also reveals that NHS workers are the least likely to take a break during a working day. Just over a quarter (26%) don’t take a break at all, and only around one in 10 takes more than half an hour. And the large majority of NHS workers (96%) work beyond their contracted hours, doing an average of five extra hours per week.
It is not just those in clinical roles who are feeling the pressure. A ward clerk supervisor, who has had to take time off work because stress levels had exacerbated an existing mental health condition, says: “So-called efficiency savings have resulted in remaining staff being overloaded – particularly those who aren’t frontline like administrators and secretaries.” One senior manager admits: “I feel I can’t help my team or myself more to cope and adapt to change and pressure.”
Danny Mortimer, chief executive of NHS Employers, says: “Frontline work in the NHS is rewarding but it can be emotionally and physically challenging, so it’s vital those staff have the right support. The culture in the NHS has improved demonstrably and there is more specialist support. But we cannot be complacent as progress is uneven and the NHS must keep innovating to meet ever-growing demand on its services.”
While NHS staff are the most stressed, other sectors are not far behind: 58% of local government staff, including social workers, 51% of central government employees and 46% of charity workers report being stressed all or most of the time.
Jo Cleary, chair of the College of Social Work, says continuing funding reductions are taking an unbearable toll on social workers. “Our members report juggling highly complex workloads, with little time to reflect and plan their work. Putting this kind of pressure on social workers, while expecting them to do complex, delicate work with some of the most vulnerable people in our society, is dangerous. We also risk deterring people from staying in social work, or even entering the profession in the first place. We are very clear on this: social work needs greater investment from government as an immediate priority.”
On a more positive note, two-thirds of respondents believe the work they do in the public or voluntary sector is always or often worthwhile, and 40% think their contribution is always or often valued. Many staff working for campaigning NGOs, for example, who despite working an average of nine extra hours a week are among the least stressed in our survey, say that they actively choose to work long hours because it gives them a sense of purpose. But respondents warn that this sense of duty can be taken advantage of and many report being asked to do more and more work.
Sally Cupitt, head of the National Council for Voluntary Organisations’ charities evaluation services says: “We must do our best to make sure staff feel supported and valued in their work. A small amount of stress can be a good thing, but sustained or excessive stress can be damaging to health and wellbeing. Charities should adopt employee wellbeing policies wherever possible, such as employee assistance programmes and flexible working options.”
The survey shows that stress at work is taking its toll on people’s health and wellbeing. Poor sleep, headaches, stress-related mental health issues and even digestive problems are among a range of physical and psychological symptoms reported by respondents, 39% of whom have sought medical advice or counselling.
Asked how people try to reduce their stress levels outside of work, most say they relax by spending more time either alone or with friends and family; around45% exercise, catch up on sleep, or watch TV. Worryingly, 28% report drinking more.
Commenting on the survey findings, a Local Government Association spokesman says: “Councils are taking steps to adopt flexible working practices where possible because they know they help build a more engaged workforce, attract the best talent and increase productivity.”
The Cabinet Office says its own People Survey of more than 274,000 civil servants paints a very different picture. “Staff engagement continues to rise and 81% of respondents said their manager is considerate of their life outside work”, says a spokesman.Frances O’Grady, the general secretary of the TUC, which represents many public sector workers, says spending cuts, attacks on pay and pensions and mass redundancies have had a huge effect on a demoralised public sector workforce. : “This survey lays bare the damage cuts have had on frontline services, with staff regularly overworked, stressed and unable to do their jobs as they would like.” Public servants have understandably had enough and many are rightly fearful of the new round of austerity the government is about to unleash in its July budget.” She warns that if the government continues to treat public servants as second-class citizens, it will struggle to hold on to and recruit the skilled, dedicated staff needed to deliver public services. “When that happens, we all pay the price.”
In their own words
“Excessive stress in child protection social work is commonplace. Over the past six years it has affected my physical and mental health at times, placed a strain on personal relationships, led me to question my choice of profession, and frequently leaves me tired, exhausted, emotionally drained and overwhelmed. I’m stressed a lot of the time and the stress has increased over the past year. I was seconded to a new post which lacked clarity and effective management oversight. I was given additional responsibilities without a reduction in my previous, already overwhelming day-to-day responsibilities. Senior management was poor and chaotic. I had to spend months fighting to be paid appropriately for my level of responsibility.
“The public sector is being destroyed by ever-increasing cuts to funding. Alongside this there is an ever-increasing demand for services from my department specifically (children and families), yet there is no money provided for more staff. We are also affected by funding cuts to services we rely on to assist in supporting the families we work with. What would help? Investment in social work, local authority social work receiving the appropriate funding to ensure there are adequate staffing levels, which are proportionate to the demand for service.” Social worker
“I’ve lost weight as I miss at least three meals a week. I suffer from constipation, piles, insomnia [and am] constantly exhausted. I constantly feel I haven’t done my best but it’s impossible to do it all.” Midwife
“The number of people working here has been slashed but the workload has not. There is a lack of trust of the workforce and flexibility from the management. It feels like they are expecting more and more but giving less and less. The government has contributed to the perception of the public sector workforce as being lazy and money-grabbing. There have been many changes in the organisation and no one has any certainty or job security despite permanent contracts.” Local government development officer
“I got very stressed around Christmas and new year, when I was working completely on my own with 14 young people to support, no one to offload on to and as a result my own mental health was suffering. I was signed off work for two weeks in January after constantly bursting into tears, not sleeping and just not feeling like my usual happy self.” Social housing professional
“A lot more strain has been put on the voluntary sector due to cuts in other areas. We have seen an increase in the amount of vulnerable people we see weekly. Because there are gaps in services, we are expected to fulfil a need, in fact lots of different needs. As cuts increase, these gaps will increase and I fear that we cannot adequately meet the needs of some of the most marginalised and vulnerable people in our society, which is hard to take.” Charity project worker
“The public sector is the victim of large-scale cuts and austerity. While the cash impact of this might be significant, the combined low feeling of motivation and self-worth is stressful, as is making up for missing or stretched colleagues and the government continues to demand more.” Central government regional director ………’