Battling Health Inequalities: Doctors on the Front Line

Written by Hannah Parker

“...overwhelming workloads, widespread vacancies and plummeting job satisfaction are becoming ‘the new normal’ in the NHS.”

This year, the three Royal Colleges of Physicians’ annual survey of consultants in the UK confirmed that overwhelming workloads, widespread vacancies and plummeting job satisfaction are becoming ‘the new normal’ in the NHS.

However, the 2023 census of consultant physicians also revealed that doctors are increasingly battling against the impact of social harms on health, which is growing the demand for NHS services.

Illness caused by socio-economic factors including living in mouldy and damp homes, lack of access to healthy food, smoking and obesity are now significantly contributing to the workload of physicians in the UK. Almost a quarter (24%) of those surveyed said more than half or almost all of their workload is due to illnesses or conditions related to social determinants of health.

At the same time, nearly two in five (39%) UK consultant physicians say they have an excessive workload almost all or most of the time, while almost one in a five (18%) ‘almost never’ feel in control of their workload. Overall, 55% of those surveyed have experienced an increase in treating patients with illness caused or worsened by the wider determinants of health.

During our President’s Conference in 2023, Sir Michael Marmot illustrated that public health in the UK has significantly declined in the period since austerity was first introduced in 2010.

While in recent years political focus has been dominated by the sharp increase in the number of people on waiting lists, exacerbated by the pandemic backlog, our census shows there is more at play.

As College President, Mike McKirdy, said: “Prevention is better than cure, and we must see a concerted effort from across government and wider society to address the underlying socio-economic factors which perpetuate this cycle of illness and increased demand on the NHS.”

RCP Medical Workforce Unit on behalf of the Federation of the Royal Colleges of Physicians of the UK (2024): ‘Focus on Physicians: The UK 2023 census of consultant physician’, RCP Medical Workforce Unit, London.