Ambulance crews ‘stretched to breaking point’ as mental health sick days soar

Huge surge in number of ambulance staff signed off for metal illness as pressure mounts

Ambulance handover delays outside hospitals in England have risen to their highest level since the start of the year (Getty/The Independent)

Ambulance staff took almost a quarter of a million mental-health-related sick days last year as stressed crews are being “stretched to breaking point”, new figures show.

Chronic staff shortages have put paramedics, technicians and call handlers under huge pressure – with ambulance waiting times hitting their worst level on record during winter and morale sinking to a new low.

Now, figures obtained under freedom of information laws show that in 2022, One in 16 of England’s NHS ambulance workers took time off for conditions such as anxiety, stress and depression – the equivalent of 1,100 staff.

NHS bosses and unions say deteriorating working conditions caused by staff shortages are driving the absences, which have increased by a third since 2020, from 188,134 to 247,711 lost days.

At some trusts, nearly a third of staff have taken at least one day off sick citing mental ill health, while the number on long-term sick leave for psychiatric reasons has increased by 38 per cent in just two years.

“Increased demand, reduced resources, and queueing at emergency departments” has put workers under huge stress, said Jo Mildenhall, paramedic psychological health manager at the College of Paramedics, as she warned that the problem could get worse without changes.

“Mental ill health, including burnout, stress, psychological trauma and moral injury, is a rising and significant issue, and without further investment into addressing the causative factors and providing additional interventions and supports, we are likely to see the issue increase further,” she said.

A total of 6,029 of the 17,447 workers in England took time off for mental health reasons across the country’s nine ambulance trusts in 2022 – up from 5,126 in 2020 and 5,958 in 2021. Some 1,243 staff were on long-term sick leave for mental illness last year, an increase from 904 in 2020.

The situation is particularly bad at the South Central Ambulance Service, which covers Hampshire, Berkshire, Oxfordshire and Buckinghamshire, where 32 per cent of staff took at least one day off as a result of mental ill health last year.

The next most badly affected trust was East of England, with 30 per cent of staff taking time off for mental illness. In London, the figure was 17 per cent, while it sat at 12 per cent in Yorkshire, 14 per cent in the West Midlands, and 18 per cent in the South West.

“The government’s failure to fund services has left too few staff and ambulances. Excessively long shifts without proper breaks, and lengthy queueing outside hospitals, are having a negative impact on wellbeing,” said Sara Gorton, head of health at trade union Unison.

“Increasingly, crews are having to deal with patients dying before they can reach them. Demand is so high that paramedics have no time between incidents, causing high levels of stress.

“Staff shouldn’t be left with damaged mental health for doing their jobs. Ministers must act now to address capacity issues that are triggering burnout.”

Lengthy queueing outside hospitals is having a negative impact on wellbeing, says union representative (Getty)

Liberal Democrat health spokesperson Daisy Cooper, whose party submitted the FOI requests, said the government urgently needs to improve conditions for ambulance crews, who “dedicate their lives to saving others”.

“The Conservative government has been letting them down and taking them for granted for far too long. Their poor treatment leads to staff shortages, adding misery to patients waiting for an ambulance,” she said.

One experienced call handler for an ambulance trust in the North of England was signed off sick for two months after staff shortages and mounting abuse from frustrated 999 callers took their toll.

“We were down to minimum staff, the calls were stacking, it got to 6am in the morning and I couldn’t take any more. I’d spent the night and my breaks walking around the car park just crying,” she told The Independent.

A demand surge meant her team was unable to process even the most critical calls in time, despite working flat-out.

“There were people in the queue actively dying – we couldn’t get to them. And it began to feel like it was my fault. It wasn’t my fault, and I know that now because I’ve had counselling, but at that time, and [despite] how many times I’d been shouted at, screamed at, sworn at, threatened, I still had to keep sitting there and doing it over and over again.”

She is now back at work, but said her trust is struggling to retain staff because of the huge pressure on the service.

The call handler said she was well supported by her trust, which arranged counselling for her relatively quickly, putting her in a position to return to work. Ministers say they are offering targeted support for NHS workers and will publish a long-term workforce plan to address staff shortages.

But Miriam Deakin, director of policy and strategy at NHS Providers, which represents health service trusts, said there had been a lack of investment and that the “worrying” numbers reflected “mounting pressure on ambulance workers”.

“Anxiety, stress and depression are consistently the top reasons for staff sickness. Employers are trying to support staff wellbeing, but efforts are being undermined by a lack of investment in wellbeing initiatives across the NHS,” she said.

A study published in the Journal of Paramedic Practice last year found that more than half of paramedics were suffering from burnout due to huge workloads.

In February it was revealed that the number of sick days taken by NHS staff had surged over the winter, and that they were now costing the health service £468m, up from £279m before the pandemic.

The figures come as NHS workers represented by Unison, including ambulance crews, have voted to accept a government pay offer of a 5 per cent rise – though inflation means the pay rise will still amount to a real-terms cut.

A Department of Health spokesperson said: “We continue to support NHS staff, and the NHS provides physical and mental health support, including targeted psychological support and treatment for those with more complex mental health needs brought about by serious issues such as trauma.

“Our urgent and emergency care recovery plan will reduce pressure on hospitals by scaling up community teams, expanding virtual wards, and getting 800 new ambulances onto the roads. The NHS will also shortly publish a long-term workforce plan to recruit and retain more staff.”