Number | Stressors | Round 1 Per cent respondents (number of respondents) | RO | Round 2 Per cent respondents (number of respondents) | RO | Round 3 Weighted average (0–2) | RO |
---|---|---|---|---|---|---|---|
1 | The lack of long-term planning means that the service is always reactive | 54 (14) | 10 | 58 (14) | 5 | 1.6 | 1 |
2 | Decisions taken by management are often ‘quick fix’ and driven by standards imposed externally, (eg, HIQA, accreditation, appointing consultants without supportive resources) while ignoring unique local or clinical concerns | 77 (20) | 1 | 54 (13) | 7 | 1.44 | 2 |
3 | The shortage of NCHDs and/or consultants impacts on our ability to deliver safe care | 65 (17) | 5 | 58 (14) | 5 | 1.44 | 2 |
4 | The contribution of doctors is perceived as having been devalued by commentary from both the HSE and the media and in recent years has contributed to a negative working environment and lack of trust | 77 (20) | 1 | 79 (19) | 1 | 1.44 | 2 |
5 | The facilities and infrastructure are inadequate to provide appropriate clinical care while respecting the patient's dignity | 50 (13) | 16 | 63 (15) | 3 | 1.36 | 5 |
6 | The threat of complaints (and/or litigation) is a backdrop to daily practice exacerbated by the Medical Council's hostility to the profession | 77 (20) | 1 | 75 (18) | 2 | 1.32 | 6 |
7 | There is inadequate time to accomplish the important paper work required to support safe clinical care (eg, screening referrals, checking results, reviewing letters) | 54 (14) | 10 | 50 (12) | 8 | 1.32 | 6 |
8 | There is a lack of good management leadership which truly understands the complex demands and responsibilities of the clinician's role | 69 (18) | 4 | 50 (12) | 9 | 1.28 | 8 |
9 | Expectations of patients (and/or of their families) have increased and are sometimes unrealistic. This includes a sense of entitlement, often to procedures or investigations which might be available in the private sector but are not necessarily appropriate according to best practice | 62 (16) | 6 | 50 (12) | 10 | 1.28 | 8 |
10 | The number of patients to be treated exceeds international norms | 62 (16) | 6 | 63 (15) | 3 | 1.18 | 10 |
HIQA, Health Information and Quality Authority; HSE, Health Service Executive; NCHD, Non-Consultant Hospital Doctors; RO, rank order.