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Workplace pressure

Burnout in healthcare: signs, help and time off

Spot the signs early and ask for specific changes

By , Editor Updated How we check sources

Short answer

Burnout comes from long-term work stress which nobody has dealt with. The World Health Organization describes three signs: exhaustion, growing distance or cynicism about your job, and a drop in how well you feel you work. Tell your GP and your manager or occupational health what has changed, and ask for specific changes to hours or workload.

Key facts

How the WHO classes burnout
An occupational phenomenon in ICD-11, linked to work stress. The WHO does not class burnout as a medical condition.
Your employer's duty
Employers must assess the risk of work-related stress and act on the findings. The Health and Safety Executive (HSE) sets out six areas to check: demands, control, support, relationships, role and change.
Time off sick
You self-certify for the first 7 days. After 7 days in a row, including non-working days, your employer can ask for a fit note.
Disability
Where a mental health condition has lasted or is likely to last 12 months and has a substantial effect on daily life, the Equality Act 2010 requires reasonable adjustments in England, Scotland and Wales. Northern Ireland uses the Disability Discrimination Act 1995.

Signs of burnout in clinical work

In healthcare, burnout tends to show up at work before anyone names the problem. Say a community pharmacist starts to dread the first hour of the dispensary queue. A GP rereads the same results inbox three times. A ward nurse feels numb with patients they used to enjoy caring for. Watch for these changes in yourself:

  • You wake up tired after a full night in bed, and days off no longer restore you.
  • You feel detached, irritable or short with patients and colleagues.
  • Routine tasks, such as a prescription query or a discharge letter, take far longer than before.
  • You skip breaks to keep up, then cannot switch off at home.
  • You make more slips, or spend more time worrying about making one.

Burnout overlaps with depression and anxiety, and the two need different help. A GP can check if you need treatment as well as changes at work. If you have thoughts of harming yourself, use the numbers on our urgent help page today.

Steps to take this week

  1. Keep a two-week record. Note your hours, missed breaks, sleep and tasks left undone at the end of each shift. Leave patient details out.
  2. Book a GP appointment. Say what has changed, for how long, and how your work is affected. In England you can also refer yourself to NHS Talking Therapies.
  3. Ask your manager for a meeting and an occupational health referral. Take the record. Ask for one or two named changes, not general support.
  4. Ask for a stress risk assessment. NHS employers often use the HSE Management Standards or a local version. A risk assessment puts the problem in writing and gives your employer actions to complete. Our guide to HSE workplace stress duties explains the six areas.
  5. Contact your union or professional body if nothing changes. The PDA, BMA and RCN advise members on sickness meetings, adjustments and grievances.

Changes to ask for in your setting

A specific request gets a specific answer. Pick changes which match the pressure in your record.

  • Community pharmacy: a protected break with cover arranged, a second trained person at the busiest times, or fewer late closes in a row.
  • GP practice: a cap on extra on-the-day appointments, protected admin sessions, or a fixed finish time for the duty doctor.
  • Hospital: a rota review, fewer consecutive long days or nights, and, for resident doctors in England on the 2016 contract, exception reports when hours run over.
  • Community and district teams: a caseload review which counts travel time and paperwork.

Anyone working more than six hours is entitled to a 20-minute rest break under the Working Time Regulations 1998. If you never get one, say so in the meeting. Our workload and understaffing guide covers how to raise staffing gaps through the right channel.

Who helps with which part

  • GP: assessment, treatment, fit notes and referrals.
  • Occupational health: advice to your employer on adjustments, phased return and fitness for particular duties. Reports go to your employer with your consent.
  • Line manager: rota, workload, cover and the stress risk assessment.
  • Confidential clinical services: NHS Practitioner Health treats some groups of health professionals. Check the eligibility list before you apply.
  • Profession charities and peer groups: listed below. The BMA counselling line answers 24 hours a day on 0330 123 1245 for doctors and medical students.

Locums and self-employed staff rarely have occupational health. Use your GP, the charities below and our guide on locum pressure.

Time off and going back

If you need time off, a fit note can say you are not fit for work, or you may be fit with changes such as altered hours or duties. Your employer should consider the advice. A phased return, agreed in writing, helps many people back. Our guide on returning to work covers what to agree before your first shift.

Support organisations for burnout

Related guides

Common questions

Is burnout a medical diagnosis in the UK?

No. The WHO lists burnout in ICD-11 as an occupational phenomenon caused by unmanaged work stress. A GP may record stress, anxiety or depression, and a fit note can state work-related stress.

Can I be signed off work with burnout?

Yes. A GP or another authorised healthcare professional can issue a fit note if your health stops you working. You self-certify for the first 7 days off.

Will telling occupational health put my registration at risk?

Occupational health gives your employer advice about fitness for work and adjustments, and needs your consent to share a report. Health regulators focus on whether a condition affects safe practice and if you are getting help for the condition.

What can my employer do about burnout?

Your employer must assess work-related stress risks and act on the results. Practical changes include protected breaks, workload caps, rota changes, a phased return and an occupational health referral.