The COVID-19 pandemic may be over, but its scars remain for those on the frontline of the health sector – not least in the ambulance services. And our research conducted separately in the UK and Australia shows things are getting worse across the globe.
Ambulance staff in many other countries, including Germany, France, Poland, Spain, USA, Japan, Israel and India, are also facing increased pressures. This is due to more people using ambulance services, more complex patient needs, not enough staff and resources, and unmanageable workloads. All these factors have made it difficult for many ambulance services to operate.
We studied two services similar in size and structure: the Welsh Ambulance Services NHS Trust in the UK, and Ambulance Victoria in Australia. We found that both services are close to a point where they may not be able to meet the needs of the people they serve. And we identified similar issues and problems in both locations which are causing many employees to consider leaving the profession.
We found that nearly 45% of ambulance staff in Wales and 29% in Victoria are considering quitting. And in Victoria, 16% of ambulance services staff said they were looking to leave the profession within the next year, while 23% of participants in Wales said the same.
These are highly skilled healthcare professionals who are thinking about leaving their jobs for good. The main reason staff in both services gave us is unmanageable workloads, with many echoing the sentiments of one another.
“The workload is huge and continues to grow. I regularly work 50 plus hours per week to keep on top of everything and still struggle.” (Wales)
“We are consistently given demands that are impossible to achieve. We are worn out and no one cares.” (Wales)
“I’m falling out of love with a job that I have loved and excelled at for nearly a decade and a half. Managers are pushing [targets] and budgets and times, while on road staff are exhausted.” (Victoria)
“Morale is the lowest I have ever seen in the ambulance service.” (Wales)
“Listening to the distressing phone calls I receive from road colleagues who are struggling … There is no respite of this pressure … I am hugely concerned for my frontline colleagues’ welfare.” (Wales)
These comments feed into the issues of staff retention in both services as demands intensify. However, there is a perceived lack of understanding and support from management and more critically, a lack of resources. The real concern lies in how this will impact the quality of care provided to patients in both places.
Our findings are supported by other research which indicates that ambulance services staff were the most likely to say their mental health had deteriorated following the COVID-19 pandemic, and by default, their ability to work effectively in the longer term.
Our research also shows that ambulance workers in Wales and Victoria, Australia are highly engaged and passionate about their work. They identify strongly with the job that they do. But they are approaching a crisis point due to increasing workload, burnout and low morale.
The problems we found in our studies can be solved by ambulance management on either side of the globe. The most important thing is to provide more resources to support and retain this highly skilled workforce, which could help to reduce burnout and keep staff in this essential job.
Ambulance services must prioritise improving staff wellbeing, and efforts to do so should be inclusive, employee-led and proactive. Creating a stable and sustainable workforce could help in responding to changes in service and health needs. All levels of management should be given the appropriate training too. Taking these approaches could ensure that the work of ambulance services staff and other healthcare professionals is properly valued.
We hope that the findings from our studies will be used to create new ways to improve the workplace culture in Wales and Victoria. We also welcome other healthcare organisation using our findings to protect and support the wellbeing of their staff.
The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.