LUGANO, Switzerland, 10 September 2024 – The European Society for Medical Oncology (ESMO) is calling on all actors of the oncology community to commit to improving the well-being of the cancer workforce and join in 11 actions outlined in a paper published today in ESMO Open. (1) The ESMO Resilience Task Force recommendations to manage psychosocial risks, optimise well-being, and reduce burnout in oncology provide an evidence-based plan for individuals and organisations to address the growing pressures placed on the profession and mitigate the threat they pose for the quality and equity of cancer care.

Burnout among healthcare professionals is a global issue with high prevalence across Europe, affecting doctors across different specialties (2) and career stages as well as allied professions such as nurses. Leading causes of burnout in this sector include compassion fatigue, repeated exposure to death and dying, increased administrative burden, financial constraints and inadequate work-life balance. (3) An ESMO survey conducted between 2013-2014 on the subject revealed that the problem affects more than two thirds of young oncologists in Europe, (4) and a series of three global surveys conducted in the course of the COVID-19 pandemic further highlighted the difficulties faced by oncologists in dealing with increasing pressures in their professional life. (5, 6, 7)

“The ESMO paper published today distils the findings from these three surveys, which received a combined total of more than 3,700 responses, into actionable recommendations based on what oncology professionals from over 100 countries have reported,” said author Dr Jonathan Lim, The Christie NHS Foundation Trust, Manchester, United Kingdom, member of the ESMO Resilience Task Force. “As oncologists on the ground, we see every day that morale is low and that the workforce is in crisis: our hope is that this work will now serve as an evidence basis that individuals can use as leverage to advocate for change within their institutions, taking from the recommendations what is most valuable and feasible within their respective countries, cultures and working environments.”

The recommendations target improvements in three areas important to healthcare professionals’ wellbeing:

1. information and training to support oncologists’ development and practice,

2. strategies and resources to safeguard their psychological and physical health, and

3. activism and advocacy for the discipline of oncology and the well-being of its workforce.

They are designed to guide action at the level of individual healthcare professionals, institutions, as well as national and international societies. Proposed measures include providing more training and individualised mentoring to support doctors and restore a sense of control over their career development; ensuring manageable workloads and offering more flexible working conditions, but also creating more pleasant working environments with suitable equipment and the time and space to communicate with colleagues and reduce isolation.

In a context where attrition is high, with one in four oncologists reporting that they were contemplating a career change or move to industry, (8) investments in workforce retention and strategies to attract more people to the field are also essential to ensure the sustainability of institutions’ oncology services. Tailored support measures are equally required to address the specific needs of different groups within the workforce, such as women and young oncologists, who were found to be at higher risk of distress and burnout during the pandemic years, or senior oncologists, who may choose to retire from clinical practice early if they are unhappy with their working conditions.

Corresponding author and Chair of the ESMO Resilience Task Force Dr Susana Banerjee, Medical Oncologist at The Royal Marsden NHS Foundation Trust and Professor of Women’s Cancers at The Institute of Cancer Research, London, United Kingdom stated: “Too many people working in oncology experience burnout, and this has a knock-on effect for institutions and patients. We hope that the recommendations laid out for institutions, societies and individuals, will help shift attitudes and priorities within the oncology sector – reducing burnout of professionals, improving efficiency for hospitals and maintaining excellent patient care."

The paper highlights for each area of action various initiatives that the Society itself is undertaking to help address the issue and provide tangible support to practitioners, including efforts, to push for necessary political measures to protect the oncology workforce.

ESMO Director of Public Policy Dr Jean-Yves Blay argued that concerted action by all countries to increase the number of healthcare professionals trained each year must go hand in hand with provisions to ensure the health and well-being of the workforce. “Not only is the workload increasing for oncology professionals, whose numbers are already insufficient across the globe and who are up against an annual cancer incidence that is projected to rise by 75% between 2022 and 2050, (9) but the pressure associated with the work is also growing as a result of the rapidly expanding volume of knowledge in our field. Parallel to this, we are seeing the same sociological change as in other economic sectors, with new generations of doctors expecting a better work-life balance to navigate a decades-long career in oncology,” Blay explained.

Failing to make the necessary changes, Blay warned, would cause the quality of care to deteriorate across Europe and, associated with increasing medical nomadism as high-income countries deplete the medical workforces of low- and middle-income countries to try to meet their own labour needs, inevitably lead to a rise in health inequities. “All of these things could severely impact quality and equity of cancer care. These are not cosmetic measures, they are fundamental for the future of cancer care,” Blay emphasised.

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