Shielding healthcare workers: the impact of workplace discrimination on workforce health

AIMS: To understand the impacts of shielding on junior doctors (JDs) in Scotland during the COVID-19 pandemic. METHODS: 11 JDs and 2 consultants took part in qualitative individual semi-structured interviews (September-November 2022). Reflexive thematic analysis was used to analyse the data. The local Research Ethics Committee confirmed ethical approval was not required (‘not research’ letter given). RESULTS: ‘Negativity and stigmatisation’ were discussed by 82% of JDs, with one JD being told that providing reasonable adjustments would set a ‘bad precedent'. Several were threatened with punitive action including dismissal. Other themes included ‘overlooked and undervalued’ as 73% described their contribution as being dismissed or unrecognised and had to ‘pester’ their supervisors for work. All JDs reported inadequate support at workplace and Occupational Health levels. Mental health impacts included guilt, anxiety, and isolation. Consultant interviews were consistent with these themes and provided insight into supervisory challenges including not receiving guidance or resources, and ongoing issues supporting disabled and pregnant JDs. DISCUSSION: These findings offer novel insight into the experiences of shielding from a JD and supervisor perspective. This ‘natural experiment’ revealed that the support infrastructure available to JDs in Scotland with disabilities and during maternity didn't withstand the pressures upon it or was absent entirely. These findings are in line with existing literature in this area and reflect a concerning paucity of support for these JDs, and a wider culture of stigmatisation and workplace maternity and disability discrimination impacting workforce health. Particularly in the current climate of widespread burnout and a recruitment and retention crisis in healthcare, the medical community stand to lose a lot if they don't recognise the reality of a diverse workforce, where all healthcare workers are given the support they need to thrive. KEY MESSAGES: • The infrastructure for supporting junior doctors with disabilities, health issues, and during maternity in Scotland is insufficient. • These findings indicate concerning workplace maternity and disability discrimination impacting part of the healthcare workforce in Scotland.