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Burnout in frontline ambulance staff

02 January 2022
Volume 14 · Issue 1



Staff retention is a significant issue for ambulance services across the globe. Exploratory research, although minimal, indicates that stress and burnout, in particular, influence attrition within the paramedic profession. These need to be understood if their impact on retention is to be addressed.


To determine the presence of and contributory factors for burnout in the ambulance service to inform recommendations for positive change.


A two-phased survey approach was adopted using an adapted Maslach Burnout Inventory and Copenhagen self-assessment burnout questionnaire, to measure levels of burnout, depersonalisation (cynicism) and personal achievement. Open-ended questions explored factors that influenced these. Demographic and comparative analysis identified trends and thematic analysis was carried out on the qualitative data.


Ninety-four per cent of ambulance staff in this study (n=382) reported a sense of personal achievement within their professional role; however, more than 50% were experiencing varying levels of burnout with 87% displaying moderate or high levels of depersonalisation towards their work. Causes of stress were complex: themes attributed were a perceived lack of management support, the public's misuse of the ambulance service, involuntary overtime and a poor work-life balance.


Burnout poses a genuine threat to retention in the ambulance service and needs addressing. Proactive screening, better communication between practice staff and management and access to counselling services are recommended. This problem of burnout is beginning to be acknowledged but further evidence is needed to understand it in more depth in order for effective solutions to be developed.

In August 2019, there were 28 308 registered paramedics in the UK (Health and Care Professions Council (HCPC), 2019). Retaining these professionals is an increasingly significant problem, with attrition rates rising rapidly (National Health Executive, 2015; Iliffe and Manthorpe, 2019). The broad skillset of paramedics means that those who are not satisfied with their employment are increasingly finding their professional contribution is in demand in other healthcare sectors. Indeed, Egan (2017) reports that fewer than 80% of registered paramedics are employed by NHS ambulance services.

Retention, attrition and associated concepts are complex, with many factors contributing to sickness and staff motivation. For example, the ambulance service is experiencing rising public demand: the National Audit Office (2017) reports a 5.2% increase in annual call-outs recorded since 2012, with ambulance services receiving 11.7 million 999 calls between April 2018 and March 2019 (Association of Ambulance Chief Executives, 2019). This results in growing workloads and has a negative impact on meeting response targets.

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