The Hospital Doctors Union (HDU) pressed on with its campaign to end dangerous complacency on NHS staff fatigue by winning unanimous backing from Trades Union Congress delegates for a call to lobby government for change.
In a speech to secure official TUC support, HDU (formerly HCSA – the hospital doctors’ union) delegate Dr Sasha Burn branded fatigue a “growing, systemic threat to workers’ safety, dignity and wellbeing.”
“Fatigue is not a personal failing. It is not a matter of ‘resilience’. It is an organisational hazard – created by decisions, by staffing levels, by rota design, by the way work is structured.
“Like any hazard, it can be prevented.”
The full text of the speech is available below. View video of the speech.
The HDU motion, seconded by Unite the Union and supported by the Royal College of Midwives and seafarers’ union Nautilus International, warned that in the NHS employers were trying to mask staff shortages with “on-call” systems and unsafe patterns of work which put patients and health workers at risk.
It urged the TUC to lobby for government action on fatigue as “a major workplace safety issue” backed by stronger guidance and regulation.
“The proposal aims to secure safer staffing levels, evidence-based rota and scheduling design, adequate rest breaks, suitable rest, toilet and welfare facilities, protection from extreme temperatures, protected recovery time between shifts, compensatory rest after periods of on-call and confidential mechanisms for workers to report fatigue without fear of detriment.”
Dr Burn told delegates: “When we get this right, everyone benefits. Worker wellbeing improves. Sickness absence falls. Retention strengthens. Productivity rises. Errors and accidents decline. And the public is safer.
“Fatigue is preventable. It is manageable. And it is time the UK treated it as the serious workplace hazard it is.”
Delegates’ support for the HDU motion commits the Trades Union Congress to lobby for legislative change.
It comes four years after HDU, then the HCSA, signed up to the Fight Fatigue campaign, which was launched following a national survey of 2,000 anaesthetic trainees that delivered shocking findings on the impact on doctors.
Speech by Dr Sasha Burn, on behalf of the Hospital Doctors Union, formerly the HCSA:
“We bring this motion because fatigue is no longer an occasional inconvenience in the workplace — it is a growing, systemic threat to workers’ safety, dignity and wellbeing across the UK economy. And it is putting the public at risk too.
From healthcare to transport, from emergency services to manufacturing, from social care to every safety critical sector, workers are being pushed past the limits of what is safe, sustainable and humane. Fatigue is not a personal failing. It is not a matter of “resilience”. It is an organisational hazard — created by decisions, by staffing levels, by rota design, by the way work is structured. And like any hazard, it can be prevented.
Congress, we’ve all heard the stories. Unite’s recent survey of bus drivers revealed what many of us already knew: exhausted workers are driving vehicles full of passengers through busy streets, terrified to admit they’re fatigued because they fear being penalised. That is not just unfair — it is dangerous. It puts workers, passengers and pedestrians at risk. And it is happening because employers are failing to manage fatigue risks properly.
In healthcare, we see the same pattern. Staff shortages, relentless pressure, long shifts, inadequate rest facilities, and poor rota design are pushing workers to the brink. When a nurse, a doctor, a paramedic or a porter is exhausted, it is not only their own safety at stake — it is the safety of the patients they care for. But the principle is universal: wherever tiredness undermines safe performance, people get hurt.
And let’s be clear: employers are increasingly trying to plug staffing gaps with badly designed “on call” systems that mask short staffing and push workers into unsafe patterns of work. This is not fatigue management — it is fatigue creation.
Congress, we must call this what it is: a national workplace safety issue. Fatigue contributes to errors, accidents, sickness absence, burnout, poor retention and reduced productivity. It is costing workers their health, costing employers their staff, and costing the public their safety.
That is why this motion demands national recognition of fatigue as a major occupational hazard. We need stronger guidance. And where guidance isn’t enough, we need regulation. We need legal duties requiring employers to assess fatigue risks and manage them properly — through safe staffing, sensible scheduling, adequate welfare facilities, protected recovery time between shifts, and compensatory rest after on call periods.
Workers must also have confidential ways to report fatigue without fear of detriment. No worker should ever be punished for saying they are too tired to work safely.
Health and safety reps must be trained and empowered to identify, monitor and challenge fatigue risks. And fatigue management policies must be negotiated — not imposed — through collective bargaining.
Congress, this is about dignity at work. It is about safety. It is about the right to rest, the right to recover, and the right to work in conditions that do not harm us.
We call on the General Council to lobby government to work with unions, regulators, employers and occupational health experts to develop sector specific fatigue management guidance. Because when we get this right, everyone benefits. Worker wellbeing improves. Sickness absence falls. Retention strengthens. Productivity rises. Errors and accidents decline. And the public is safer.
Fatigue is preventable. It is manageable. And it is time the UK treated it as the serious workplace hazard it is.
Congress, let’s protect workers. Let’s protect the public. And let’s make fatigue management a core part of safe, modern, union organised workplaces.
I move.”
ENDS