Care Under Pressure

Care Under Pressure 3

Optimising the delivery and impacts of interventions to reduce hospital doctors’ mental ill-health in the NHS


  • The NHS needs motivated doctors to provide the best care for patients. However, doctors experience high levels of stress, anxiety, and other mental health issues due to very challenging demands and pressurised work environments. However, existing workplace support for doctors seems to be having limited effect.
  • This research builds on our existing work – Care Under Pressure 1 (CUP1) – which brought together evidence to produce guidance and recommendations to reduce doctors’ mental ill-health in the workplace. One conclusion from CUP1 was that we do not need more initiatives, but we need to improve the ones that we already have.
  • In Care Under Pressure 3 (CUP3) our aim is to work with and learn from eight NHS Trusts to minimise doctors’ mental ill-health and its impacts on the workforce and patient care. Ultimately producing guidance for all NHS Trusts.


CUP3 has three phases:

  • Phase 1: Map existing interventions to reduce doctors’ mental ill-health in the NHS; and use this to select eight different NHS Trusts
  • Phase 2: Work with these Trusts to understand their existing strategies to reduce doctors’ mental ill-health
  • Phase 3: Develop guidance for all NHS Trusts to help them evaluate and implement strategies to reduce doctors’ mental ill-health

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Key Publications

Pearson, Alison, Daniele Carrieri, Anna Melvin, Charlotte Bramwell, Jessica Scott, Jason Hancock, Chrysanthi Papoutsi, Mark Pearson, Geoff Wong, and Karen Mattick. “Developing a typology of interventions to support doctors’ mental health and wellbeing.” BMC Health Services Research 24, no. 1 (2024): 573.

Bramwell C, Carrieri D, Melvin A, Pearson A, Scott J, Hancock J, Pearson M, Papoutsi C, Wong G, & Mattick K. (2023). How can NHS trusts in England optimise strategies to improve the mental health and well-being of hospital doctors? The Care Under Pressure 3 (CUP3) realist evaluation study protocol. BMJ open, 13(11), e073615.