Spinal Frontiers · Wellbeing · Mental Health
Confidential support made for doctors and healthcare staff, country by country, the second victim experience, burnout and moral injury.
Surgery carries an emotional load that is rarely talked about: complications, patient harm, complaints, long hours and moral strain. This page gathers confidential help made for surgeons, trainees and the whole spine team, and what is known about the second victim experience after harm. Asking for help is part of looking after patients.
You are not alone, and you do not have to use a general helpline. Doctors and healthcare staff have their own confidential services, run by people who understand clinical work: find one in your country ↓
Confidential services run for doctors and health staff, by country. Many are run by doctors; each states its own rules on confidentiality, and a few are linked to the professional bodies, so ask before you disclose anything you are unsure about.
NHS primary care mental health and addiction service for health professionals, with assessment, treatment, urgent and crisis signposting, and self-help resources.
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24/7 telephone counselling with BACP-registered counsellors, and confidential peer support from a fellow doctor; members can also have up to six structured counselling sessions.
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One-to-one emotional support from a trained doctor-adviser during GMC fitness-to-practise procedures.
Details not confirmed on the service's own site; check before relying on them.
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Peer support through a confidential, anonymous online forum, plus signposting and advocacy; it does not offer one-to-one counselling.
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Charity running free, confidential peer support groups and learning sessions for healthcare workers; not a therapy or crisis service.
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Confidential psychotherapeutic consultation service for doctors, set up by the BMA and the Royal Medical Benevolent Fund.
Details not confirmed on the service's own site; check before relying on them.
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Financial grants, money advice, talking therapies for doctors through a partner provider, and telephone befriending.
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Confidential helpline answered by doctors in recovery, with information on addiction, recognising problems in colleagues, and recovery.
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Free, independent, clinically supervised mental health support service, plus wellbeing grants and resources.
Details not confirmed on the service's own site; check before relying on them.
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Self-help, guided self-help, peer support and virtual therapy with accredited specialists.
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Online wellbeing resources, toolkits, learning and urgent-help signposting; no helpline is shown on the home page.
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Up to six telephone counselling sessions for work-related or personal emotional issues.
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Counselling for work-related stress, by phone 24/7 or in person, delivered by ICAS.
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No Northern Ireland equivalent of NHS Practitioner Health was found; RCGP NI has campaigned for one. UK-wide services (BMA line, Sick Doctors Trust, DSN) remain available.
Details not confirmed on the service's own site; check before relying on them.
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Confidential help from experts for stress, burnout, mental health difficulties and alcohol or drug misuse.
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Telephone and email peer support after stressful or serious events (patient harm, violence, suicide) and for exhaustion, staffed by trained peers, psychosocial specialists and psychotherapists.
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Non-profit association offering collegial and second victim support, crisis prevention and training of peer supporters for hospitals; runs the PSU-Helpline.
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Each state medical chamber runs a structured help programme with a named contact person, aimed at treatment and safe return to work.
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Anonymous written first-contact counselling with experienced doctors via an online platform; not therapy.
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Peer-support telephone line run by the junior section of the German emergency medicine society.
Details not confirmed on the service's own site; check before relying on them.
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No confidential support programme run for doctors by an Ärztekammer could be found; a 2024 report says the Vienna chamber refers doctors to an unnamed counselling service.
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Confidential advice from experienced doctor-counsellors who help find a way through the crisis and refer to specialist help where needed.
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Peer support line staffed by volunteer psychiatrists for any personal or professional issue; not a crisis line.
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State programmes offering confidential assessment, referral, treatment coordination and monitoring for addictive, psychiatric and other potentially impairing conditions, as an alternative to discipline.
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Signposting to confidential, no- or low-cost mental health care; the foundation does not provide care itself.
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Volunteer-run directory connecting healthcare workers with pro bono therapists.
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Support for stress, burnout, mental health, substance use and professionalism concerns, with assessment, referral, case coordination and peer support.
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24-hour intake and crisis support line, short-term counselling, referrals and peer support.
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Confidential listening and support from medical advisers who help find solutions and resources.
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The Canadian Medical Association lists every provincial and territorial physician health programme with its phone number.
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Confidential, qualified telephone advice and referral for personal and professional challenges, linking to state doctors' health services.
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Peer support from an experienced doctor; calls answered immediately with a doctor's callback within four hours.
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Free confidential advisory service for stress, mental health, substance use and physical health; helps arrange clinical care.
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Confidential advice, referral and peer support, including after a difficult shift.
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Central contact point and multidisciplinary platform for support, prevention and referral, plus a knowledge centre with webinars.
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Help with personal problems, complaint cases and other challenges, plus a mentor scheme and collegial networks.
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Free line with psychologists who listen and refer, plus social assistance; departmental entraide commissions can help with financial, professional and health difficulties.
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National 24/7 listening platform with trained listeners and psychologists, plus a mobile app and a network of consultations.
Details not confirmed on the service's own site; check before relying on them.
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Long-term professional support for carers in difficulty, founded by doctors in Toulouse, with training days.
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Peer helpline and meetings for health professionals in recovery from substance use disorder.
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Online information and resources on the second victim experience.
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Up to three conversations with an experienced doctor for support, advice and guidance on private or work matters; supporters do not treat, prescribe or keep records.
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Resource centre at Modum Bad offering four-day courses on stress, burnout and the doctor's role, and one-day individual or couples counselling.
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Free helpline, pro bono therapy with volunteer psychiatrists, psychologists, GPs and counsellors, plus training and psychoeducation.
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Comprehensive health, social, legal and employment support so doctors receive treatment and return safely to work, run through the provincial Colegios de Médicos.
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Confidential mental health support for emotional distress, psychological problems or addiction, plus support groups and training.
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No current, doctor-specific confidential support service from the Swedish or Finnish medical associations could be confirmed on an official website.
Details not confirmed on the service's own site; check before relying on them.
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Most surgeons will at some point be involved in a complication or an error that harms a patient. The distress that follows has a name, the second victim experience, and recognised ways to support colleagues through it.
Albert W. Wu, BMJ 2000;320:726-7 (editorial, PMID 10720336)
The editorial that coined the term: patients are the first victims of error, but the clinicians involved are wounded too and need open discussion, honest disclosure and system fixes rather than blame.
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Vanhaecht K et al., Int J Environ Res Public Health 2022;19(24):16869 (ERNST consortium)
The European consensus definition: any health worker directly or indirectly involved in an unanticipated adverse patient event, error or injury who is negatively affected by it. Open access.
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COST Action CA19113
Pan-European network that built shared knowledge on second victims; the funded Action ended in September 2024 but the site still hosts its final report, the RESCUE e-book on a European support strategy, a training manual, course, videos and podcast.
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Aktionsbündnis Patientensicherheit (APS, Germany) and Plattform Patientensicherheit (Austria); Strametz et al.
German-language recommendation (2020, written during COVID-19) for clinical and administrative leaders: what second victims are, their consequences, the Scott three-tier support model, and practical measures such as peer conversations and debriefing. Most of it applies beyond the pandemic.
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Österreichische Plattform Patientensicherheit
Austrian patient-safety platform that co-publishes the second-victim recommendation and ran an Aktionstag Second Victim at MedUni Wien on 7 May 2026. It does not itself offer counselling.
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PSU-Akut e.V. (non-profit, Munich)
Non-profit association that trains peer supporters for hospitals, runs crisis-prevention work and second-victim support for staff after adverse events; backed by Bavarian bodies including the Bayerische Landesärztekammer.
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Stiftung Patientensicherheit Schweiz
Swiss feasibility study and recommendations (2025-26) on building a just, restorative culture after incidents, with downloadable definitions, frameworks, measurement tools and maturity models; it names support programmes for first and second victims as a policy goal.
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Royal College of Surgeons of England with Bournemouth University
Surgery-specific guidance on the second-victim effect, what a supportive culture looks like, practical and medico-legal steps for the surgeon, the medical director's role, and a confidential 'first responder' meeting within 24-48 hours, with checklists.
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Royal College of Surgeons of England
Launched in 2024 to help hospitals set up one-to-one peer support for surgeons after adverse events, building on the RCS good practice guide.
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Bryan J et al., British Journal of Surgery 2026;113(1):znaf258
36 studies: anxiety, guilt, sleep disturbance and low mood were each reported by roughly half of surgeons after an adverse event; talking to colleagues was the commonest coping strategy, and stigma the main barrier to seeking help.
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Bradford Teaching Hospitals NHS Foundation Trust and Yorkshire research partners
Free website for staff affected by patient safety incidents and those who support them, including a Just Culture Assessment Framework and an Organisational Staff Support Model. Latest news item is from 2023, so check for updates.
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Royal College of Surgeons of Edinburgh
One-hour wellbeing webinar (15 April 2025) with surgeons, a GP and psychologists on recognising the second-victim response and supporting recovery after patient safety incidents.
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NHS England
The NHS framework (successor to the Serious Incident Framework) that shifts incident response from blame to learning; compassionate engagement of affected patients, families and staff is one of its four aims, with dedicated guidance.
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NHS England (supported by GMC, NMC, BMA, RCN and others)
Decision tool for managers to judge fairly whether a staff member involved in an incident needs individual support or action, or whether the problem lies in the system.
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University of Missouri Health Care
Pioneering second-victim programme (Scott and colleagues) whose stages of recovery and three-tier support model are widely used; free brochures and handouts that other organisations are invited to reuse.
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Edrees H et al., BMJ Open 2016;6:e011708
Open-access case study of how Johns Hopkins built RISE, a hospital-wide peer support service for staff after adverse events; low awareness was the main barrier and use grew after publicity.
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Betsy Lehman Center for Patient Safety (Massachusetts state agency)
Research library and tools to make the case for, and run, peer support for clinicians after adverse events; MITSS (Medically Induced Trauma Support Services) is now part of this centre.
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What burnout and moral injury are, how common they are among surgeons, and what helps.
World Health Organization
WHO's definition: a syndrome from chronic workplace stress that has not been managed successfully, with exhaustion, mental distance or cynicism, and reduced professional efficacy; classed as an occupational phenomenon, not a medical condition.
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British Medical Association
BMA report (2021, page updated 2026) based on 1,900+ doctors: most recognised moral distress at work, caused mainly by short staffing; sets out structural and personal steps, including peer support.
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Rabin S, ... Wessely S, Journal of Healthcare Leadership 2023;15:153-160
Clear open-access review of moral injury in health workers: common causes (understaffing, resource pressure), links to burnout, and options for prevention and support including peer groups and trauma-focused talking therapies.
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Shah Thibodeau P et al., Int J Environ Res Public Health 2023;20(13):6300
Open-access review of 15 studies linking moral injury to burnout, compassion fatigue, depression, anxiety and PTSD symptoms in clinicians; calls for system-level interventions.
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Abduljabbar FH et al. (AO Spine members), Spine 2021;46(20)
Survey of 818 spine surgeons in 86 countries: about 31% met burnout criteria, with younger age and longer working weeks linked to emotional exhaustion, and burnout tied to poorer quality of life.
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van Niekerk M et al., Journal of the Pediatric Orthopaedic Society of North America 2023;5(1)
Review of 16 reviews: burnout is common in orthopaedic surgeons and about half of residents may be affected; evidence on what helps is thin. Free full text.
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American Medical Association
Articles and guidance on measuring and preventing physician burnout, team-based care and practice efficiency; the CME track is for AMA members.
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Coping with a complaint, claim or investigation: free guidance from the defence organisations.
Medical Defence Union (MDU)
MDU guide on managing the stress that comes with a complaint or claim (first published 2022, updated since); the page is public but the MDU describes its guidance as intended for members.
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Medical Protection Society (MPS)
Free article for consultants reminding them that complaints and complications affect their wellbeing, advising early contact with their defence organisation and pointing to NHS Practitioner Health.
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Medical Protection Society, delivered by ICAS (commercial provider)
Independent, confidential 24/7 telephone counselling (face-to-face can be arranged), funded by MPS, for members under work-related stress.
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MDDUS, delivered by healthcare rm (commercial provider)
Free, confidential 24/7 phone line with self-help resources and talking therapies; extended to admin staff employed by members.
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Every entry was opened and checked on the date shown in our records; descriptions are in our own words. Services change their hours and remits, so check the provider's page. This page is not medical advice and does not replace your own doctor or occupational health service. We re-check it every quarter. Know a service that should be here? Write to spinalfrontiers@nspine.com.
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