Levels of stress and burnout in trainee and qualified NHS psychological professionals: A systematic review and narrative synthesis

• Trainee NHS psychological professionals report moderate levels of stress • No included studies explored levels of stress in qualified NHS psychological professionals • Trainee and qualified NHS psychological professionals report low-to-moderate levels of burnout • Trainee psychological professions are entering qualified roles already burnt out from training, holding implications to their wellbeing, service delivery, and workforce retention • No stress or burnout research exists for the newer NHS psychological professions that have been a result of the workforce expansion and investment Background: Stress and burnout are widespread among NHS staff, with NHS psychological professionals particularly at risk. Despite ongoing investments into the expansion of this workforce, the extent to which these conditions are experienced remains unclear. Objectives: This systematic review sought to establish levels of stress and burnout within trainee and qualified NHS psychological professionals. Methods: Systematic searches of nine electronic databases identified peer-reviewed papers meeting criteria for inclusion. Screening was conducted at all stages by the primary and secondary researchers, and quality assessed using the Newcastle-Ottowa Scale (Wells et al., 2000). A narrative synthesis was employed, conforming to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement (Moher et al., 2009) and Systematic and Synthesis Without Meta-Analysis (SWiM; Campbell et al., 2020) guidance. Results: Eight studies were included in the review. Three studies explored stress in trainee NHS psychological professions, reporting moderate levels. No studies identified in this review reported stress in qualified psychological professionals, leaving levels unestablished. Two studies explored burnout in trainee NHS psychological professions, reporting moderate levels that were comparable between trainee professions. Three studies explored burnout in qualified NHS psychological professions, reporting low-to-moderate levels, with variability between qualified professions. Conclusions: Given the limited number of included studies, their heterogeneity, and the focus on few NHS psychological professions, this review provides a tentative picture of an at-risk workforce. To ensure its sustainability, future research must examine all psychological professions, use consistent measures, and report all data to gain robust insights and draw meaningful conclusions.