Questions raised over ability of NHS and its staff to 'spring back' from Covid-19 pressures
The speed at which the NHS and its workforce will be able to ‘spring back’ once ongoing surges in Covid-19 cases have been curtailed will require an ‘honest conversation’.
That is the nub of a stark message issued today by NHS Employers in response to a Royal College of Physicians (RCP) survey showing that one doctor in four has sought mental health support during the pandemic.
Rebecca Smith, managing director of NHS Employers – which is part of the NHS Confederation – said: ‘These survey findings are sadly far from surprising, given the monumental pressures on the NHS workforce right now, with record numbers of patients in hospitals with coronavirus and about 53,800 staff away from work for reasons related to the virus, all while we are rolling out the largest ever mass vaccination programme.
This way of working is clearly unsustainable, and an honest conversation will be needed about how quickly the NHS can spring back once this peak subsides [Rebecca Smith, NHS Employers]
‘It is important that staff are able to access support, and we should be encouraging this in terms of supporting their wellbeing.'
Ms Smith lauded the ‘dedication and commitment’ of all NHS during the Covid, but added: ‘This way of working is clearly unsustainable, and an honest conversation will be needed about how quickly the NHS can spring back once this peak subsides.’
To see NHS Employers guidance on supporting staff wellbeing, visit: https://www.nhsemployers.org/covid19/health-safety-and-wellbeing/supporting-staff-wellbeing
To see NHS England and Improvement resources on supporting NHS staff wellbeing while looking after others, visit: https://people.nhs.uk
RCP survey results
Almost one respondent in five (19 per cent) in the RCP survey said they have sought informal mental health support during the pandemic, while 10 per cent said they had sought formal mental health support from their employer, GP or an external service.
While a third reported feeling supported (35 per cent) and determined (37 per cent), most (64 per cent) felt tired or exhausted, and many were worried (48 per cent).
The second wave of coronavirus is undoubtedly hitting the NHS far harder than the first, with three quarters of doctors finding this second wave either slightly or much busier compared to the peak in April, and 56 per cent very concerned about the impact of rising Covid-19 admissions on their organisation’s capacity to deliver safe and effective care.
Respiratory medicine bearing the brunt
Improvements in treatments for Covid-19 mean that in this second wave a much smaller proportion of hospitalised Covid-19 patients are requiring ventilation in intensive treatment units (ITUs), according to the RCP. This, however, has placed huge pressure on the wider medical team in all specialties, particularly respiratory medicine.
In some hospitals, up to 95 per cent of Covid-19 patients are receiving care outside of intensive care units, being placed in medical wards acting as Covid-19 wards. One physician in five (20 per cent) has been redeployed during this wave, most to these Covid-19 wards.
Hospital admissions are at the highest ever level, staff are exhausted, and although there is light at the end of the tunnel, that light seems a long way away [Andrew Goddard, RCP]
Andrew Goddard, RCP president, said: ‘There is no way to dress it up – it is pretty awful at the moment in the world of medicine. Hospital admissions are at the highest ever level, staff are exhausted, and although there is light at the end of the tunnel, that light seems a long way away.'
Professor Goddard added: ‘Staff will be in desperate need of a break and will need specific time away if they’re to be at their best after the pandemic.
‘Workforce shortages need to be urgently addressed post-pandemic if we’re ever to reduce the immense pressure on NHS staff and ensure that they are prepared and supported to get the NHS back on an even keel.’
The frontline response
On 12 April 2020, at the peak of the first wave, 21,684 patients with Covid-19 were in hospital, of whom 15 per cent were ventilated ( a total of 3,301).
In comparison, on 15 January, 10 per cent of the 37,475 patients in hospital with Covid-19 were on ventilation (3,789 patients). That represents a 73 per cent increase in the number of patients with Covid-19 being treated by the wider medical team beyond ITUs.
Improvements in treatment options mean that in this second wave a much smaller proportion of hospitalised Covid-19 patients are requiring ventilation on ITU. However, their conditions are still severe enough to require inpatient hospital treatment on a general Covid-19 ward.
This, the RCP said, is placing huge pressure on the wider medical team in all specialties –particularly respiratory medicine –as the physicians, nurses and other healthcare practitioners staffing these wards work hard to care for a rapidly increasing number of patients.
To visit the RCP website for more information, go to: https://www.rcplondon.ac.uk
Author: Ian A McMillan