Respiratory professionals ‘close to burnout’ as Covid-19 heaps extra pressure on them, charity warns
Long-standing concerns over a lack of investment in respiratory departments across the UK appear to have been exacerbated by the Covid-19 crisis.
That is the message delivered by the British Thoracic Society (BTS), a charity which has released results of a survey it completed among NHS respiratory leads across the country at the end of November.
About one third of leads – or 85 out of the 244 in the UK – responded on behalf of themselves and colleagues, including physios.
They were asked about current staffing levels and whether any departmental changes had occurred since February.
Key findings: workload pressures
- 71 per cent of respondents said they had insufficient numbers of medical staff to manage their workloads
- 80 per cent had too few non-medical staff
- 71 per cent lacked sufficient bed space to cope with the number of patients they were treating
- despite the option of delivering care virtually or remotely being touted as way of helping to reduce hospital crowding and improve care, only 50 per cent said they have enough resources (staff and equipment) to manage patients in this fashion
The BTS found that respiratory professionals have to juggle treating patients with Covid-19 while continuing to provide routine clinics and services. Despite having also started to deliver long-Covid clinics, chronic and endemic workforce deficiencies are still not being addressed, it claims.
Respiratory professionals want to do the best for their patients – it’s what they train for many years to do – but they are dangerously stretched and close to burnout right now [Jon Bennett, BTS chair]
Jon Bennett, BTS chair said: ‘Sadly, the understaffing of respiratory departments is nothing new. Winter after winter for years we have been seeing the NHS buckle under the pressure of increased emergency admissions of patients with respiratory illnesses.
‘These fall disproportionately on respiratory departments, which always step up to the mark, every time, performing over and above their scheduled duties,’ Professor Bennett said.
A 'sad indictment'
‘It is a sad indictment that respiratory services have never been prioritised and thus it is no surprise that they are struggling to cope with a global pandemic of respiratory disease.
‘Respiratory professionals want to do the best for their patients – it’s what they train for many years to do – but they are dangerously stretched and close to burnout right now.’
What changes have occurred since February?
- staff sickness: 87 per cent said it increased
- workload: 91 per cent said it had increased
- patients’ waiting times: 73 per cent said they increased
- extra working hours: 80 per cent reported a rise
- ability to take annual leave: 66 per cent said the chances to do so had decreased
- make-up of patients: 60 per cent said they care for increasing numbers of patients who would have gone to intensive care in the first wave
Plan needed for future 'catastrophic' events
The BTS called for the implementation of a number of short and medium interventions to tackle under-staffing, while new professionals come through the system.
Professor Bennett added: ‘Respiratory professionals are committed to their patients and will now dig even deeper to ensure their care, but cannot go on under this pressure forever.
‘Planning today for better resourced respiratory departments will ensure that the NHS is prepared for the perennial “winter pressures” and future potential catastrophic events such as the current pandemic.’
Physiotherapist Rachael Moses, who became BTS president in recent weeks, said: 'Often the dedicated funding for allied health professionals is forgotten, with already stretched teams being expected to do more with less.
'Never has the importance of multidisciplinary respiratory teams been recognised and appreciated than over the last few months.
'As a community – including patients, professionals, families and caregivers – we are hoping that 2021 will see dedicated funding pathways to enable our specialist workforce to grow. Only then can we truly meet the ever increasing demands on our services and enable us to provide the world class care we are so very capable of.' [Ms Moses' comments were added on 23 December 2020]
To find out more about the BTS, visit: http://www.brit-thoracic.org.uk
Getting It Right First Time
According to NHS Getting It Right First Time (GIRFT) figures highlighted by the BTS, more than 40 per cent of Covid-19 patients admitted to hospital require oxygen therapy. This is mainly delivered in respiratory wards, while others happen in ‘extra capacity’ or ‘outlying’ wards staffed by respiratory specialist teams.
Another 17 per cent require extra breathing and other organ support delivered in respiratory support units or in intensive care.
Respiratory specialists, with acute and geriatric medicine, also contribute to the care of the 43 per cent Covid-19 patients requiring specialist care but less intensive respiratory support.
To see the GIRFT report (launched in December), Clinical practice guide for improving the management of adult COVID-19 patients in secondary care, visit: https://www.gettingitrightfirsttime.co.uk/wp-content/uploads/2020/12/Covid19-Clinical-Practice-Guidance-S-FINAL.pdf
Author: Ian A McMillan