NHS Frontline Workers and the Covid Pandemic 1 Jan 1970

By law, all workers are entitled to work in environments where risks to their health are properly controlled. The law also applies to the NHS. Even so, at the start of the Covid crisis, despite lack of PPE and other safety measures, NHS staff were expected to be present for work. The result? Over 850 healthcare workers have died from the virus. Nurses, doctors, porters, healthcare assistants, support workers, receptionists, managers, paramedics, and others, needlessly infected and dead.

In addition, sickness and stress is taking its toll. In January, there were over 46,000 hospital staff off sick, while the number or doctors seeking psychiatric help has doubled since the pandemic started. Soberingly, recent research by King’s College London found that more than 1 in 8 respondents to a survey of healthcare workers had thoughts of suicide or self-harm (ibid).

Human, not super-human

Healthcare professionals have the training to treat the sick. They do not have special abilities that make them immune to the pressures inherent in a system that was already on its knees and is now struggling to avoid complete collapse.

However, there is a prevailing pressure on healthcare workers to turn into work no matter how unsafe the environment: to be ‘heroes’. The pressure is insidious: from the Government’s attitude that NHS staff have a moral and ethical obligation to demote their own needs in the service of others, to the general public and the ‘clap for carers’ which while well intentioned, supports that attitude.

Long standing resource issues

The Government’s lack of preparedness and hesitancy to act decisively from the outset, led to our Covid cases becoming some of the highest worldwide. A chronic lack of resources meant that hospitals were unprepared for the overwhelming influx of seriously ill patients, with insufficient ICU beds and ventilators, as well as sparse supplies of PPE. This had a serious impact on the safety of the work environment. Indeed, the Commons Public Accounts Committee recently announced that England’s inadequate planning for the pandemic, left 30% of frontline workers risking their own lives and that of their families.

Given these facts, it is not a stretch to assume that if the NHS were adequately resourced, we would not have required ‘heroism’ from the healthcare workers at the front line: it should not have been inevitable that they were at risk of catching Covid at work.

Mental health

At the beginning of the pandemic, the focus for healthcare workers was how to physically protect themselves, their patients, and their families. As time has passed, the mental health burden is becoming clear. Healthcare workers are facing life and death decisions many times a day. Families cannot be at the bedside of dying patients, so frontline staff provide emotional support via video calls. There is no facility for the staff to debrief and to recover. They just have to move onto the next one, and the next. That feeling of being chronically unprotected and unsupported is traumatizing.

To compound matters, due to staff shortages, healthcare workers are enduring long shifts, often back-to-back, with little time off in between. Travelling to new places of work to support overwhelmed facilities, being redeployed into unfamiliar settings, all without adequate training, are additionally stressful. On top of this, some are isolating from their families out of fear of bringing infection home.

In these conditions, reports of overwhelmed staff should not be surprising. Indeed, research shows that working during a pandemic results in severe and enduring stress to frontline health care works. Burnout, trauma, anxiety, and depression are the consequence.

Long Covid

In addition to the mental health challenges and acute physical problems wrought by the virus, the Long Covid syndrome is also a real concern.  One in five patients recovered from acute Covid infection report long-term symptoms, ranging from fatigue, to shortness of breath and neurological problems. Naturally, this will impact healthcare workers too.

The All-Party Parliamentary Group on Coronavirus believes that Long Covid should be recognized as an occupational disease for healthcare workers, and that there should be a compensation scheme for those impacted. This call is driven by the recognition that frontline staff, ‘were specifically asked to go to work and save lies, while everyone else was asked to stay at home. They were exposed to an increased level of risk of catching the virus, often without adequate levels of PPE’.

The future is bright?

With the vaccine rollout, it is anticipated that the Covid outbreak in the UK will become more manageable as the months pass. Post-Covid, there must be a serious re-evaluation of how NHS staff are viewed and treated. The greatest assets of the NHS should be recognised, not just with ‘feel-good’ clapping and hand-painted rainbows mounted in our windows. They must also be backed by work-related mental health support, appropriate education and training, and of course commensurate financial compensation.

Stephanie Prior, Medical Negligence lawyer

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