It looks like the United Kingdom is in the midst of a coronavirus second wave which history tells us is a common pattern with these viral pandemics. Winter is a challenging time for the NHS every year due to the rise in respiratory illnesses on top of the routine cases causing systems with little slack to bulge at the seams. There are thoughts that the second wave of the pandemic will be 10 times harder than the first because you’ve got staff exhaustion, you’ve got elective recovery, you’ve got winter, and you have got COVID all happening at the same time.
So, we are now faced with managing the wellbeing of our staff both from a physical and mental health standpoint and this will be a significant challenge for healthcare organisations.
Protecting the workforce to enable them to work is essential.
The latest NHS England data has shown the number of COVID-19-related absences of staff, either through sickness or self-isolation, has risen from 11,952 on 1 September to 19,493 on 1 October. Staff absence has almost doubled in the North West in this time as well – from 2,664 to 5,142 during the same period. Figures from earlier in the year from NHS Digital recorded that from March to May overall sickness absence rates peaked nationally at 6.2%.
This increase staff absence is having a profound impact on the ability of the NHS to deliver both urgent care services and routine work where there is little slack in the system. Furthermore, this is on top of a significant backlog of work causing long waiting lists as a result of the first wave virus/lockdown.
The time it is taking for NHS staff to get tested is also compounding the staff absence issue. A survey by the RCP in September 2020 suggested that 40% of the doctors surveyed who were off work said it is because they are self-isolating while awaiting a test for someone in their household. It is vital that those key workers and their families have rapid access to testing with the results being prioritised to minimise the time they need to take off work.
Along with the physical causes of absence from work there is increasing evidence that the UK is sleepwalking into a mental health crisis.
Increasing uncertainty, fear and isolation will have a profound effect on the mental health of the nation. In a report from October 2020, the Centre of Mental Health modelling has predicted that up to 10 million people (almost 20% of the population) will need either new or additional mental health support as a direct consequence of the crisis. 1.5 million of those will be children and young people under 18. It goes on to say that some groups are more at risk of experiencing mental ill health, including people with existing mental health conditions, NHS workers, ICU patients and their families, those who have been bereaved and those affected by unemployment.
As the weight of the second wave continues to take its toll, we must be mindful that people have been working under sustained pressure for some time now. Many staff are tired and worn down with a large number who have been working under sustained pressure. They also have their own family responsibilities and may have been for elderly relatives or worried about children returning to school or university.
Clinical staff may start to increasingly wonder whether they are still in the job they signed up for.
Many clinical staff have had to work in very different ways to deliver the care in a safe and effective way. However, changes to this way of working has it challenges. The move to a telephone consultation model can demoralise staff who are used to working in a face to face environment.
It is well known that when working in a healthcare environment there have always been challenges that require professionals to suppress their own emotions to portray a work-based façade. This is known as ‘emotional labour’ but is really hard work and rarely spoken about.
How to alleviate the burden on healthcare professionals?
- Providing staff with the tools required to keep their own reserves topped up can help with suggestions such as working in pairs or connecting with another person at the end of a shift to debrief.
- It goes without saying a relentless proactive and compassionate response will help support NHS staff who are experiencing mental health difficulties before they reach crisis point.
- There should be a culture of embedding values and behaviours that both support staff wellbeing and hence allow them to provide care for patients to promote outcomes.
- It is important to keep on discussing mental health and resilience as teams.
The consequences of failing to act on staff mental health wellbeing are profound. Investing in supporting the key worker workforce from falling unwell with both physical and mental health problems may help prevent a perfect storm of absences this winter resulting in the NHS falling over which doesn’t bear thinking about.
OnMedica related CDP
An evidence-based approach to reducing the risk of depression, anxiety and stress-related harm.
Learn practical strategies designed to strengthen your ability to cope with adversities. You can use them yourself or pass them on to patients and colleagues.
Why good people deliver bad care?
In this TEDx Talk, Yvonne Sawbridge says that caring professionals offer hard, emotional work. In the same way in which physical labour is recognised and accounted for in management practice, emotional labour needs to be recognised as a role requirement for nurses and other caring professions. All of us have an emotional bank account that is depleted by everything we see and do, and people working in caring professions need support to top this account back up.
National wellbeing support
NHS England and NHS Improvement is offering NHS staff free access to psychological and practical support and have compiled a useful Our NHS People Wellbeing Support PDF with all the information. This includes: