Thinking about and caring for NHS workers now it matters the most

NHS staff may not have supernatural powers or wear eye-catching uniforms, but after emerging as real heroes of the Covid-19 pandemic are they now suffering for their selfless efforts?

A new thought-provoking and poignant three-part TV drama will tell the story of NHS medics during the pandemic, and it is set to be aired next week (19 Feb). [1] cited 13.2.24

The series is said to pay tribute to sacrifices made by NHS staff during that time, revealing the reality of hospital life in the face of momentous challenges.

The NHS is now said to be experiencing some of the most severe pressures in its long history, with the problems caused by the pandemic being just the tip of the iceberg. Here we look at some of the fallout following it and the impact on staff.

Next month marks the fourth anniversary since the government announced the first lockdown, and thrust those working on the frontline of the battle against the deadly virus firmly into the spotlight [2] cited 13.2.24

The nationwide show of gratitude for the tireless efforts of NHS staff, many it has now emerged ill-equipped at first for the job by not having appropriate PPE, was shown at the time on the doorsteps of millions of households across the country [3] cited 13.2.24

But when those front doors closed and the clapping and public displays of appreciation stopped, and we slowly returned to normal life, what has been the lasting impact on those who fought so hard to care for the people most severely affected by Covid?

Healthcare workers faced immense physical and mental strain during the pandemic due to long hours, exposure to the virus, and witnessing high levels of serious illness and death.

Many experienced burnout, exhaustion, and trauma, which may have had long-lasting effects on their mental health and overall well-being.

The pandemic has left a significant mark on NHS staff, both in terms of the challenges they faced during the crisis and the potential long-term effects on their health and work practices.

High sickness absence rates

Analysis of staff sickness data published by the NHS showed more staff off sick on any given month in 2022 than at the worst point in the year before the pandemic: even the month with the lowest rates of sickness in 2022 (May 2022 at 4.9%) was higher than December 2019, the worst month that year (4.86%) [4] cited 13.2.24

Research showed that in total across 2022, some 27 million days were lost to sickness absence, equivalent to 74,500 full-time staff, including some 20,400 nurses and 2,900 doctors.

While the increase in respiratory and infectious conditions is not surprising given Covid, there has also been a stark rise in staff who need to take sick days for anxiety, stress and burnout, which were said to account for a quarter of sick days.

In total across 2022, some 6 million working days were lost in total to mental health and wellbeing related illnesses.

While the reasons for long-term staff absence may vary, the need to provide meaningful support to help staff get better and to return to work fit and well is very clear.

UNISON, the UK's largest health union, has called for fair sickness absence policies that help staff get well, and not punish them for being sick [5] cited 13.2.24

NHS Employers, the employers’ organisation for the NHS in England, has produced a  toolkit intended to supportively manage sickness absence [6] 13.2.24

Long covid

Worryingly tens of thousands of NHS workers who caught Covid suffered life-changing consequences as a direct result of it.

NHS staff have been significantly affected by long Covid, which refers to persistent symptoms lasting beyond the acute phase of the illness. Here are some key points:

• NHS Trusts in England are reported to have lost nearly 2m days in staff absence due to long Covid in the first 18 months of the pandemic [7] cited 13.2.24

• As of 18 May 2021, estimates by the Office of National Statistics suggested that approximately 122,000 healthcare workers and 31,000 social care workers were self-reporting symptoms of Long Covid [8] cited 13.2.24

It made them the group most affected by the condition in the UK at the time. The number surpassed other occupational groups, including teachers.

• According to a BMA poll a fifth of doctors with long Covid were said to have been unable to return to work - with many more forced to cut their hours and facing cuts in income, debilitating symptoms and a lack of support [9] cited 13.2.24.

• Analysis by BBC Panorama suggests that between 5,000 and 10,000 NHS workers could be off sick with long Covid [10] cited 13.2.24

The programme Forgotten Heroes of the Covid Front Line tells the stories of some NHS workers who are living with long Covid and struggling to return to work. They now face the prospect of having to retire early or even being sacked.

Other countries have already designated Covid as an occupational disease, providing financial support to affected workers.

The situation highlights the need for continued research, support, and understanding of long Covid’s impact on healthcare professionals.

Ongoing work pressure caused by the pandemic

There is a significant NHS treatment backlog resulting from the impact of Covid on service delivery.

The backlog in secondary care consists of care that would normally have been delivered but was disrupted due to Covid-19 [11] cited 13.2.24

Before the pandemic there were already 4.43 million people on waiting lists for care. As of December 2023, the waiting list stood at 7.6 million cases, involving approximately 6.3 million individual patients waiting for treatment.

Working to clear the backlog will inevitably come with particular challenges, added pressure and ongoing demands that staff will have to deal with. The potential impact could include:

• Work-related stress caused by immense demands, which can impact on employees’ well-being, affecting their overall health.

• Relentless demands can lead to anxiety, burnout and feeling completely overwhelmed.

• Under pressure employees can exhibit changes in behaviour e.g. irritability, mood swings, and interpersonal conflicts can arise.

• Employees experiencing excessive pressure may take sick leave or struggle to attend work consistently.

• High-pressure situations can diminish job satisfaction leaving employees feeling unfulfilled and dissatisfied with their roles.

• Physical Symptoms: Headaches, muscle tension, and gastrointestinal issues can manifest due to stress.

• Prolonged exposure to pressure can lead to chronic health conditions.

High demands without adequate support can harm employees’ well-being and job satisfaction.

Duty of care

If it was ever in any doubt, the pandemic showed everyone that many NHS workers are resilient, dedicated, unselfish and caring.

While many are coping with the stress of work, and support is being provided, there will always be room for improvement.

The NHS duty of care to employees is the legal and moral obligation that NHS organisations have to protect the health, safety and wellbeing of their staff.

It does mean that NHS employers must provide a safe and supportive working environment, where staff can cope with the demands of their roles and receive appropriate assistance if they are struggling with pressure of work.

Some of the ways in which NHS employers can be expected to fulfil their duty of care to employees are:

• Conducting regular risk assessments and implementing measures to prevent or reduce work-related stress.

• Encouraging a culture of openness and feedback, where staff can raise any concerns, and where managers can provide constructive and supportive feedback.

• Promoting a healthy work-life balance.

• Providing meaningful support, such as occupational health, counselling, employee assistance programmes, and peer support networks.

The NHS should provide a safe and supportive working environment, where staff can cope with the demands of their roles and receive appropriate assistance if they are struggling with the pressure of work. It will, of course, benefit both the staff and the patients, as well as the organisation as a whole.