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HCSA – the hospital doctors’ union has warned that the impact of the Covid-19 response on NHS staff could become the “greatest challenge of all” for the health service in months to come.
Steps to prevent short-term burnout and long-term workforce issues are contained in a new paper looking at the lessons from the first stage of the virus response which provides a detailed front-line assessment on a range of issues from PPE to testing.
Rather than seeking to attribute blame in hindsight, it instead focuses on the lessons that must be learned if we are to respond successfully to the pandemic in the coming months and years.
In her foreword to the report, HCSA President Dr Claudia Paoloni states that:
“In coming months, the NHS will have to catch up on thousands of postponed procedures and appointments at the same time as continuing to cope with the challenge of Covid-19. It will need to grapple with the challenge of providing care to a highly vulnerable group with complex healthcare needs, who will continue to require shielding from the virus. As we move towards winter, we will have to manage new outbreaks alongside winter pressures including seasonal influenza.
“These challenges must be met by a health service which did not start from a position of strength. But perhaps the greatest challenge of all will be supporting the number of staff affected by this crisis over a longer period. We cannot simply move to a “new normal” and continue as we are in perpetuity. We cannot allow the legacy of Covid-19 to be a wellbeing crisis among NHS staff.”
In the paper, HCSA makes a number of key suggestions to the government and NHS leaders, including:
- That a two-stage independent inquiry process should be announced. Such a process should include an urgent limited inquiry focusing on action in the short to medium term to be launched no later than August 2020. This would be followed by a detailed longer-term process to commence by March 2021.
- That there can be no move towards a “new normal” where NHS staff are expected to continue to work at an unsustainable intensity in perpetuity.
- Urging caution on increasing NHS capacity without necessary adjustments and warning that attempting to tackle the backlog without learning the lessons of the first wave has the potential to far outweigh in terms of damage and danger any expected benefits of increasing capacity.
- Arguing that while it is right to consider the use of physically separate locations for treatment of Covid-positive patients, for the foreseeable future all hospital facilities must continue to be treated as potential Covid-19 positive sites. HCSA is clear that there is currently no such thing as a “non-Covid” facility – there are only Covid-positive facilities and Covid-unknown facilities.
- Positive changes to staff facilities should not be reversed, including availability of hot food and rest areas especially during night-shifts and access to free parking.
- Warning the Government that any move to institute a new era of pay restraint or austerity in response to the financial challenges presented by Covid-19 must not be contemplated.
- That, given the investment to date, consideration should be given to the possibility of repurposing Nightingale Hospitals to provide non-emergency care that could assist in reducing the waiting lists which the NHS now faces.
- Ensuring that no detriment is suffered by junior doctors as a result of Covid-19 and steps should be taken to ensure that the new skills and experiences acquired in the most challenging of environments are recognised.
- Guidance should be issued by NHS Employers to prevent job plans being agreed which are directly or indirectly discriminatory, including against BAME workers. Doctors must not be treated adversely either financially, or in terms of development opportunities, because of steps taken as a result of their sensitivity to Covid-19.
- Urging PCR screening of all patients and staff, which should take place as frequently as possible for all hospital staff and longer-term patients in order to mitigate the known shortcomings of the test in detecting positive cases.
- The retention of current guidance on PPE for the foreseeable future, including the continued deployment of facemasks and face coverings by all individuals in all areas of hospitals to reduce transmission.
- Calling on the government to reengage with employers and staff representatives to ensure a standard pay policy is put in place which would be applied fairly in any future Covid-19 peak, whether local or national, whenever extremely punishing emergency rotas are implemented.
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