Learning how to support NHS staff during pandemics

Britain’s national health service, the NHS, is a well-loved institution and regularly tops polls of the things that make people proud to be British. The vast majority of people alive in the UK today (around 85%) were born after the establishment of the NHS and have never known life without it. It has been a source of comfort throughout our lives that should anyone become ill the NHS is available, free at point of contact, offering equitable and high-quality medical care.

With Covid-19 rates skyrocketing at the start of 2021, NHS staff are once again being relied upon to manage ever-increasing numbers of patients. There is a real risk for the first time in our living memories that the NHS will become overwhelmed, and care for a range of conditions will need to be rationed. Clinicians could have to triage patients and decide where and when to withhold urgent care for capacity reasons.

The stress the pandemic places on NHS staff comes from many fronts: not having the resources to do their jobs effectively, struggling with tiredness, supporting patients’ families, and increased sickness levels amongst colleagues. In April 2020, NHS Digital reported that monthly sickness rates amongst NHS staff hit 6.2% – this is the highest level recorded in data that goes back to April 2009. At the end of December 2020, some hospitals were reporting absences of between 8 and 12%. Last April the number of patients in hospital with Covid peaked at 15,702 (on 10th April 2020), it is currently 32,294*. Now with 106% more Covid patients, the same number of staff and an increased sickness rate, the NHS has to redeploy staff to cope.

We are all familiar with the images of healthcare workers whose faces are marked from spending their shifts wearing PPE (personal protective equipment). We are shown photos and videos daily of frontline staff asking us to stick to the lockdown rules, to prevent conditions worsening. One of the responses has been to reinstate the Thursday Clap for Carers, renamed as Clap for Heroes to embrace all those in frontline roles: teachers, supermarket workers, etc. However, a recent poll by the Nursing Times showed that healthcare staff would prefer the public support the NHS by adhering to the lockdown rules.

At Picker, we have worked for over 20 years to ensure staff and patients are at the forefront of healthcare provision and policy. We measure excellence in healthcare provision based on the eight Picker Principles of Person Centred Care. For healthcare staff, this means we strive to ensure their individual needs and requirements are an integral part of planning for their working environment.

Our research into staff experience includes the National NHS Staff Survey, which we coordinate on behalf of NHS England and NHS Improvement. The survey covers more than 200 NHS organisations from a range of care settings. Each February, the results are published and provide detailed insight into the NHS’s state from the point of view of its staff. The survey taken in 2019 included responses from more than 550,000 people – half of the service’s workforce.

The most recent survey was sent to staff between October and November 2020. All NHS staff (those employed directly by the NHS, roughly 1.1 million people), were offered the opportunity to share their views on a range of themes including their health, well-being and safety at work and their organisation. New for 2020 were questions to gather insight from the first wave of the pandemic.

NHS organisations use the results to understand their performance and benchmark themselves against other trusts. As well as coordinating the survey nationally, we work with over 150 NHS organisations on their Staff Survey and run workshops with staff engagement leads to help them understand and take actions from the data.

Question 20 above will give us quantitative data, but the more detailed insights are likely to come from the two subsequent open-ended questions that invite staff to share their experiences of working through the pandemic in their own words. Giving people a chance to reflect on a period when normal practice has changed to cope with the pressure, these should provide rich evidence on what has worked and what hasn’t from the perspective of those on the front line. These findings should not only inform our understanding of what it has been like to work through the pandemic but provide insight into how the experience can be used to improve working practice in the future.

It is important, therefore, that we are ready to respond to the suggestions and insights that staff provide. We owe it to them to listen carefully and put in place systems to ensure we are better prepared for future pandemics and support them in the transition back to a new normal.

To make sure you are up to date with the feedback, follow us on twitter where we will post links to the national results with commentary, as well as information about our webinars.

The full results of the National NHS Staff Survey are due to be published on 11th March and will be available here.

*Figures from 11th January 2021