NHS healthcare workers are being pushed above and beyond their limits as a result of the rising no. of COVID-19 cases, limited resources and staff shortages.

Staff are both emotionally and physically exhausted and the psychological effects of the pandemic will have a lasting impact on their mental health. The impact of other pandemics such as the SARS is well noted, with increased rates of depression, burnout, post-traumatic stress disorder (PTSD) and anxiety.

Early warning walls were available on the impact of COVID-19 from China and Singapore. Data published from these countries detailed the mental effects the pandemic was having on healthcare workers. Mix this with pre-existing rates of stress-related illness, high suicide rates compared to other occupations and we have a perfect storm. With all this data available the UK was still unprepared.

To assess the factors associated with staff burnout during the COVID-19 pandemic a study of 2,707 healthcare workers identified these to be:

1. Feeling pushed beyond training
2. Exposure to Covid-19 patients
3. Making life-prioritising decisions

To deal with the intensity of the current wave, many staff have been redeployed again to areas such as ICU, with limited experience and training, with increased exposure to Covid-19 patients, and senior staff increasingly having to make life-prioritising decisions, such as whether someone is suitable to be admitted to ICU and go on a ventilator. Staff are doing this day-in and day-out, for months. It is not difficult to understand why our workforce is burning out.

A senior nurse based in a London emergency department reported to the Independent “We were seven short this morning. Some are sick with Covid, some are isolating and some have been off for weeks for mental health reasons. Every day we are relying on the goodwill of colleagues to come in to do extra shifts.”

“The extra support we had in the first wave, with free food, transport, and extra pay for additional shifts has been scrapped. Many of us are not from the UK, feel isolated and drained, and haven’t seen our families for eight or nine months. I have never seen so many nurses cry during shifts. Every shift is a struggle.”

Some healthcare workers have been forced to take prolonged sick leave for mental health reasons or have even resigned. “I have already been off long term for mental health reasons and I became so unwell, I attempted to take my own life,” another nurse said. “On my return, I’m being pushed to be redeployed. I was told I had a job to do and to get on with it. Many of us felt like lambs to the slaughter.”

The support provided to staff during the first wave, such as free parking, food, accommodation, access to psychologists and wellbeing hubs, is no longer in place at most trusts, at a time when the staff need it the most.

A report from the Royal College of Nursing Research Society in May 2020 showed 24% of 4,063 nurses and midwives across the UK, surveyed between 28 April and 12 May, said they were suffering severe or extremely severe depression. This is a dangerous situation for a profession that already had a high suicide rate before Covid-19 struck.

One senior nurse said: “I feel sorry for some of the junior staff. I remember I had to teach someone over the phone how to do non-invasive ventilation, as we didn’t have enough staff and I just couldn’t leave.”

“When junior nurses ask for help and feel overwhelmed, sometimes they are left by themselves to get on with it, as there just isn’t enough support. After months of this, I was forced to take a period of sick leave as I couldn’t cope anymore and felt so guilty.”

The pandemic has also had an impact on the next generation of doctors and healthcare workers. Many postgraduate exams are being cancelled or postponed as have some speciality recruitment interviews, which trainees have dedicated months preparing for. The uncertainty, unpredictability and the detriment to their career pathway has also contributed to psychological distress and burnout.

The goodwill of staff, on which the NHS has run on for many years, is running out. Over the coming weeks and months, the Covid surge is likely to continue. The government, key policy makers and local/national stakeholders must ensure that the mental health of staff is not neglected in the face of the rising Covid admissions and deaths, and that adequate support is in place to curb an impending mental health epidemic in the UK – the aftermath of which may see many staff members off on long-term sick leave or resigning completely.   

If you’re concerned about yourself, a loved one or a colleague the NHS offers an urgent mental health helpline. To find your local helpline please visit https://www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline.  

For a full list of mental health services available from charities, organisations and support groups please visit https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/.