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/.

As we begin to feel the effects of a second wave of the coronavirus (Covid-19) pandemic it can be extremely daunting for key workers to leave their home and go into work.
This page will give you some helpful tips on how to keep calm, focused and take care of your mental health and well-being.

During the coronavirus pandemic key workers (aka critical workers) and those whose are unable to work from home are required to go into their place of work.
Working under new conditions and might not be so easy and many can find it hard to cope with the new way of life. However, by doing small things for yourself you can make a massive difference to your mental health.

Understand difficult feelings and emotions

Going into work during the coronavirus pandemic might make if feel like a difficult and stressful time. Some of these feelings maybe new, or things you've experienced in the past. There is no right or wrong way to feel or react to your situation. But these are some common feelings that you might experience during this time:

Stress
Going into work during coronavirus might make you feel stressed, for example if you:
- come into contact with a lot of people, including those who may have coronavirus
- have more work to do or you are working longer hours than you normally would
- feel uncertain about keeping your job or worried about money

Some of these effects will be felt straight away. Other effects could take longer to notice, including after the stressful event has ended.

Anxiety
Feelings of anxiety may be felt because you are worried about your own health or the health of those around you, including those who you care for or live with. On top of this you may also have other worries such as losing your job or financial difficulties as a result of the coronavirus.

Guilt
If you are worried about spreading coronavirus you may feel guilty about going into work or you may feel guilty if your response to a particular situation was different to those around you or how you would have normally reacted.
But we all react to difficult situations in different ways, so it's important to be kind to yourself. These are unprecedented times and the first for all of us.

Anger
You might feel anger about having to go into work during coronavirus. This may be because:
- you have to go into work when others do not
- you have to keep working in an environment where you may catch coronavirus
- you don't feel supported by your employer to do your job
- you don't have the right equipment to do your job
- there are a lot of major changes in your life, including at work

When most of us experience anger, it doesn't have a big effect on our lives. Anger only becomes a problem when it gets out of control and harms you or the people around you.

Learning healthy ways to deal with anger can help your mental and physical health. Mind have some useful tips on how you can cope with anger.

Taking care of your mental health and wellbeing

Taking care of your mental health and wellbeing is vital in helping you cope if you are going into work during coronavirus. Working long hours or under a lot of pressure can make this even more challenging to do.
Doing small things for yourself can make a big difference to your mental wellbeing. These are some ideas you can try:

Connect with people
Talk to someone you can trust and rely on. Just by telling someone how you feel can make a difference even though they can’t change the situation.
Make plans to video chat with people or groups you enjoy the company of. Keeping in touch with others as much as you can be helpful and help you take your mind off things.

Use available support
It’s okay to ask for help if you are struggling with your mental health. You could talk to a helpline or listening service about your mental health:
Call, text or email Mind's Infoline for information and signposting to support your mental health
If you want to talk to someone at any time about how you're feeling, you can call Samaritans on 116 123
If you prefer not to talk, Shout has a textline supporting key workers and their mental health during coronavirus. Text the word KEYWORKER to 85258

Be cautious with news and information
Make sure you are getting your news from trusted sources. If news stories make you feel anxious or confused, think about switching off or limiting what you look at for a while.
Social media could help you stay in touch with people but might also make you feel anxious. This may include people sharing news stories that you want to avoid, or posting their worries about coronavirus. Consider taking a break or limiting how you use social media.

Make time for yourself where possible
It may feel very difficult to make time for yourself while you are working, particularly if you are working more than usual or if you are under a lot of pressure. You may feel guilty about relaxing while your colleagues are working. But making time for yourself is important for your physical and mental health. Try to use the time when you're not working to take care of yourself, as this can help you keep going when you are at work.

Mind have put together some ideas you could try:

Find ways to relax - If you're finding it difficult to switch off from work, try some relaxation exercises which you can try at home or if you are taking a break at work.
Do something you enjoy - Having something else to focus on outside work can help you stay well. This could be something small, like reading a book, colouring, having a video chat with a friend, having a bath or listening to music.
Try mindfulness- Mindfulness is a way of paying attention to the present moment, using techniques like meditation, breathing exercises and yoga. It has been shown to help people become more aware of their thoughts and feelings. This means that instead of being overwhelmed by your feelings, it becomes easier to manage them.

See Mind’s pages on mindfulness for more information, including some mindfulness exercises that you could try.

Try to keep active
Try to build physical activity into your daily routine, if possible. There are options for most ages and abilities. This includes things you can do in your home, as well as activities to try outdoors.

Getting active at home
These are lots of different ideas you could try for getting active around the house, including:
- cleaning your home
- dancing to music
- going up and down stairs
- seated exercises
- online exercise workouts that you can follow
- sitting less – if you notice you've been sitting down for a long time, just getting up or changing position can help

Getting active outdoors
If you are getting active outdoors, the current Government guidance for most of us is to stay a safe distance (at least 2 metres) from any people you don’t live with.
If you are self-isolating, the guidance is that you should not leave your house, even for exercise. But you can exercise in your garden, if you have one.

Look after your physical health
It may feel difficult to take care of your physical health if you're feeling busy or stressed. But looking after your physical health can have a big effect on your mental health. There are many small changes you can try to take care of your overall wellbeing:

Think about your sleep - establish a routine around bed time, to help set a regular sleeping pattern. Give yourself some tech-free time before sleep, avoiding bright screens. Practice a relaxation exercise before you go to bed. Make sure where you sleep is as comfortable as possible.

Eat regularly and stay hydrated - think about your diet. Your appetite might have changed since the start of lockdown. This may be because your routine has changed, for example if you’re working more than usual. If possible, try to eat regular meals and keep a balanced diet, as this can help your mood and energy levels. See our tips on food and mood for more information.

Drink water regularly - drinking enough water is important for your mental and physical health. Changing your routine might affect when you drink or what fluids you drink.

If you need to self-isolate because you have symptoms of coronavirus, you can ask someone to drop off essential food items for you. If they do this, ask them to leave food at your doorstep, to avoid face-to-face contact with each other. You may find that supermarkets feel busier than usual at the moment. If you're feeling anxious about going to the supermarket, arrange an online delivery.

Think self-care, sleep, routine, rest. You may find yourself working longer hours or more shifts so take care of your physical health as best you can.

The coronavirus pandemic has changed the way we work, live, socialise, shop and travel on a scale we would never have thought.

Working in healthcare is demanding on any day, but with the pressure COVID-19 brings, it is more important now than ever to look after our mental health and well-being. Many healthcare workers have worked extremely long hours and under extreme high pressure. Many would have also been exposed to traumatic situations or faced with moral dilemmas as result of poor staffing levels, lack of proper equipment or confusion with new guidelines. The risk of long-term psychological issues arising from such situations is worrying for healthcare workers.

It’s natural for anyone working in the healthcare industry today to feel anxious and stressed, it is one of the most challenging industries and one that is faced with constant change and uncertainty.

Follow our five steps to help healthily cope with stress. 

1. Talk
Never has talking been more important. Everyone is going through change as a result of COVID-19. Talking helps to ease your worries and help you see things from a different point of view.
If you are feeling worried, scared or helpless at work, have a chat with your manager or a member of the senior team, it will help them see things from view and provide the support you require. If you don’t feel confident to be able to do that, there are people you can speak to via NHS recommended helplines.

Talking to close friends and family is also good as they can help to give you advice and sometimes it’s nice to talk to people outside of your work without the fear of being judged or worry about any implications your concerns may have.

It’s equally important to keep talking to your students and check-in with them of how they are feeling. Young minds are constantly developing and taking in new information, however many of them won’t have the emotional capacity to handle or healthily process this.

If you can encourage all the staff to adopt the same practices, it can help the well-being of the whole workplace.

2. Stay connected
You may find yourself locked away due to the ever-increasing number of restrictions and overtime find that you are out of touch with friends and family. Technology surrounds us, so there are lots of ways you can remain connected. WhatsApp, video calls via Zoom, Skype, Google Duo and Facetime to name just a few and various social media platforms can all help you from feeling isolated. And, if social media becomes too overwhelming then it’s okay to disconnect for a while. 

3. Stick to a routine
Whilst there is disruption around us, you must stick to a normal routine. Do the things you would usually do (as much as the restrictions allow). This includes keeping on top of basic things like shopping, cleaning, laundry, eating, sleeping and exercising. If you keep up with the little things, you’ll be able to handle new changes and extra tasks that come your way.

 4. Don’t be hard on yourself

Each day we are all facing new situations, no-one knows what the future holds, all we can do is our best. As a healthcare professional you are fully trained, qualified and experienced so never doubt yourself. You wouldn’t be hard on your patients when you are treating and supporting them, so why be hard on yourself?

If you find yourself having to take on more responsibilities, or work a different way. i.e. treating patients via online videos, try to keep what you are doing simple. Don’t over complicate your work or do things that are not necessary, keeping to the basics will help keep the pressure off yourself.

5. Take time out for yourself
Regularly taking some time out for your physical well-being is vital.
Find a few minutes in the day for a bit of peace or get some fresh air. Even if it means taking 10 minutes out to eat lunch without having any distractions around you. this will do wonders in easing your mind, refocus and help to keep you calm and in control.

When you’re not at work, it’s important to take your mind of ‘work’ by finding something to distract yourself with. There are lots of things you can do which don’t require a lot of investment, such as:
- Going for walks, bicycle rides or even a class at the gym. If going out is not an option; join a fitness class online
- Jigsaw puzzles – doing a bit at a time will give you the motivation to complete it
- Painting, making a collage, embroidery, pottery
- Playing an instrument – there are lots of tutorials on YouTube
- Cooking, learning a new dish or just experimenting with different foods. There are tonnes of social media groups, recipes and videos online showing you step by step guides

Whatever you do, remember the time is for you, no one else. It’s tempting to keeping looking at our phones, to stop temptation, switch off your phone and leave it another room.

We all need time to reflect, relax and recharge; after all, we’re only human.

Further guidance and support can be found by visiting the following websites.

The government’s guidance on mental health and well-being - https://www.gov.uk/government/publications/covid-19-guidance-for-the-public-on-mental-health-and-wellbeing?priority-taxon=774cee22-d896-44c1-a611-e3109cce8eae

Macmillan Cancer Support - Emotional Health and Well-Being for Health and Social Care Professionals - https://www.macmillan.org.uk/coronavirus/healthcare-professionals/mental-health-and-wellbeing-support

MIND is a leading mental health charity that provides support to anyone experiencing mental health problems - https://www.mind.org.uk/information-support/coronavirus/coping-as-a-key-worker/

NHS practitioner help supports the well-being of all NHS staff  - https://www.practitionerhealth.nhs.uk/covid-19-workforce-wellbeing

Royal College of Nursing has published COVID-19 guidance on mental health care delivery - https://www.rcn.org.uk/clinical-topics/mental-health/covid-19-guidance-on-mental-healthcare-delivery

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Almost 900,000 public sector workers who have been working on the front line fighting the coronavirus pandemic will be rewarded with an inflation-busting pay rise, but nurses and care workers will not be included.

Chancellor, Rishi Sunak announced the pay rise after months of political pressure to reward frontline key workers. Public sector workers including doctors, dentists, teachers, police officers and the armed forces will benefit from the rise. But no new rise has been announced for other NHS staff including nurses, care workers cleaners and porters who have all risked their lives and more than 300 NHS workers have lost their lives throughout this pandermic. 

With inflation currently just 0.6%, the biggest increase of 3.1% goes to teachers, followed by the doctors and dentists receiveing 2.8%.

Below is a breakdown of the pay rises in full. 

• School Teachers 3.1 per cent
• Doctors & Dentists 2.8 per cent
• Police Officers 2.5 per cent
• Armed Forces 2 per cent
• National Crime Agency 2.5 per cent
• Prison Officers 2.5 per cent
• Judiciary 2 per cent
• Senior Civil Servants 2 per cent
• Senior Military 2 per cent

Chancellor of the Exchequer Rishi Sunak said: "These past months have underlined what we always knew – that our public sector workers make a vital contribution to our country and that we can rely on them when we need them. It’s right therefore that we follow the recommendations of the independent pay bodies with this set of real-terms pay rises."

"Each award is recommended by independent pay review bodies, and this year government accepted the headline recommended rise for each workforce. This year’s pay awards reflect the enormous effort made by those in the public sector in responding to the unprecedented challenges for the country during the Covid-19 outbreak."

The pay awards for the armed forces, prison officers, senior civil servants and NHS staff work will be backdated to April this year, whereas the pay rise for police and teachers starts in September which run on a different pay year (September-August).

NHS nurses are not included in the announcement because they negotiated a three-year deal in 2018.They are already in the final year which expires in April 2021 and hasn't yet been renewed.
The Treasury pointed to the three-year Agenda for Change pay deal agreed in 2017, which it said saw starting pay for newly qualified nurses increase by 12 per cent, citing an average rise of 4.4 per cent for nurses outside of the most senior roles. The Royal College of Nurses has calculated that the average salary for a nurse has fallen by 8 per cent in real terms since the Tories were elected in 2010.

Unions said the pay rises which ministers have failed to commit to for months amid widespread public outcry are minimal in comparison to the real-term cuts seen over a decade of austerity.

They also highlighted that public sector, including social care workers – who have also risked their lives during the crisis – would receive no such increase. TUC general secretary Frances O'Grady said: "These rises are welcome, but there's still a long way to go to restore pay after a decade of real terms cuts," she said. “Many public sector workers, like job centre staff and local government workers, aren’t getting these rises. They deserve a decent pay settlement too." “And the government should urgently announce a pay rise for social care workers, who put their lives on the line to care for others during this pandemic.”

Social care workers are reliant on private firms which is why they not get a dedicated pay rise either. Policing minister Kit Malthouse said social care workers would have to rely on increases in the minimum wage to improve their pay levels.

As almost a million public sector workers were awarded pay rises, Mr Malthouse said: "The vast majority of social care workers are paid in the private sector so our ability to influence pay rates there is limited." He told BBC Radio 4's Today programme that - apart from "nationalising the entire thing" - the minimum wage rate was the best tool the Government had to recognise the efforts of care workers."
"What we have done is raise the level of the minimum wage very significantly over the last few years to get it up towards the £10.50 mark. That, we hope, will push through into these private sector jobs."

"Everybody looks at people who work in social care during coronavirus and thinks they have done a fantastic job in very, very difficult circumstances. But that's the mechanism by which we think we can increase pay in that sector."

Given that the whole nation were clapping for carers and front line NHS staff every Thursday evening for almost 10 weeks to show their appreciation this is very disheartening to those who risked their lives and continue to do so. 

The Treasury said the money for the pay increases of up to 3.1% would come from existing departmental budgets, meaning cash-strapped government departments must work out how to pay for them.

Labour shadow chancellor Anneliese Dodds said the Conservatives had frozen public sector pay for seven years, and the rises they introduced after that failed to plug the gap. She said the pay rise was "good news" but added that it "won't make up for a decade of real-term pay cuts" for many front-line workers. 

The British Medical Association said doctors had hoped for "far better". Dr David Wrigley, vice-chairman of the British Medical Association, said doctors would feel "disappointed and let down" as pay "has fallen way behind" over a decade. He told BBC Breakfast: "These are the sort of rises we'd expect to see in normal times, not in a time when many of us have not had a day off in six months and have been putting our lives on the line."

Health Secretary Matt Hancock said: "These past few months have been an incredibly challenging time for our NHS, and the resolve, professionalism and dedication of staff has been on show throughout. We are able to accept the recommendations of the independent pay review body for dentists and doctors."

"I am committed to supporting the entire NHS and social care workforce through improved recruitment and retention and delivering 50,000 more nurses and 6,000 more doctors in general practice."

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For those who have recovered from Covid-19, the road to recovery is long and tedious. Once the brilliance of ICUs disappears from the public eye, it will be the turn of rehabilitation services. 

Physiotherapists are not only part of multidisciplinary teams that save lives. They are also part of the multidisciplinary teams that give people their lives back and ensure they are as independent and meaningful as possible.

Covid-19 is testing processes and every skill of those working in the medical and healthcare field. It affects each patient very differently. People with milder cases have tiredness, loss of appetite and decreased stamina, while others are so impacted they cannot sit on the edge of the bed without the physical support of four physiotherapists. Something like this can take up to 12 months for patients to recover from. 

Spending time in bed, not moving, can also result in a significant decline in muscle mass and strength and this has been linked to falls, functional decline, increased frailty and immobility, all of which increases the risk of pressure ulcers and subsequent infection. This needs to be addressed and online physiotherapy can play a key role here as face to face appointments are not currently possible during the lockdown.

Online physio services also address the issues of travel distance and lack of care resources which can be a frequent barrier to accessing care. For many patients, it is also convenient, particularly if fatigue is an issue which is a key feature of Covid-19 along with breathlessness. With this in mind tolerance to exercise will need to be in short bursts, paced to individual needs and take place several times a day. Resilience building this will need to be at their own pace and will benefit from support to progress to self-management.

This could involve a variety of bed-based exercises to increase joint mobility and strength, to chair exercises, to standing which will include balance work and repetitive more advanced exercises. If breathlessness is an issue then some breathing exercises will need to be given. Pacing is essential and patients must be encouraged to listen to their body

The key to recoverment is movement and patients will need to be encouraged to engage in a rehab programme and gently increase activity levels and set goals. 

The NHS is launching Your Covid Recovery for people suffering with the long-term physical and mental impacts of the virus. In the coming months tens of thousands of the most seriously affected coronavirus survivors will be offered online recovery services. Everyone will be able to access advice about recovering from the virus via the portal from later in July, and a second phase of personalised services for those who need specialist rehabilitation will be launching later this summer. 

Patients will be able to speak with nurses and physiotherapists over the phone, join a survivors’ community, follow exercise tutorials to help regain muscle strength and lung function, and access mental health support through the portal. 

This comes after the first centre to provide rehabilitation services for Covid-19 survivors, as well as non-coronavirus patients, the NHS Seacole Centre in Leatherhead, Surrey, began treating patients in late May.

Announcing the launch of the rehabilitation service on the NHS’s 72nd anniversary, the institution’s chief executive Sir Simon Stevens said Covid-19 has been “the biggest challenge in the NHS’s history”. He said: “As we celebrate the birthday of the NHS and look ahead to the next phase of our response, while in-person care will continue to be vital, the health service is embracing the best that new technology can offer us to meet the significant level of new and ongoing need."

“Rolling out Your Covid Recovery, alongside expanding and strengthening community health and care services, is another example of how the NHS must bring the old and the new together to create better and more convenient services for patients.”

Health Secretary Matt Hancock said the Government has invested millions of pounds into coronavirus research and will support the NHS to deliver long-term rehabilitation. He said: “We are learning about this disease all the time, and increasingly know that for some people, Covid-19 has debilitating lasting effects.”

He added: “The new research will help us understand how to prevent and treat the long term complications suffered by some." “I suffered from coronavirus first-hand so I know the impact it can have. I’m determined to ensure we have the best possible treatment for coronavirus, both to save lives, and to help anyone suffering from the aftershocks.”

As the UK begins to emerge from lockdown, buiness leaders have backed one last 'huge' applause to thank key workers on the 72nd anniversary of the NHS. 

People are being asked to come out and clap at 5pm on Sunday 5th July on the 72nd anniversary of the NHS to say thank-you to all the NHS staff who have worked during the coronavirus crisis.

Weekly claps became the norm in the first few months of lockdown with streets of neighbours heading out to their doorsteps, back gardens and windows to give thanks for the effort of healthcare workers during the Covid-19 crisis. The last clap took place on 28th May, after the woman who came up with the idea claimed the show of gratitude had "had its moment" and risked being politicised.

But this Sunday, it will come back as a one-off, with NHS bosses hoping to make it an annual event for the anniversary. Public buildings will be lit up in blue, including the Royal Albert Hall, Blackpool Tower, the Shard and the Wembley Arch, the health service said. As a mark of respect broadcasters will also suspend transmissions for a moment.

People are also being encouraged to put a light in their windows the night before to remember all those who have died from COVID-19, the same day pubs, hairdressers and restaurants will be allowed to open for the first time.

 The Clap for Carers initiative started on 25th March by Dutch-born Londoner Annemarie Plas. The weekly tradition was often accompanied by the banging of pots and pans. It was Ms Plas herself who called for the tradition to end after its 10th week and she expressed her hope that it could instead become an annual event.

 NHS chief executive Sir Simon Stevens says he hopes the public will use the anniversary as an opportunity to "say a heartfelt thank-you" to hospital staff.

Sir Simon said: "This year has been the most challenging in NHS history, with staff displaying extraordinary dedication, skill and compassion to care for the 100,000 patients with COVID-19 who needed specialist hospital treatment and many others besides."

"During this testing time our nurses, doctors, physios, pharmacists and countless more colleagues were sustained by the support of the public, not least through the weekly applause for key workers."

"No health service, not even the NHS, could have coped alone with this coronavirus pandemic. From bus drivers and teachers to care staff and food retailers and, of course, the public who took action to stay at home to stop infection spreading, everyone played their part."

A coronavirus vaccine is not yet available, however when it is frontline key workers in the health and social care sectors and those with heart and kidney disease, and the over 50s will be given priority, the health secretary has announced. He said he will priorotise those people for vaccinations who are at higher risk of getting COVID-19.

Human trials began on a second potential vaccine being developed at Imperial College London this week, while production has already started on another possible inoculation at Oxford with the aim of building up stockpiles to be ready for deployment if it is approved for use in the autumn. He said "AstraZeneca has struck a deal for the manufacture of the Oxford vaccine. They’re starting manufacturing now, even ahead of approval, so we can build up a stockpile and be ready should it be clinically approved.”

Speaking at the daily Downing Street coronavirus briefing, Matt Hancock said his approach to vaccines was ”to throw everything at it as fast as we can” in order to have inoculations ready to use as soon as they are deemed safe. 

Millions will have to wait their turn as demand for protection from Covid-19 is high. The Joint Committee on Vaccination and Immunisation (JCVI) issued interim advice that jabs should go first to frontline health and social care workers and those at increased risk of serious disease and death because of age and underlying health factors. Mr Hancock said that work was under way to see whether black, Asian and minority ethnic people should be added to the list because of research showing that they make up a disproportionate share of cases and deaths. 

The health secretary said: "As we learn more about the virus we will continue to take into account which groups may be particularly vulnerable, including, for example, those from ethnic minority backgrounds so that we can protect the most at risk first, should a vaccine become available, and get this country back on our feet as soon as we possibly can." “In the long run, the best way to defeat this virus is of course the discovery of a vaccine. And since the start we’ve been supporting the most promising projects."

In deciding who comes first in the queue for the vaccine, Matt Hancock said ministers will be “guided by the clinical science, prioritising those in most need”.  

The Recruitment & Employment Confederation (REC) has called for the government to ensure that temporary and locum staff working in the NHS and the care sector are provided with equal access to PPE and COVID-19 testing kits. Half (48%) of specialist recruiters have flagged this as a major concern in the fight against Coronavirus. 

These agency health and social care staff are vital in the fight against Coronavirus, and they must be able to carry out their duties as safely as their colleagues who are permanent staff. This call comes as part of a four-point plan from the REC to help bridge staffing shortages and ensure that we harness the expertise of specialist health and social care recruiters during this pandemic. The manifesto, ‘Backing the NHS and care sector at a time of crisis’, also sets out how government can work with the recruitment sector to:

• build agile and sustainable recruitment supply chains; compliance checks and hiring processes must remain effective but must be sped up to meet demand for staff;
• set the right standards for recruitment by developing a formal partnership agreement with the Department for Health & Social Care; and
• take a lead on longer-term workforce planning by launching a review of future NHS and care sector workforce strategy and reviewing immigration policy.

Tom Hadley, Director of Policy and Campaigns at the REC, said: “We want to work with the NHS and care sector to ensure that all workers, including temporary and locum staff who are providing crucial frontline support, are kept safe at work. Looking at the longer-term, 70% of healthcare recruiters would welcome a post-crisis review of how flexible staffing can best be harnessed. The NHS already had 100,000 unfilled vacancies prior to the pandemic – we want to build a genuine partnership approach with government to pre-empt and address both immediate and future workforce challenges.

“The recruitment industry places more than a million people into temporary, contract and locum placements every day. We want to work with the government to harness the contribution of recruitment experts during this time of national emergency, and this manifesto sets out four priority areas that will help to make this happen.”

This guidance covers the donning (putting on) and doffing (taking off) of personal protective equipment (PPE) in health and social care settings.

For the latest information please visit https://www.gov.uk/government/publications/covid-19-personal-protective-equipment-use-for-non-aerosol-generating-procedures

Further guidance on PPE and hand hygiene can found by following the video links below.

• Safe donning and doffing of PPE: https://youtu.be/3vdLKlNXoCs
• How to safely wear a face mask: https://youtu.be/M4olt47pr_o
• Hand washing guidance: https://www.youtube.com/watch?v=fXWA7TTop_w 

Being concerned about the news is understandable, but for many people this is taking its toll on people's mental health, particularly those already living with conditions like anxiety and OCD. 

People across the UK are now staying at home for long periods without the contact with friends, family and colleagues which would normally be part of everyday life. Some people may find the change easy to adapt to, but for others this will be a very difficult adjustment to make. It can make existing mental health problems worse.

Many are beginning to realise that this unique moment requires a focus on mental health as well as physical. 

So how can we ensure our mental health is protected during the Covid-19 lockdown? Here are some tips for minding your mental health during the lockdown .

1. Get dressed and set up a routine

Creating a routine will help bring a sense of purpose to your days. With nowhere to go or nobody to see, it may seem pointless to get dressed and showered, but you’ll feel untidy and dirty by the end of the day. So, by just starting with simply getting dressed will help make you feel fresh and more like yourself. Without doubt, this is the quickest, easiest thing you can do that reaps the most benefits.
Think of a few things you could do that would make you feel accomplished – like studying for an hour, cooking, gardening or doing a workout video – and a few things you want to do – like gaming, binging Netflix. Perhaps do work around the house that you haven’t got around to all these years due to a lack of time. Lists are super useful here and will help you to look back and see what you have achieved with your day.

2. Stay connected

Advances in mobile technology in particular mean that we can stay connected through calls, text, WhatsApp, email, social media etc. Use this time to get in contact with people.
Try to connect with people who you haven't heard from in a while or people in your community who are likely to be isolated right now. The additional time at home can bring tension but it can also be an ideal opportunity to reconnect and strengthen relationships within the family.
Remember you can always mute WhatsApp groups and Facebook groups if you’re finding them too overwhelming. You can also mute keywords and unfollow accounts on most social media platforms., which will help limit unwanted content on newsfeeds.

3. Maintain a healthy lifestyle

The negative impact of sleep disruption on mood is well-established. Without the structure of having to get to school, college or the workplace, it can be easy to fall into unhealthy sleep habits like going to bed later and getting up later. Changes to your sleep cycle now could go on to impact your mood in the weeks and months ahead.
Scheduling a balanced range of activities in your day including:
• Getting adequate and healthy sleep
• Daily routine of working and resting
• Eating nutritious food
• Exercising at home, there are lots of video on YouTube you can try out
• Practice meditation or try to relax when you can
• Do not be afraid to discuss your anxieties and fears with someone. It helps to ventilate and talk things out.

4. Working from home

If you find yourself working from home for the first time, it means figuring out how to stay on task in a new environment that may not lend itself to productivity. But there are ways to deliver results and avoid going stir-crazy, from setting up a good workspace to the way you talk to your team.

• Have a clear workspace is crucial for your state of mind, and not just in terms of being in a "working" mindset but also so you're able to turn off when the working day is over.
• Washing and dressing appropriately is very important when working from home. It will not only improve your state of mind, it will psychologically prepare you to start work. Likewise, changing out of work clothes when you clock off for the day helps your brain to understand that the working day is over.
• Remember to eat. With no access to a canteen or shops you most likely will have to make lunch. Try to plan ahead what you will make so that it is built into your schedule and it’s a healthy and nutritious meal.
• Taking breaks regularly is very important to avoid being burnt out. Overworking will only result in less productivity and frustration. Being cooped up inside can lead to fatigue, therefore even walking around the garden or even watering plants around the house will help keep your mind active and focused.
• Establishing boundaries is very important, especially if you're employed by a company, you'll probably have set hours of work, and it's important to stick to these when you're working from home. Be ready to start your day at the same time as you would normally arrive in your office or workplace, and finish your day at the same time. Setting a “to do list” will help you stay on track, organised and create order. Sharing this with your employer is also helpful so they are aware of your work.

5. Maintain hygiene

Whilst it is important to maintain hygiene, do not be preoccupied with it all the time. Be mindful of washing hands, and not touching metal surfaces, do not cough or sneeze without tissue paper.

6. Limit social media usage

Whilst it’s important to stay digitally active, it is also important to carefully choose your news and media sources, particularly if some of the information you are receiving is leaving you feeling overwhelmed. Remember that some of the information online is driven by the views, opinions and agendas of individuals, and it may not be helpful for you to take those on as your own right now.
Choosing one or two well-informed sources and limiting yourself to set times during the day to check for ups for example at 9am and 5pm.
Try and share the positive stories you see: of people who have recovered or even a post on social media that made you laugh.

7. Understand the risk

Stay up to date on COVID-19 but only trust the information that comes from authentic sources.
From the government: https://www.gov.uk/coronavirus
From the NHS: https://www.nhs.uk/conditions/coronavirus-covid-19/
Try not to be glued to the news 24/7
Do not believe every message or tweet circulated in social media

8. Be prepared

Make a list of helpful contact numbers and emails – such as for healthcare and keep enough supply of non-prescription medicines to last at least a month. Talk to family and friends nearby about how you can support each other, in case one household is quarantined. For example, dropping supplies outside the front gate. Use self-help tools. There is a list of clinically approved apps that have been put together by ORCHA – who’ve been set up to help regulate the safety and value of these apps and make sure people find the right app for the right reason. They have recommended Wysa to cope with stress or anxiety issues. Wysa has released free tool packs for everyone to cope with the stress of isolation and current health anxiety. They want to ensure that everyone has mental health resources during this crisis.

At this time, it is important that everyone gets the help they need – and this includes looking after yourself.

Please continue to follow NHS guidance, stay at home, protect the NHS, and save lives.