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/.

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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