Safety recommendation
It is recommended that NHS England and NHS Improvement investigates and evaluates the risks associated with the potential impact of staff fatigue and emotional distress on nosocomial transmission of COVID-19.
Response:
NHS England and Improvement recently published a suite of products to support excellence in infection prevention and control measures. These are available at https://www.england.nhs.uk/coronavirus/publication/every-action-counts/.
This work was based on extensive engagement with frontline staff, with over 6,000 responses received to a survey and virtual roundtable discussions and webinars.
The issues of fatigue and stress were raised in this feedback and the final products propose actions to tackle this issue. The key factors in this were creating a culture of kindness and support, which would set the mood to enable a speak up culture.
This change in culture will be supported by IPC leadership training, situational reminders and creating IPC champions to reinforce the messages around protecting yourself and others.
Embedding this work in the NHS will also focus on changing behaviours in non-clinical areas, where staff have been found to be at greater risk of contracting COVID-19 as they step away from the intensity of delivering patient care. We will be evaluating impact measures of the ‘Every Action Counts’ campaign to inform any further changes or support required by frontline staff.
The issue of workforce stress due to working through the pandemic has been highlighted by work led by Kevin Fong on the experience of intensive care staff.
Professor Fong’s work found a substantial burden of mental health symptoms being reported by ICU staff towards the end of the first wave of the pandemic in July and July 2020. The severity of symptoms identified were considered likely to impair some ICU staff’s ability to provide high quality care as well as negatively impacting on their quality of life.
In recognition of the need for targeted support to ICU/critical care staff, the NHS has put in place a range of health and wellbeing resources for this staff group, including sessions for critical care leaders on support resources available and training at least one nurse per critical care team in restorative clinical supervision by April to enable wider support.
This work complements NHSE/I’s wider wellbeing support offer for all staff, which features a confidential staff support helpline, offering staff access to trained advisers by phone or text, f+Q22urther bereavement and counselling services and a range of wellness resources and professional line manager support.
Further to this, NHSE/I has been piloting an enhanced health and wellbeing offer across 14 systems, with systems focusing their enhanced service on priority areas/sectors/groups where they had identified the greatest need locally.
In addition to the health and wellbeing offer, NHSE/I has also put in place integrated staff mental health support through 40 system-wide mental health and wellbeing hubs which provide proactive outreach and assessment services, ensuring staff receive rapid access to evidence based mental health services and psychosocial support, including a national enhanced mental health service for staff with complex needs.
Response received on 24 March 2021.