The Ward Round: No vaccine for burnout

For most NHS workers the last 11 months have been the most stressful of their careers. A horrible mixture of last-minute redeployment, understaffing, exhaustion, and facing a brand-new disease with initially few treatment options. They reached their limit months ago.

With barely any time to briefly recover, the second wave hit, seeing acute, general and intensive care beds fill up.

Well-being initiatives ebbed and flowed – with some trusts scrapping things (like free car parking and hot meals at night) only to bring them back again as the second peak emerged.

And the government’s hard line on staff pay will not have helped to boost fading morale.

Although covid hospital admissions have started to fall and 10 million people are now vaccinated, staff are still under immense pressure in all care settings. Any pressure from the centre to start recovering suspended services would be premature.

The public will of course be hopeful that normal service will resume from the spring, and fairly so, but this is not only dependent on hospital capacity, but also staff recovery. It is perhaps easier to focus on available beds rather than the number of people able to staff them.

Commenting about staff well-being on Twitter, following a piece from NHS Providers’ Chris Hopson in the Guardian, chief executive of Birmingham Women’s and Children’s Hospital FT Sarah-Jane Marsh stressed: “There can be no service recovery without people recovery.”

“In children’s services, people recovery means actually treating children again,” she added, highlighting how the impact of covid has spread far beyond acute and intensive care.

With trusts making very positive sounds about their staff vaccination campaigns, they are right to be hopeful sickness rates will improve. But there is currently no vaccine for burn out.

Due to a change in rules, key workers are able to carry over four weeks’ leave into the next two years, and employers should ensure staff do this. Without giving staff a proper break the NHS risks losing its greatest asset.

Money for training

As we all know the pandemic will have a lasting impact on the health service. An area where its impact could be mitigated is education and training.

Concerns have been raised by medical training programme directors that without additional funding from Health Education England they might be unable to recruit enough middle grades and registrars into posts next year.

I’ve been told it was “made clear” that funding would not be available for training extensions in the first wave and the situation remains unclear for the second. Training directors have been asked by HEE to survey their trainees, to work out how many might need to extend their training to hit the right competencies.

After taking the concerns to HEE, Wendy Reid, director of education and quality and medical director, said it is the organisation’s job now to work with medical royal colleges, the GMC, NHSE/I, hospitals and trainees themselves to “get their education and training back on track”.

“We are planning a package of measures, to be agreed over the next few weeks, around maintaining immediate recruitment progress, maximising new recruitment, new education and training flexibilities and tailored support to trainees,” Professor Reid said.

This could be cause for trainees and their employers to feel cautiously optimistic but a firmer commitment on funding is yet to be given and I’m told depends on the scale of the issue, which is not yet clear. This will not help with the anxiety many medical trainees are feeling, unsure about how their future career and progression will be affected. 

And a final point – will September’s agreement between the NHS and the private sector to provide training opportunities continue? And how has this unprecedented agreement worked out so far?

I’ve heard a mixed picture of how smoothly this agreement has gone – if any readers can shed any further light I’d be keen to hear from you.