Staffing is the issue keeping NHS leaders awake at night — and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, will make sure you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. Contact me in confidence. 

My interest was piqued last week following news that nearly 40 members of the same department in the Royal Lancaster Infirmary were sent home to self-isolate after contracting covid-19.

As a result, University Hospitals of Morecambe Bay Foundation Trust transferred the Royal Infirmary’s paediatric inpatient ward temporarily to Furness General Hospital.

Medical director Dr Shahedal Bari said in response that the hospital was encouraging all its staff to be “extra vigilant” with infection control practices.

This case is not unprecedented. Earlier this month HSJ was made aware of a 12-strong orthopaedic team who all had to self-isolate after a face-to-face meeting, and there are without doubt other examples of this around the country that have not hit the local papers.

At the end of May, my colleague Rebecca Thomas reported on warnings from national director for acute care Keith Willett that the risk to staff of covid-19 infections within hospitals and between staff is very high. And this recent situation in Lancashire further emphasises how big a challenge this will continue to be for trusts and other healthcare organisations.

Social distancing measures may have been relaxed by the government from 4 July but this will still massively affect the ability of the health service to restart elective activity and begin dealing with growing waiting lists.

In terms of space, some organisations will be at a disadvantage. Talking to a doctor working at a central London hospital with an ageing estate, they told me portacabins are being put up in the grounds to create more office space.

“The ageing hospital infrastructure, the need for hot desking, cramped offices and other social spaces make social distancing in an acute hospital all but impossible,” I was told.

And research from a doctors’ union, The Hospital Consultants and Specialists Association, has shown that nearly a third of medical staff feel colleagues and managers have only practised social distancing rarely or not at all in hospital communal areas (according to a survey of 427 union members).

“The need to tackle the growing backlog of procedures must not become an excuse for complacency around infection control. If it does, we risk nosocomial infections rising again and lives being lost needlessly," HCSA president Dr Claudia Paoloni said.

“We can label different areas covid and non-covid, but we must be clear that there is no such thing as a covid-free zone. We can lessen the chance of transmission through PPE, regular testing of staff and patients, and continuous cleaning, but we cannot eliminate it.”

Track and trace teething problems

Of course, the success of the track and trace system and ensuring all staff are provided with adequate PPE are both essential in improving infection control and keeping them safe and reducing the need for multiple members of the same team to isolate.

I was this week made aware of a GP surgery in South East England where one of the GPs has to isolate for two weeks, but with no information about who the contact was. The surgery believe the contact was a patient, which shouldn’t result in the GP having to isolate as proper PPE was worn. The system has clearly not taken this into account.

NHS Providers chief executive Chris Hopson said hearing that significant numbers of frontline teams having to self-isolate “highlights the importance of local risk assessments, so that staff protected by PPE at the time of the contact can be excluded from isolation where appropriate”.

“It also re-emphasises the utmost importance of ensuring all trusts receive sufficient and timely supply of PPE, of support for trusts to implement strict infection and prevention control measures and to have access to regular testing,” Mr Hopson said. “These measures will be equally important in all health and care settings.”

Mr Hopson added that NHS Providers is “continuing to push” for recognition that the 14-day isolation period will have an impact on frontline services.

And considering how NHS and care staff desperately need a break, and with added childcare pressure on many this summer, two weeks enforced isolation will only add further strain on an already stretched workforce.

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