The United Kingdom’s National Health Service (NHS) is in the midst of arguably the most challenging chapter of its history. The health service, alongside international counterparts, is grappling with the effects of the coronavirus pandemic on the public’s health. Over 26,000 people have now lost their lives to the virus in the UK, including more than 100 NHS staff. Whilst the focus has been on the provision of personal protective equipment (PPE) and swiftly expanding bed capacity in the NHS to meet potential future needs, the mental health and emotional well-being of clinicians has been somewhat of an afterthought. I would argue that the vulnerabilities of NHS staff go beyond the physical health threat from the virus.
According to the most-recent NHS staff survey published last year, 40% of respondents said that they felt stressed at work. Although the survey didn’t go further into exploring other mental health issues, the Health Service Journal reported that an estimated 348,028 working days had been lost due to stress, anxiety and depression. The working environment in the NHS today looks very different to how it did before the coronavirus outbreak was declared a pandemic. There has been a sharp increase in demand on the health service, healthcare professionals are having to work in PPE for long-periods of time, and the number of patients dying is also on the increase. These factors all contribute to poor mental health amongst clinicians.
After a decade of government-led austerity, the focus of healthcare funding has been to play catch-up on the provision of resources; in the form of PPE, ventilators and critical care bed capacity. Though these are all vital tools to weather this storm, I fear that not enough was done to prepare NHS staff for the emotional toll this crisis would have on them. I think it was an important step for the NHS to introduce mental health support at the beginning of April, yet these interventions might already be too late for a system of professionals who are already seeing high rates of poor mental health and workplace stress. The coronavirus pandemic will only widen the cracks in the mental health of NHS staff.
The notion of “NHS Heroes” is a double-sided coin when it comes to the mental health of clinical staff. On the one hand, the fact that the public admiration of the NHS and those that work in the organisation has only grown since the onset of the pandemic is extremely positive for morale. However, this notion of heroism also puts clinicians on a pedestal. I would argue that the framing of doctors and nurses as such only adds to the pressure to carry on working, despite feeling physically and emotionally fatigued. As a consequence, clinical staff might feel unable to ask for support from their colleagues or their support network outside of work. This puts undue pressure on them to sometimes continue working at the detriment of their mental health. I think it’s important that this concept of NHS staff being heroic doesn’t deter their ability to look after their own mental health and emotional wellbeing.
Social distancing measures are also taking their toll. Things like visiting family and friends, looking forward to holidays, or just going out for a meal at their favourite restaurant now feel like distant memories. Working in the NHS has never been easy, especially in recent years with an ageing population with increasingly complex health needs. However, the coronavirus pandemic has not only added to the challenges of working in the health sector, it has also closed off many avenues of support and emotional release. Not having plans to look forward to whilst doing a job which is both physically and emotionally challenging will doubtless have an long-term impacts on rates of burnout, staff turnover and vacancy rates.
I don’t think there are any easy ways to overcome the hurdles that healthcare professionals are facing in the NHS and in health systems across the world. Setting up specific mental health support services for NHS staff is a start but this is hardly a new concept. Activities in the workplace that promote positive mental health could also be an opportunity for frontline staff to take some time away from their stressful working environments. Equally, empowering staff to look after their emotional well-being away from the workplace by educating them about techniques like mindfulness or meditation could help combat the effects of social distancing. But I think ultimately, there needs to be a broader conversation about mental health among healthcare professionals during this pandemic, which needs to be instigated by leaders of government and NHS employers.
The focus of the UK government during the coronavirus pandemic has been on the provision of physical resources, such as PPE and ventilators. These are relatively easy to both implement and to explain to the public, because there is a numerical value attached to these interventions. The promotion and improvement of emotional well-being of NHS staff, however, is a little more abstract and not as straightforward. That being said, this shouldn’t make the mental health of NHS staff any less important than their physical well-being. Yes, this virus has tragically killed many frontline staff but the mental health cost of this pandemic is yet to be known. What is clear, though, is that if the discourse surrounding working conditions and well-being isn’t opened up to include the mental health impacts of the coronavirus pandemic, the NHS workforce will suffer in the long-run.
- Hadley Stewart is a London-based writer, broadcaster and medical journalist.
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