Workforce burnout and resilience in the NHS and social care – Health and Social Care Committee Oral Evidence

The Health and Social Care Committee, chaired by Jeremy Hunt MP, has launched a new inquiry to examine workforce ‘burnout’ across the NHS and social care. The focus of the committee is on workforce planning, including the effectiveness of the NHS People Plan. The level of training needed to meet the demands of the Health and Social Care Sector is also being examined.

With the media’s focus throughout the pandemic being fixed upon the rising number of COVID-19 cases and the mortality rate,  it is easy to forget the impact being felt by frontline workers. The Committee has now heard from a number of key witnesses whose evidence has shone a light on the struggles being faced.

A consistent theme of the evidence is the increased pressures generated by COVID-19 and the resilience of services to cope with high levels of stress. The situation health and care workers find themselves in is of course entirely novel and one for which they were ill prepared.

NHS staff have throughout the crisis been re-deployed and re-trained. Hours and shifts have been increased to cope with the extra demand and also to address the increasing level of sickness amongst staff. These stressors have then been compounded by the level of severe illness and death healthcare workers are witnessing, including amongst their own colleagues. Unsurprisingly, many are facing anxiety over their own ability to cope at work. Unfortunately, the feedback to the committee indicates that mental health support on the frontline is inadequate.

Macmillan Cancer Lead Nurse, Denise Crouch, described the exhaustion amongst staff as their own ‘COVID fatigue’. Of course, health and care workers have long since been working extensive hours, but the intensity they have felt during the pandemic is incomparable to what they experienced previously.

NHS staff shortage

Dr Chaand Nagpaul, Chair of the Council of the British Medical Association (BMA) gave stark evidence. Prior to the pandemic, there was already an NHS shortage of 10,000 doctors and 35,000 nurses. The BMA’s October survey showed that 60% of consultants plan on reducing their hours or retiring early once the pandemic is over as a result of burnout, amongst other factors. The implications for future care are clear.

The capacity issue is clearly having a demoralising effect on staff who feel, according to the BMA, that they simply cannot do their best to look after patients.

Vic Rayner, Executive Director of National Care Forum was particularly concerned about the social care arena. She reported that some 79% of care workers have reported feeling close to burnout. The huge pressures they are facing have only it seems, been intensified by unhelpful media coverage regarding care homes.

The effect

The threat of losing both health and social care workers from their jobs through burnout creates significant concern for patient safety. Re-deploying staff to take on roles they were not trained for risks further safety issues and anxiety and stress for staff members.

It is unsurprising, therefore, that most prominent feature of the evidence was how important it is for health and care workers to know that there will be enough staff recruited for the future. More fully trained workers means more capacity for providers to treat and adequately manage the care of their service users.

The solutions proposed were clear. Health and social care services have called for a long-term plan by the Government to tackle the workforce crisis present prior to COVID-19 and the fallout. Such a plan must address both the workload intensity and the immediate need for recruitment as well as the provision for healthcare workers of adequate space, time and resources to focus on their wellbeing.

An investment to prevent a complete burnout of the workforce means an investment in patient safety and the standard of care that can be provided. It is hoped that the issues considered in the committee will pave the way for an effective plan for the future to ensure the safety of both patients and their carers.

In light of the above, both BLM and its clients might expect to see an influx of stress claims brought by healthcare staff resulting from their experiences coping with the COVID-19 crisis. Equally, we should also prepare for potential claims by those such staff were caring for in relation to injuries stemming from a lack of appropriate staffing levels and allegedly poor care being delivered by exhausted staff.

Although both the public and private sector may be affected by this, those working in the private sector should bear in mind that they would not benefit from the same indemnity provided to the NHS by section 11 of the Coronavirus Act 2020.  It is complexities such as this that care providers and their insurers should prepare for.

Katrina Poole, Trainee Solicitor, BLM

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