COVID-19 and the workforce – what we’ve learned

During the COVID-19 pandemic, the RCP has conducted four surveys of our UK members and fellows. The first three surveys took place on 1–2 April, 22–23 April and 13–14 May, with the fourth, and final survey for now, on 3–4 June.

The fourth survey asked our members to share their continuing experiences of testing, personal protective equipment, time off work, rotas, working patterns and risk assessments, along with a series of questions about the restart of the NHS.

Commenting on the results of the survey, the RCP president Professor Andrew Goddard said:

“I am spectacularly proud of the ways in which doctors have so quickly adapted their working lives to cope with the COVID-19 pandemic. It is illuminating to see, however, that so many of them do not want to return to how they were working before.

“We need to listen to doctors’ concerns and continue to adapt the way we are working, not only secure and retain our NHS workforce, but also to prepare for the possibility of a second peak of the virus later this year.”

The results

Headlines

• Only 45% of respondents say they want their working pattern to be what it was before the pandemic.
• Just 10% feel they are prepared for services to return to normal and almost a third of members (31%) said they thought it would take between a year and 18 months for the NHS to get back on an ‘even keel’ where services had stabilised to a new normal.
• Issues with access to PPE and testing have improved but 17% of doctors still report being unable to access the PPE they need for managing patients with COVID-19 and almost a third report not having been fit tested (32%) or feeling confident fit checking their own PPE (33%). 
• Despite advice that all healthcare workers be risk assessed for COVID-19, only 24% have had a formal risk assessment. Only 26% have been able to access antibody testing, and of those, 30% report the results as positive. Last week the RCP called for all those at highest risk to be risk assessed within a fortnight.

Resumption of services

When asked how long they believed it would take for the NHS to get back on an ‘even keel’ (backlog managed and services stabilised to a new normal) respondents’ views varied from less than 6 months to up to 2 years:

• A year to 18 months – 31%
• 6 months to a year – 28%
• 18 months to 2 years – 23%
• Longer than 18 months to 2 years – 17%
• Less than 6 months – 2%

We also asked respondents to tell us how prepared they feel for services to resume on a scale of 1–5. With 5 being ‘Ready to resume’ and 1 being ‘Not ready at all’. The results show that we have a long way to go yet before the majority of respondents are fully prepared to resume services. 

Working patterns and practices

22% of respondents said they were working in a clinical area that is different from their normal practice. Of those, 40.5% reported working on a COVID-19 ward. It is important that employers begin to consider how to return staff to their normal areas of practice to support the restart of wider NHS activity.

During the pandemic, 59% of respondents reported working on an emergency rota. We also asked respondents to tell us the status of these rotas: 27% said that the rotas had been discontinued, 44% that de-escalation had started, 14% that de-escalation plans had been made but not started and 15% that no plans had yet been made.

Clinicians have worked incredibly flexibly during COVID-19. Throughout the pandemic, 49% reported that their job plan had been altered informally, with 11% reporting that their job plan had been formally altered, 43% saying that they are now working more flexibly and 30% reporting working more programmed activities (PAs), with 20% saying that they are working some PAs from home.

45% of clinicians said they wanted to return to their previous working patterns, with 26% saying that they want to work the same number of PAs but more flexibly. 14% also responded that they wish to work fewer PAs in the future.

Time off work

People taking time off work has continued to fall with 5% reporting currently taking time off work. Of those, 9% report having confirmed COVID-19 with a further 7% suspecting that they have COVID-19.

As the COVID-19 pressures slowly reduce we also asked people whether they had had time off or had arranged to have time off to recuperate. 28% reported having had time off, 19% hadn’t had time off or arranged it but were planning on doing so, with 19% yet to take time off but who had arranged to.

Testing

Access to PCR testing has continued to improve with 97% of respondents now reporting that they are able to access testing for themselves, 86% for members of their households and 97% for their patients. 9% reported having been tested in the past 2 weeks, with 15% getting their result back within 24 hours, 47% between 24–48 hours, 12% between 48–72 hours and 13% in 72 hours+.

In this survey, for the first time we also asked respondents whether they have been able to access antibody testing for themselves. 26% reported having been able to access a test. We asked those respondents who had been tested to tell us the results of these tests. This was an optional question but of those who felt comfortable sharing the results, 31% had tested positive for COVID-19 antibodies and 69% negative.

Concern for health and risk assessments

To date, only 24% of respondents report having had a formal assessment of their risk undertaken, an increase of 6% compared with the 18% who reported this in the last survey. Progress on formal risk assessments remains slower than we would wish. In response to the PHE review of the disparities in risk and outcomes of COVID-19, we called on employers to ensure that all at-risk staff have had an initial risk assessment undertaken within 2 weeks. This is something we will be carefully monitoring in the weeks ahead.

Respondents were also asked to tell us whether they were concerned about their health. 38% said they were concerned or very concerned about their health, a drop of 10% (down from 48%) compared with our survey on 13–14 May. Respondents from BAME backgrounds continue to be significantly more concerned, with 59% saying they were concerned or very concerned (although this has reduced by 17% since the last survey). 53% of respondents were concerned or very concerned about the health of those that they live with, a drop of 8% compared with the last survey.

Personal protective equipment (PPE)

Access to PPE is improving but 17% of respondents still report not having the PPE they feel they need when managing patients with COVID-19. 11% reported having found themselves in a situation in the past 2 weeks unable to access the PPE that PHE advises, a drop from the 16% who reported this 3 weeks ago.

The ability to get fit tested remains a challenge with 31% reporting not having been or able to get fit tested. In this survey for the first time, we asked respondents to tell us whether their employers were providing them with regular updates and communications about the supply of PPE to their organisation. The majority (72%) reported that they were, however, 28% reported that this wasn’t happening.

What we are doing

The RCP continues to raise the supply of PPE, risk assessments for staff and the need for improvements in testing at every opportunity. RCP president Professor Andrew Goddard and the senior officers continue to work closely with national NHS leaders across the UK, including the chief medical officers and national medical directors.

In addition, the RCP provides regular commentary in the media about the impacts of COVID-19. We have submitted evidence to numerous parliamentary select committees in the past few weeks and continue to liaise with MPs and peers.