The eighth survey of RCP fellows and members shows that that despite the positive news about vaccinations, the pressures placed on doctors by the pandemic are taking a significant toll.
The impact of COVID-19 on the mental health of frontline doctors, who have worked for almost a year under the most challenging conditions the NHS has ever faced, is now beginning to show. In a survey of members of the Royal College of Physicians (RCP) almost a fifth (19%) said they have sought informal mental health support during the pandemic, while 10% said they had sought formal mental health support from either their employer, GP or external services.
While a third of doctors report feeling supported (35%) and determined (37%), the majority of doctors (64%) feel tired or exhausted, and many are worried (48%).
Despite 85% of doctors reporting having had the first dose of a vaccine, only 16% have had both doses. Over half (58%) are either very worried or slightly worried about having to wait 12 weeks for their next jab, an issue which has caused considerable anxiety within the profession.
The second wave of coronavirus is undoubtedly hitting the NHS far harder than the first, with three quarters of doctors finding this second wave either slightly or much busier compared to the peak in April, and 56% very concerned about the impact of rising COVID-19 admissions on their organisation’s capacity to deliver safe and effective care.
Improvements in treatments for COVID-19 mean that in this second wave a much smaller proportion of hospitalised COVID-19 patients are requiring ventilation in Intensive Treatment Units (ITU) . This, however, is placing huge pressure on the wider medical team in all specialties, particularly respiratory medicine. In some hospitals, up to 95% of COVID-19 patients are receiving care outside of Intensive Care Units on medical wards acting as COVID-19 wards. 20% of physicians have been redeployed during this wave, most to these COVID-19 wards.
The rapid rise in cases is being felt by doctors across the NHS from emergency departments to general COVID-19 wards and ICU. Delays to treatment in other areas of medicine due to the prioritisation of COVID-19 patients are also being acutely felt.
Although the pandemic brings unprecedented pressure, the RCP considers understaffing to be the root of many of these problems, with 55% of consultant posts unfilled even prior to the pandemic. The RCP has long called for the number of medical school places to double in order to grow the medical workforce and this month published a costed blueprint for making this happen.
Professor Andrew Goddard, president of the Royal College of Physicians, said: “There is no way to dress it up – it is pretty awful at the moment in the world of medicine. Hospital admissions are at the highest ever level, staff are exhausted, and although there is light at the end of the tunnel, that light seems a long way away.
“I am extremely concerned about the mental health of frontline doctors, who may be suffering from burnout and a feeling of not being valued. I'm not sure that before the pandemic many physicians would have contemplated that they might need formal mental health support in their career.
“Staff will be in desperate need of a break and will need specific time away if they’re to be at their best after the pandemic.
“Doctors have demonstrated remarkable resilience throughout the pandemic, working under the most challenging conditions the NHS has ever faced, but they can’t continue working this way forever. Workforce shortages need to be urgently addressed post-pandemic if we’re ever to reduce the immense pressure on NHS staff and ensure that they are prepared and supported to get the NHS back on an even keel.”
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About the role of physicians in the frontline response to COVID-19
On 12 April at the peak of the first wave there were 21,684 patients in hospital with COVID-19, 15% of which were ventilated (3,301 patients). In comparison, on 15 January, 10% of the 37,475 patients in hospital with COVID-19 were on ventilation (3,789 patients). That represents a 73% increase in the number of patients with COVID-19 being treated by the wider medical team beyond ITU.
Improvements in treatment for COVID-19 mean that in this second wave a much smaller proportion of hospitalised COVID-19 patients are requiring ventilation on Intensive Treatment Units (ITU)... However, their conditions are still severe enough to require inpatient hospital treatment on a general COVID-19 ward. This is placing huge pressure on the wider medical team in all specialties, particularly respiratory medicine, as the physicians, nurses and other healthcare practitioners staffing these wards work hard to provide care to a rapidly increasing number of patients.
About the survey
This survey was sent out via an email to approximately 25,500 RCP members in England, Wales, Scotland, and Northern Ireland on Friday 15 January 2021 and was filled in by 1,890 people over a period of 48 hours.
This is the eighth survey the RCP has sent to its members during the COVID-19 pandemic.
Further information about our surveys can be found on our website.