Tracking the impact of COVID-19 on the workforce

On 1-2 April we surveyed our fellows and members about the impact of COVID-19. We shared what we learned with the health and social care secretary and the chair of the health and social care committee.

On 22-23 April we conducted another survey, again asking our fellows and members

• whether they were currently taking time off from their normal work schedule or had taken time off recently
• if they were able to access testing for COVID-19
• if they were able to access the appropriate personal protective equipment (PPE).

We also asked if they

• were working in a clinical area that is different to their normal practice
•  had received the necessary support to move into a new role
• if they were experiencing any shortages of medicines, oxygen or other consumables or equipment.

Commenting on the results RCP president Professor Andrew Goddard said:

“We’re living through the darkest times the NHS has ever faced and this survey shows the reality of the situation facing hospital doctors at the moment.

“The lack of PPE remains their biggest concern and it is truly terrible that supply has worsened over the past three weeks rather than improved.

“Healthcare workers risking their lives couldn't care less how many billion pieces of PPE have been ordered or supplied. If it isn't there when they need it, they are in harm's way.

“It is encouraging that testing rates have improved for staff and that sickness rates have fallen. However, we are only 6 weeks into what will be many months of upheaval for the NHS and getting services back up and running is going to need Herculean effort.

“Testing and PPE supply will be critical in getting 'normal' services going and we mustn't underestimate the challenges ahead. As the number of COVID cases fall one of those challenges is getting doctors back into their normal working areas. Until this happens 'normal' business can't restart"

The results

Headlines

• General access to PPE has worsened. 26.5% of respondents report being unable to access the PPE they need for managing COVID patients, compared to 22% in our first survey
• The survey found that staff absences have dropped from 18% to 8% in the past three weeks except in SAS and locally employed doctor grades
• 91% of those with COVID-19 symptoms said they are now able to access testing for themselves, up from just 31% three weeks’ ago. However, 29% are still unable to access testing for a symptomatic member of their household. 
• 29% of respondents reported working in a clinical area different from their normal practice which presents challenges when considering how to restart non-COVID-19 services.
• Medicine shortages are becoming a growing problem with 17% of respondents reporting issues with medicines (in-patient settings)

Time off

2,129 people responded, compared to 2,513 three weeks ago. Overall less than 8% said they were currently taking time off, with little difference between the parts of the UK. This is compared to 21.5% in London and 18.3% in the rest of England three weeks ago. 33% of those taking time off said they were ill with COVID-19, and 32% that they had suspected COVID-19.

These averages mask a stark disparity though: 23% of locally employed doctors and 15% of SAS doctors said they were currently taking time off. Of those, 42% were ill with COVID-19 and 36% were off work due to suspected COVID-19.

While the number of SAS and locally employed doctors was small (just over 5% of the total) these findings require further investigation. This is particularly important given a large proportion of these doctors are from black and minority ethnic (BAME) backgrounds, and the disproportionate impact of COVID-19 on BAME communities.

Testing

Access to testing has improved since our first survey, but our members are still reporting that they are not always able to access what they need for themselves, their households and their patients.

Personal protective equipment

Access to personal protective equipment (PPE) remains an issue and may be worsening. 26.5% of respondents report being unable to access the PPE they need for managing COVID patients, compared to 22% in our first survey. It is therefore a concern that 23% said they don’t know how to raise concerns about PPE in their organisation.

In this survey we asked several more detailed questions about specific pieces of PPE in different settings. Just under a third of respondents said they were working in an aerosol generating procedure (AGP) area. Of them, 31% report being able unable to always access long sleeved disposable gowns, and 37% unable to always access full-face visors.

86% of respondents were working in non-AGP areas with confirmed or possible cases of COVID-19. Worrying almost 40% are not always able to access eye protection, and 15.5% not always able to access fluid repellent face masks.

Only 69% of respondents report either having had, or being able to access, fit testing. Over a third (34.5%) said they don’t feel confident fit checking their PPE.

Medicines and consumable shortages

We also asked our fellows and members to tell us about access to medicines, oxygen and consumables. We asked them whether these shortages were new (since COVID-19) or pre-existing.

24.5% reported shortages in consumables since COVID-19, compared to 3% before its onset. New shortages in medicines were also reported in both inpatients (17% compared to 9%) and outpatients (12% compared to 11.5%).

Clinical areas

29% of respondents reported working in a clinical area different from their normal practice. Over half (53%) are now working on acute medicine wards and 14% on a COVID-19 ward. The majority of members had been supported with the transition: 73.5% had access to training, 59% access to psychological/emotional support and 51.5% received mentoring.

What we are doing

The RCP continues to raise the supply of PPE and access to testing at every opportunity. The RCP president Professor Goddard, and the whole senior officer team 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.