Recovery Watch: Trusts must not penalise staff during long-covid recovery

This week Recovery Watch explores growing concerns about the impact long covid is having on the NHS workforce, amid warnings from the former health secretary and unions that staff must have their employment rights protected.

Much has rightly been written about the effect of coronavirus on the growing elective backlog, cancer diagnostics and already pressurised emergency departments, but the aftermath of covid-19 on a person’s health has been less explored.

“Long covid” — the name which has been given to a syndrome, or group of syndromes and conditions, experienced for an extended period by large numbers of those who have had covid-19 — affects people in different ways. And health and care workers are by no means exempt from this often debilitating condition.

Staff, unions, professional groups and researchers working on long covid have told HSJ that support for those suffering with it has been patchy and various improvements are needed.

Trisha Greenhalgh, an Oxford University professor of primary care health sciences who has interviewed around 100 long-covid sufferers, told HSJ clinicians returning to work “felt like they have got better from [an] acute position”, but “they start doing shift work and get very breathless”.

Professor Greenhalgh said: “They then speak to their boss about whether they can do short days or a phased return and they say no, you are a junior doctor, you have to [work] the rota.”

Lynne Turner-Stokes, a professor of rehabilitation medicine at King’s College London and consultant at Northwick Park Hospital, told HSJ the most common long-covid symptom people describe is fatigue — people feeling tired and feeling they need to go to bed or are unable to think and concentrate.

“We offered our staff carefully graded return and encouraged them to not come in every day. We realised we could get a lot more out of our senior staff if they didn’t have to do the journey [to work],” Professor Turner-Stokes said.

A medical consultant who worked in London while it experienced the very severe first wave of the virus in the spring, speaking to HSJ anonymously, said since long covid was an “occupationally acquired condition… we expect the NHS to act as a beacon of good practice”.

“Sadly few people living with long covid report that experience from their employer, [which is] distressing not only on a personal level, but also because it prevents them from playing an active role in society.”

Unions and professional groups have also called for a range of improvements, including Unison indicating sick pay was not always being given in full.

Unison head of health Sara Gorton said: “Trusts should be ensuring continuing access to full sick pay to reduce financial pressures and reassuring staff they won’t be penalised through sickness management processes.”

“Especially as many people are likely to have contracted the disease at work,” she said, “fast tracking access to rehabilitation and long-covid clinics will be important to help get staff back on the road to recovery.”

It follows former health secretary and commons health committee chair Jeremy Hunt raising the issue of pay last month, writing to Matt Hancock to say: “There is a substantial risk that we will lose many more highly trained individuals without better, focused employment support. This should include protection of full pay, and guidance to line managers on how to handle absences and phased returns.”

The DHSC would not say if Mr Hancock had replied.

Some royal colleges have also expressed concern about the lack of national guidance on health staff who are living with long covid.

Susan Masters, director of nursing, policy and public affairs at the Royal College of Nursing, said the union wanted to see employers offering a “phased return to work, including considering if staff need to be redeployed as a temporary measure to support their full return to health”.

“We would, of course, expect full risk assessments to be undertaken as part of any planned return.”

The Royal College of General Practice is calling for a nationally funded occupational health service for primary care health professionals to help them recover from long covid and other illnesses in the future, which it estimates would cost approximately £10m per year.

Its lead for clinical policy, Gail Allsopp, said: “We are particularly concerned for our members and their teams in primary care who have been ill with covid-19 and continue to experience symptoms, and some GPs have told us this has directly impacted on their ability to do their jobs.”

A Department of Health and Social Care spokeswoman said: “We know long covid can have a huge impact on people affected and we are continuing to invest more in research and support.

“It is essential all employers provide the necessary support while staff are sick and to enable their return.”

The pandemic has forced all sectors of society to rapidly adapt and, in many ways, modernise, enabling staff to work remotely and flexibly in a way they could not before. It is vital the NHS also continues to do this for all its staff suffering from long covid, something they are likely to have caught while at work.