Staffing is the issue keeping NHS leaders awake at night - and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, will make sure you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. Contact me in confidence.
The pressure has been cranking up on NHS Test and Trace since its inception but with the schools back and infection rates on the rise, things have really come to a head this week.
I have lost count of the number of doctors, nurses, managers, not to mention teachers and other key workers, who have taken to social media at their wits' end, unable to get tested, or being directed to a testing centre at the other end of the country. There seems to be no quick solution to this testing mess.
Proper access to testing for the general public is of course a crucial part of getting back to some sort of normal.
But NHS staff should absolutely be prioritised. Not only because enabling staff to work is vital in getting electives and diagnostics back up and running again, which will be of huge benefit to the wider public, but because it would help staff, who have been through the most challenging, often traumatic, six months of their career, feel safer at work and provided for by their employer.
So, for staff listening to the HSJ workforce summit online on Tuesday it would have been galling to hear the NHS’s chief people officer Prerana Issar take on the issue.
“From staff I am not hearing right now that there’s a problem with staff getting tested,” she said, adding that “testing [for staff] is a key part of the strategy, of course, of the response to covid”.
The statement sparked a mix of incredulity, outrage and resignation on social media and in the comments below our story.
“I have an emergency medicine consultant self-isolating with no access to a test to get them back,” said one commenter.
“What a shambles... our staff were asked to go from East Sussex to Cardiff with their child... a six to eight hour round journey... 380 miles,” said another.
“Here in the West Midlands we have multiple staff off because they are waiting for tests, which they cannot access. Home testing kits being sent to some staff but those take much longer, with clinics being cancelled as a result,” added someone else.
Readers also debated whether Ms Issar had given a deliberately misleading answer to align herself with the government’s official line, or perhaps worse – she simply had not been getting good information.
This begs the question: what else has gone under her radar? With the second, and most important, part of the People Plan (the bit with the money and staffing numbers) in the works, this does not bode well and could also contribute towards a growing and unhealthy mistrust between the workforce and the centre.
Over the last six months, NHS staff have had to grapple with more than ever has been required of them. We heard at the workforce summit of experienced allied health professionals being "redeployed" into community nursing teams. Consultants sent to work in intensive care despite years spent in another specialty. Nurses breaking the worst of news to families at the end of the phone. Porters making countless daily trips to the mortuary. Staff still experiencing lingering covid symptoms and PTSD.
The very least NHS England and Improvement leadership could do is level with them. A little honesty – and respect – goes a long way. The workforce should never have been misled over this vitally important issue.
With these experiences in mind, it was no surprise that the most common question asked at the summit by delegates was: how do we support our staff to get through winter?
During a session on prioritising staff wellbeing, Sonya Wallbank, head of culture transformation for NHSE/I said her team’s focus had been on ensuring staff were “ready and able” to do their best work, even if there is a second peak over the winter.
“Staff know, having gone through this once, what it might look like for a second time,” Dr Wallbank said, although she acknowledged personal health and wellbeing needs often fall by the wayside in times of tension.
Dr Wallbank said the current phase – what system leaders are calling the recovery phase – was enabling staff to take a breath and reflect on what they’ve been through. But for many, this pause has never materialised, as it has been all hands on deck to get NHS services back on track, cope with ever increasing A&E attendances, and in some cases, creeping covid cases.
During the same session, Neil Greenberg, professor of defence mental health at King’s College London, stressed the need for staff to have “psychologically savvy chats” with team members and direct managers. He stressed how good and supportive relationships between colleagues were even more important than access to a mental health professional.
“What’s really important is we do everything we can to reinforce the bonds between team members and their immediate supervisor,” he said. “Resilience lies between individuals.”
Many NHS workers will have relied on their colleagues' support to get them through each day during the peak, but the health service's collective resilience has taken a battering over the last few months. Staff of course need each other, and strong management, but they also need to feel national leadership has also got their back.