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, ensures you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce.

Over the summer, the Health and Care Women Leaders Network warned that the female NHS workforce had been severely affected by the covid pandemic, in terms of both emotional and physical wellbeing.

It was disheartening to read a minority of HSJ reader comments below the story, suggesting there were “bigger problems” to contend with.

The entire NHS workforce has suffered over the last 14 months, but specific research was done by the network to highlight the impact the pandemic has had on three quarters of the NHS workforce.

Declaring something matters and needs addressing should not create a hierarchy of suffering.

The survey, carried out in June last year, two months after the first covid peak, found almost three quarters of respondents reported their job had a negative impact on their mental health, and more than half suffered a negative impact on their physical health.

The network has recently published more findings, this time from the latest iteration of the survey, in which it asked 1,300 members the same questions at the beginning of this year. Context here is important, as the NHS was in the midst of the third wave, and asking the same questions now might garner some different answers.

But the latest survey found the key metrics had worsened; more than 80 per cent of the female respondents reported that their job had a greater negative impact than usual on their emotional wellbeing as a result of the pandemic.

In terms of physical health, 65 per cent said their job has caused a greater negative impact on their physical health.

The authors said this deterioration suggested support from employers may either be “insufficient or absent”, but also linked to the prolonged nature of the pandemic.

Both surveys have highlighted the major shift in working patterns and caring responsibilities during the pandemic, with respondents taking on even more hours of caring responsibilities per week, rising to almost 20 additional hours.

“When women are doing the most caring, it has the potential to limit their careers as well,” Sam Allen, chair of the network and Sussex Partnership Trust’s chief executive said.

She warned that unless NHS leaders support their female workforce and recognise the prolonged impact the pandemic is having, they risk increased absence rates and people rethinking their career in health.

“Some people may think inequalities when it comes to gender have been addressed, and they’ve not, so we’ve got a long way to go,” she added.

Hidden voices

The survey is clear about its own limitations; it notes that the majority of respondents were white (88 per cent), which was higher than in the NHS workforce as a whole. Ethnic minority staff were under-represented in the findings and it described this as a “significant issue” that must be addressed in future iterations. However, it does not say how this will be done.

Of the ethnic minority staff members who did respond to the survey, Ms Allen said they reported an even worse experience.

Female staff from an ethnic minority background were found to be more involved than others in non-work caring responsibilities, saw greater reductions in their working hours, and at the same time were working more unpaid hours than white women.

Interestingly, Ms Allen also said some people did not want to disclose their gender in the survey, and for this group, the experience during the pandemic was markedly worse.

For the first time this survey also included a question on long-term health conditions, with staff members in this group reporting a greater negative impact from the pandemic, a poorer experience of remote working, and feeling less safe sharing concerns with managers.

The report was clear; the pandemic is likely to have a detrimental impact on the career progression, opportunities and earnings of women in the NHS, and ethnic minority women even more so.

Sam Allen has written to all NHS organisations urging them to read the network’s report, in which four key recommendations are set out.

Among them is a call for all providers and integrated care systems to promote and enable greater flexible working practices, which it said should be published by September 2021.

But flexible working is just a small part of the work that needs to be done. The network is calling for the impact of the pandemic on women to be considered as part of overall recovery plans, to ensure the pandemic doesn’t have a lasting, negative impact on the female NHS workforce.