Stress and anxiety levels increasing in NHS staff during COVID-19

New Nuance research reveals damaging impact of pandemic on working practices and mental health on primary and secondary care professionals

NHS workers in primary and secondary care have seen their work-life balance worsen and stress levels increase as a result of the pandemic, according to a new research report from Nuance.

The report, titled The impact of Covid-19 on clinical administration and clinician burnout in the UK, is based on an extensive online survey of over 900 NHS healthcare professionals from primary and secondary care. It gleans insights around their working practices, morale, and mental health throughout the first wave of the pandemic.

When it comes to workforce wellbeing, two thirds (69 per cent) of primary care professionals believe their work-life balance has worsened since the pandemic began. Three in four (75 per cent) in primary care feel their stress and anxiety levels at work have increased. 60 per cent of secondary care workers also said their stress and anxiety levels at work have increased in the same time period.

Telehealth driving up admin burden

Nearly four in five (78 per cent) of primary care professionals believe the necessary transition to remote consultations has caused an increase in general workload. 67 per cent also stated the pandemic has increased the amount of clinical admin at their practice.

85 per cent of all respondents agreed the burden of clinical documentation is a significant contributor to burnout. As noted by some survey respondents, remote consultations come with higher risk and more diagnostic uncertainty, so often require more safety netting. This, combined with changing regulations, creates more administration and a flood of information from WhatsApp groups, video conference meetings, and emails.

Backlogs driving stress

Only one in four primary care respondents said their working pattern had returned to be what it was before the pandemic. In secondary care, half (49 per cent) stated some services at their hospital were still on hold and 71 per cent said their hospital had a large backlog that will take a long time to clear. This survey was also conducted before the significant rise in Covid-19 hospital admissions in October, so this issue may have worsened still.

Another cause of the increase in administrative workload is the pressure placed on the interface between primary and secondary care. With patients experiencing delays in secondary care, having elective surgeries cancelled, or being discharged from hospital earlier to free up capacity, it is perhaps inevitable that there is more delivery of care taking place in the community.

“The administration clinicians were tasked with before the pandemic, combined with the increased levels of administration as a result of Covid-19, is evidently placing an unsustainable strain on the wellbeing of the NHS workforce. If nothing changes, we are likely to see many staff, particularly in primary care, suffering from burnout, which can have serious repercussions for the entire population,” said Dr Simon Wallace, Chief Clinical Information Officer, Nuance.

The report states the below in terms of conclusions and advice for NHS leaders:

  • There is a role for technology in helping ease the administrative burden that should be explored but, given the current environment and persisting stress factors, perhaps the immediate focus should be on considering, or reconsidering, what we ask of clinicians.
  • Public bodies should determine why the administrative burden has continued to rise and, in the context of rising stress and burnout, reassess the importance of bureaucratic tasks and where it is essential for information to be recorded.
  • Building resilience within the workforce, increasing access to mental health support, and reducing the emphasis on targets will allow clinicians to focus on where they deliver the most value: caring for their patients.

“The usual winter pressures and cancellation of hospital services during the second national lockdown will place further strain on overstretched staff. Additionally, with GPs set to be called upon to administer COVID-19 vaccinations to the public, doctors and professional bodies have expressed concern about how surgeries will cope with the increased responsibility and workload. More support is required, from identifying and tackling the source of such mental health strain to deploying the right technology to ease such pressures moving forwards,” Wallace added.


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