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.
An HSJ story published at the end of last month reinforced the horrendous impact coronavirus has had – and will continue to have – on the NHS workforce. The article revealed that death in service payments for over 600 health and social care staff who died with coronavirus are set to top £40m.
This accounts for less than three quarters of the staff who have, so far, died from the disease, so it is likely this figure will climb even higher.
An HSJ reader commenting on the story quite rightly pointed out that many other NHS and care staff have developed long covid and are continuing to suffer. Described to me by a doctor this week as an ‘occupational disease’, it is continuing to cause huge, and in some cases, permanent, health problems for many people.
I have been approached by multiple NHS workers over recent weeks who have described the dreadful impact long covid has had on their health and also their working lives.
One, a doctor working in an NHS trust who wished to remain anonymous, described how they have been signed off work for 18 months and are still really unwell and not sure when they will be able to return.
“My lungs have been badly affected by covid so I still need prescribed oxygen, plus I also developed heart, gastric, neurological and chronic fatigue problems,” they said.
The doctor described how after encountering a lack of support from their trust they turned to three unions for support, but were told they would not be supported as long covid is considered a “pre-existing issue”.
Another NHS employee expressed their disappointment after being told the same when approaching health unions and admitted they now feared attending a meeting with their NHS employer without any union representation.
A senior nurse, who has been involved in supporting NHS workers with long covid, said she was concerned to see “increasing numbers” of healthcare workers discovering they cannot be represented as they joined a union after catching covid.
“Most healthcare workers caught covid at work, and often because of a lack of appropriate PPE,” HSJ’s nurse contact said. “Shouldn’t this give healthcare unions a different approach?”
“Failing to offer even the basic support to newer union members risks significantly exacerbating the current staffing crisis and, perhaps more importantly, in my opinion is a moral failure of people who were on the frontline during a global pandemic,” they added.
I approached the major healthcare unions about this issue. A British Medical Association spokesman said it is “common” that trade unions provide support and representation on specific issues as long as the issue or dispute with the employer began while the doctor was already a member.
He added the BMA is pushing for long-covid to be classed as an occupation disease and lobbying for a compensation scheme.
Unison health and safety officer Kim Sunley told me: “It’s likely many staff will have caught coronavirus at work so it’s only right that their employers should be supportive.”
“This means phased returns to work, time off to attend medical appointments and a sympathetic approach to the amount of sick leave taken. Managers must show understanding and staff be no worse off financially,” Ms Sunley said.
None of the unions approached would say if they were considering a change in policy to support staff who have encountered employment difficulties when still suffering from long-covid.
According to the ONS, over 100,000 NHS staff are thought to be suffering from long covid. This issue is not going away, and NHS Employers and unions have a duty to support staff and help them return to work. The service has a pragmatic, as well as a moral, duty to support those with long covid, it can ill afford to lose any staff at this time of unprecedented pressure.
The usual T&Cs for union representation not fit for purpose in this situation.
Mandatory covid jabs
Another thorny issue NHS employers and unions must contend with is the news mandatory covid jabs are to be introduced for NHS workers.
It has been reported that employers will be given a deadline of April 2022 to make sure all staff are vaccinated, amid concerns about staff shortages and sickness.
I have spoken to some healthcare leaders who are very worried mandated vaccination is the wrong approach and they should instead continue to have open conversations with hesitant staff members.
However, others have said April is too late – as this winter will be the riskiest time for staff sickness absence with covid.
The Ward Round has covered this in detail before, but the consequences of employers failing to comply with this legal mandate could be serious. No-one can yet say how this new requirement will be monitored by the CQC, but it will certainly be added to the list of things keeping hospital chief executives up at night.