Workforce stress and burnout

Since our last State of Care report in October 2020, health and social care services have been under greater strain than ever as the country has continued to experience the effects of the COVID-19 pandemic. People across all professions, and carers and volunteers, have worked tirelessly to help those who needed care.

The impact of working under this sustained pressure cannot be underestimated. A wide range of stakeholders and organisations have highlighted the negative effects on health and social care workers, including anxiety, stress, exhaustion and burnout.

Latest research has highlighted that health and social care staff have faced a range of challenges during the pandemic that have impacted on their mental health and wellbeing. These have included: increased workload, difficulties accessing support and resources, witnessing serious illness and death at unprecedent levels, knowing colleagues who have been seriously ill or died from the virus, feelings of guilt about not being able to do more, isolation from family and friends, duration of the pandemic and concerns about the future.

In June 2021, a report by the Samaritans identified healthcare workers as one of five groups whose suicide risk may be exacerbated as a result of the pandemic. The report described how healthcare workers have struggled with feelings of anxiety, trauma and mental fatigue from their work during the pandemic, alongside the impact of being surrounded by serious illness and death at unprecedented levels, while often struggling for support and resources.

The British Medical Association (BMA) reported that 41% of doctors who responded to their COVID tracker survey in February 2021 said they were suffering from depression, anxiety or another mental health condition, which had worsened since the start of the pandemic; and that 59% said their current level of fatigue or exhaustion had been higher than normal during the crisis.

The June 2021 report from the House of Commons Health and Social Care Committee concluded that burnout is a widespread reality in today’s NHS. It highlighted the negative consequences this has for the mental health of individual staff, impacting on their colleagues and the people they care for, and identified chronic excessive workload as a key driver. It also highlighted that many adult social care staff had the additional emotional strain of taking the place of the family and loved ones who could not visit care settings.

Staff sickness rates were up in adult social care last year – pre-pandemic sickness rates for adult social care staff were 2.6%, whereas these almost doubled to 5% between March 2020 and June 2021.

The NHS workforce has been displaced for significant periods over the past year. The NHS Staff Survey 2021 reported that 10% of staff had been shielding – either for themselves or members of their households – while 19% were redeployed, especially among acute and community NHS trusts. More than a third (34%) of NHS staff had worked on COVID-19 wards at some stage, and 36% had been required to work remotely/from home.

Many people took on additional roles voluntarily during the pandemic – for example, covering COVID-19 vaccination centres on their days off. While admirable, there are potential negative impacts on staff wellbeing to consider.

The crisis has also brought to light and exacerbated longstanding problems, including excessive work pressures and staffing challenges. For example, our inspectors have described how responding to the pandemic, and the increased focus on providing care to people at home, placed pressures on the community health workforce, which was already experiencing challenges with staff recruitment and retention.

Through our provider collaboration reviews we heard about initiatives to support the mental health and wellbeing of staff during the pandemic. These included:

• dedicated wellbeing spaces that provide a calming environment for staff
• informal catch up calls and team meetings such as 'sharing cuppas' and one-to-ones with a wellbeing focus
• access to professional help such as employee assistance programmes and counselling
• mental health trusts facilitating access to counselling or other psychological therapies for NHS colleagues.

The House of Commons Health and Social Care Committee report welcomed the additional support given to health and social care staff during the pandemic but highlighted the need to maintain this going forward. This included embedding a culture where staff are explicitly given permission and time away from work to seek help when it is needed. Feedback from our engagement with voluntary and community sector organisations similarly highlighted the importance of continuing to provide increased support to staff as services recover from the pandemic.

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