Feeling like Cannon Fodder – researching the challenges of frontline doctors in the response to Covid-19

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By Dr Liz Jenkinson, Senior Lecturer in Health Psychology and Co-chair of the UWE Bristol Healthy University Group

With a new variant pushing healthcare capacity to its limits, understanding the challenges of responding to Covid-19 on the frontline is pivotal. As a Health Psychologist, I am driven to inform and develop evidence-based policy and practice in healthcare. I have been working with Jo Daniels and Sophie Harris at the University of Bath, Edd Carlton (University of Bristol/Royal College of Emergency Medicine) and Tom Roberts (North Bristol NHS Trust/Royal College of Emergency Medicine) to capture the scale of the challenge faced by healthcare professionals responding to the pandemic. Despite the popular media narrative of healthcare workers being our Covid-19 heroes, our research documents that many simply do not feel that way in terms of how they are being supported. The research highlights how frontline healthcare workers are angry at being treated as ‘Covid cannon fodder, not Covid heroes’ after responding to the virus for nearly two years.

‘It’s been ugly’: A large-scale qualitative study into the difficulties frontline doctors faced across two waves of the COVID-19 pandemic’ is the first study of its kind to capture the views of over 1,300 doctors in the UK and Ireland responding to Covid-19 since early 2020. The study was published in the International Journal of Environmental Research and Public Health this week and featured in the Sunday Times, BBC news and beyond.

Despite working at ‘100% capacity, 100% of the time’, the frontline healthcare workers told researchers of their frustrations at those not following public health advice, and towards Government for ‘failing in so many ways to support us.’ Doctors said they felt ‘expendable’ and left traumatised by events. The dual issues of a worrying lack of support for doctors’ basic needs (e.g. insufficient places to rest, food to eat, and relentless shift patterns), and a significant lack of appropriate psychological support to help them decompress was also highlighted.

Participants recruited for the study comprised frontline doctors who worked in emergency medicine, anaesthetics, and intensive care medicine in all parts of the UK and Ireland. All genders, ethnicities and seniority levels were represented in the sample of 1,379 participants who responded to a longitudinal survey asking them to answer freely: ‘What has been most difficult about the pandemic?’

Clinical psychologist at the University of Bath, Dr Jo Daniels, explains: “We are seeing increasing levels of staff attrition, absenteeism, poor psychological health, and loss of life, yet frontline doctors are expected to just carry on.”

These findings build on recent work, including the CERA study, which sought to quantify psychological distress experienced by emergency doctors during Covid-19, and the Covid-19 Clinician Cohort (CoCCo) study model, which highlighted a hierarchy of needs for frontline workers responding to the pandemic. These ranged from supporting workers’ basic needs with hot food and drinks, through to embedded peer support, psychological care, and interventions. The team say it is imperative policymakers learn lessons from this study as they respond to the impact from the latest Omicron variant.

Dr Edd Carlton, Professor of the Royal College of Emergency Medicine and Emergency medicine doctor, co-authored the research. He said: “This work demonstrates the massive impact the pandemic has had on our frontline medical workforce in terms of working conditions, morale and psychological distress. What is most worrying is that Covid-19 has compounded issues that were already commonplace pre-pandemic and now are putting a tangible strain on doctors’ own physical and mental health.”

My work at UWE Bristol continues to collaborate with the team, bringing my expertise in Health Psychology into this space. We are very grateful to those who gave up their time to tell their stories, which were striking in their agreement that this had been unrelenting, traumatic and had placed unsustainable pressure on frontline doctors. As we move into what may prove to be yet another wave of the pandemic, this research shows that there needs to be a renewed focus on properly supporting doctors to protect their health and wellbeing so that they can be there for all of us when we most need them.

Read the academic paper here and click here for an animation based on Covid-19 healthcare research.

Hosting a hospital – how an NHS Nightingale hospital was created in three weeks at UWE Bristol

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By Professor Steve West, Vice-Chancellor at UWE Bristol

As the COVID-19 pandemic has taken hold of the country, universities have radically changed how they operate to best support students and staff, and UWE Bristol is no different. But alongside all of our efforts to ensure that our students’ academic and student experience is able to continue virtually, we have also found ourselves as one of the hosts for an NHS Nightingale Hospital on our Frenchay campus.

Creating a 300-bed hospital in our Exhibition and Conference Centre (ECC) has been no mean feat, but when we were approached by the NHS, it was a very easy decision for us to offer everything we could to help. Along with many universities, UWE Bristol has a very long history of being embedded in its local community, and if this pandemic has taught us anything, it’s the importance of community support and collaboration to tackle the unprecedented situation we find ourselves in. Universities are uniquely placed to help in the current crisis, so we knew that no matter how complex the creation of this hospital would be, we were ready to get involved.

Although the prospect of having a fully operational intensive care bed hospital on our campus has been daunting at times, the reality of the construction has been remarkably smooth. I have been on the project from the outset with fantastic colleagues at all levels and disciplines playing their part in delivering this facility. Our collective effort has given hope to NHS frontline staff, and the hospital is now ready if needed to treat the sickest patients battling COVID-19.

We were first approached in late March, when a team from land surveyors CBRE, the NHS, plus the Army Logistics team, arrived onto campus to survey the ECC and surrounding area. A project team was established and after that things began to move extremely quickly, with a full project Board established two days later and increasing numbers of Kier, NHS and contractor staff arriving on site.

We collaborated with the NHS and Kier leads from the very beginning, which was essential as there was an ambitious 15 day build plan to deliver 300 fully ventilated beds in one building – one that is usually put to use for everything from student exams to events to weddings, so it has been incredible to witness how it has been turned into such a different facility.

For me, one of the most important aspects of this whole project has been ensuring that we are not simply a geographical location for the hospital but a partner in this endeavour, consistently looking for new ways to support and adapt to having this facility on campus. To that end, we provided a bespoke 2 day training programme for volunteers to be able to work safely in the Nightingale which was designed and delivered for over 350 people over the Easter break, and UWE Bristol Academic and Technical Teams also started to train clinical leads and staff in the Nightingale protocols. We have been providing 1000s of litres of disinfectant and hand gel to the site, GP, practices, pharmacies and even the local businesses such as Rolls Royce and Airbus to keep the economy moving, and now we have begun making face visors in the Bristol Robotics Laboratory.

For now, the hospital stands ready if required, and the NHS continue to have our full support. Following the official opening of the hospital last week, we are now working very closely with NHS colleagues across the region to determine how the facility might change and adapt as the disease progresses and clinical needs change.

The fact that we are host to such an important part of the UK’s fight against COVID-19 is a source of great pride to our staff and students. While having a hospital spring up in the space of two weeks across from my office is not something I could ever have predicted at the start of the year, everyone here has risen to the challenge with all the energy, willingness to collaborate and community spirit I’ve come to expect from our students and staff. This is us at our best, and demonstrates how we and the higher education sector can play such a vital role in the current pandemic.

This article was first published by Universities UK

Providing essential training for frontline staff working at Nightingale Hospital Bristol

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By Dr Marc Griffiths, PVC and Executive Dean, Faculty of Health and Applied Sciences

Over the last week the Glenside Campus has been set up to receive volunteers who will be working as frontline staff at the Bristol Nightingale hospital when it opens on the 18th April. The development and preparation for frontline staff training has been a collaborative effort between the University and colleagues from the NHS.

This approach further supports our excellent partnership working with NHS organisations across the region and many of our academic and technical staff were working over the Bank Holiday weekend to ensure facilities were ready for training purposes. The clinical simulation spaces at our Glenside Campus are equipped to deliver frontline training to 1,000 volunteers over the coming weeks and our staff have risen to the challenge.

Colleagues from across the local and regional NHS have come together with UWE staff to create a local version of the London Nightingale Hospital staff training programme. Having a campus that is equipped to deliver staff training on the required scale for the Bristol Nightingale site is testament to the investment by the University in clinical skills and simulation training for our health and social care students.

UWE Bristol has over 3,000 health and social care students and annually graduates approximately 1,500 practitioners into the local and regional health and social care system. Our integrated working with NHS partners and state of the art simulation learning facilities create the required environment for the local and regional health and social care workforce pipeline.

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