Failure to tackle nurse shortages and burnout – particularly within the social care sector – is ‘a serious risk to the country’s ability to robustly tackle future pandemics’, the UK Covid-19 Inquiry has been told.
The Royal College of Nursing (RCN), represented by Fenella Morris KC, spoke on behalf of members this week at a preliminary hearing ahead of the inquiry’s work on examining the impact of the pandemic on the care sector, due to begin in summer 2025. The RCN also presented written evidence.
The RCN warned that care services were ‘chronically under-resourced’ to deal with the pressures of the pandemic and that a lack of adequate staffing meant its nursing members reported ‘in many instances’ feeling ‘unsafe’.
In January 2020, 73% of nursing staff said that staffing levels on their last shift were not sufficient to meet all the needs of the patients safely and effectively, with an estimated 6.8% of roles in adult social care vacant in 2020/21, equivalent to 105,000 vacancies.
The RCN asked that the inquiry considered recommending legislation imposing accountability on central government for workforce planning and supply.
And concerningly, the college warned that the failure to tackle ‘the issues facing the nursing workforce, including in recruitment, retention and burnout, remains a serious risk to the country’s ability to robustly tackle future pandemics’.
‘Persistent, systemic workforce issues put nursing staff and patients at risk – this was even more in evidence during the Covid-19 pandemic,’ the RCN’s written submission added.
In addition, the inquiry was also told how care homes were ‘competing with better funded hospitals’ for personal protective equipment (PPE).
And a lack of access to appropriate PPE, testing and guidance for staff working in care homes ‘exposed key workers and those they care for, to unnecessary risk’, the RCN added.
RCN surveys completed during the pandemic indicated that nursing staff in care homes were less likely to have access to appropriate PPE and more likely to feel pressured into caring for people with Covid-19 without adequate protection, than health care workers in other settings.
The RCN also said the ‘unfair perception’ that adult social care was ‘secondary’ to acute hospital care led to care homes ‘feeling under pressure to take untested discharged patients to prevent the NHS from being overwhelmed but which, ultimately, may have resulted in higher levels of deaths in care homes’.
Ms Morris told the inquiry: ‘The appropriate analogy is perhaps a hammer hitting a wall. A weak structure – which we say was the case with the social care sector at the beginning of the pandemic – will buckle, but a robust one will not.
‘Of those who were working, their ability to work was affected by their own Covid-19 infection and a need to shield. That meant that pressures on those working were intensified, ultimately leading to moral distress and sometimes psychological injury.’
A Department of Health and Social Care spokesperson said: ‘Throughout the pandemic the government acted to save lives and livelihoods, prevent the NHS being overwhelmed and deliver a world-leading vaccine rollout which protected millions of lives across the nation.
‘We have always said there are lessons to be learnt from the pandemic and we are committed to learning from the Covid-19 Inquiry’s findings which will play a key role in informing the government’s planning and preparations for the future. We will consider all recommendations made to the department in full.’
According to its terms of reference, the aim of the inquiry is to ‘examine the Covid-19 response and the impact of the pandemic in the UK and produce a factual narrative account – including the public health response, the response of the health and care sector, and the economic response to the pandemic and its impact, including governmental interventions’. Its key aim is to ‘identify the lessons to be learned, to inform preparations for future pandemics across the UK’.
RCN members have been urged to share their experiences of working throughout the Covid-19 pandemic, with a nation-specific inquiry taking place in Scotland.
Shortages in the nursing workforce were compromising patient care even before the Covid-19 pandemic began, data has suggested.
Just this week, fresh concerns were raised around the adult social care sector and growing staff vacancies. The government was urged by the Public Accounts Committee to provide long-term financial support and a clear workforce strategy to address shortfalls in the sector.
