Lack of ‘primary care-specific’ support for staff during Covid

This article references harm and suffering experienced during the Covid-19 pandemic. The UK Covid-19 Inquiry points to a range of support services which can be accessed here

Nurses and colleagues lacked access to ‘primary care-specific’ support during the Covid-19 crisis despite experiencing increased workloads and pressures, a major national inquiry has found.

In its latest report published today, the UK Covid-19 Inquiry has urged the government to ensure improved ‘psychological and emotional’ support for all nurses and healthcare workers in the event of a future pandemic.

The inquiry sets out some of the impact the pandemic had on the nursing profession, citing the increased risk of burnout as well as the ‘significant stress and worry’ that many experienced.

Chaired by Baroness Hallett, the inquiry concluded that UK healthcare systems were ‘overwhelmed’ and ‘came close to collapse’ during the pandemic which first struck in 2020.

The 400-page document noted that many sectors reported experiencing a lack of support for staff during the pandemic, agreeing that ‘more support should have been offered’ and that support ‘should have been available earlier’.

It points to evidence given by Professor Adrian Edwards, an expert witness on general medical practice during the pandemic, who told the inquiry that there was a ‘lack of primary care-specific support during the pandemic’.

‘There were also similar examples from 111 and 999 services and from ambulance trusts,’ the report said.

‘The mental anguish’

During the pandemic, nurses were in some cases ‘balancing concern for themselves and their families with a sense of duty and a desire to help patients’ at the same time, the report found.

A children’s community nurse told Every Story Matters – a public engagement initiative launched by the inquiry to gather personal experiences from the public – that they felt guilt during the pandemic.

The nurse said: ‘The mental anguish, you tell yourself you have to park it, you have to get on for your family, for your children, everyone looks to you because you’re in healthcare, you have to hold it all together. I did feel for the children… you still have that guilt, but they were short [of staff], so I had to go in.’

Nurses’ mental health was also ‘severely impacted’ from witnessing death on a scale not seen before, the inquiry said.

In early 2020, Professor Kevin Fong, national clinical adviser in emergency preparedness, resilience and response for Covid-19 to NHS England, established a series of peer support visits by a team of doctors and nurses to understand the pressures intensive units were under.

Professor Fong ‘vividly described’ the accounts given by intensive care staff about the scale of death they experienced and its impact upon them.

He said: ‘We had nurses talking about patients raining from the sky… one of the nurses told me that they’d just got tired of putting people in body bags.’

The inquiry’s report, based on module 3 of the independent Covid-19 inquiry, recommends ‘psychological and emotional support for healthcare workers’ be embedded during a future pandemic.

All four governments should put in plans to deliver effective support for healthcare workers at scale in the event of another pandemic, it said.

Plans should cover the nature and level of support that will be provided during and after a pandemic.

‘It literally saved my life’

There were some good examples of support provided health workers during the pandemic such as helplines and online resources, the inquiry noted.

For example, the Professional Nurse Advocate Programme was launched in England in March 2021 to train nurses to ‘listen to and help understand’ the challenges colleagues were facing and to ‘provide and deliver quality improvement initiatives in response’.

Early results showed that the programme improved staff wellbeing, with ‘many examples of nurses saying that it has literally saved their life’.

‘Primary care also experienced the burden’

In the report, it was noted that the increase in workload was ‘not felt solely in hospitals’ and those working in primary care also experienced an ‘increase in their workload and the burden on them as a result of the pandemic’.

It added that GP practices were already in a ‘precarious position’ prior to the pandemic due to an ageing population, rising numbers of health conditions per person and an insufficient number of GPs – meaning the demand for primary care appointments had already ‘increased rapidly’.

Professor Edwards said that ‘very little had been done’ to prepare general practice for a pandemic and the increased workload led to ‘worsened wellbeing and increased levels of burnout’.

Vaccinations

The increase in workload in primary care was further exacerbated by the vaccination effort, with general practice nurses and staff undertaking vaccinations ‘alongside their usual workload’.

Inquiry witness Professor Philip Banfield, chair of the British Medical Association UK council from July 2022 to June 2025, said that general practice did an ‘exceptional job’ at ‘spearing’ the vaccination programme despite the increase in workload.

He added: ‘Demand on general practice – which was understaffed even before the pandemic – has been consistently high throughout the pandemic and increased further due to the backlog of unmet need.’

The inquiry will focus more on vaccination in module 4, due to be published on 16 April.

‘Nursing staff were the constant presence in every setting’

Chief executive and general secretary of the Royal College of Nursing (RCN) Professor Nicola Ranger said the report was ‘right to call for better support’ and warned that nursing can ‘never again be failed like this’.

‘Nursing staff were the constant presence in every setting during the pandemic and went through a level of trauma which isn’t captured by this report,’ she said.

‘They faced an unprecedented scale of death and saw their own colleagues die, some in the very same places they worked.

‘Many isolated from their entire families to continue saving lives. Their contribution and sacrifice must never be forgotten.

‘The report is right to call for better support for healthcare staff at the next pandemic, but we cannot forget those left behind from the last one.’