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Doctors not confident their hospitals would cope with a second COVID-19 surge

Nearly half of anaesthetists are unconfident that their hospitals would be able to provide safe Covid-19 and regular services should there be a second wave.

A survey of members by the Royal College of Anaesthetists (RCoA) shows that 44% of respondents questioned that ability of their hospitals to cope.

Over one-third also cited low or non-existent rapid testing for staff at their hospitals and one-in-five said there are currently insufficient infection prevention and control measures to prevent staff from infecting surgical patients with COVID-19.

Results also highlighted the increasing trend in mental distress amongst anaesthetists and the disruption to the training opportunities for anaesthetists in training:

  • nearly two-thirds of respondents have, to some extent during the past month, suffered mental distress due to the pressures faced during the COVID-19 pandemic
  • over one-third of respondents reported a low or very low level of team morale, compared with nearly one-in-five in May
  • 89% strongly agree that the pandemic is affecting their training opportunities, career and professional development.

The RCoA has been calling for an increase in resources, facilities and staff to support a return to non-COVID-19 activity.

While the Government has now announced £3 billion of additional funding for the NHS, more detail is needed as to how this will be spent and whether this will be enough to support the service and its staff through what is expected to be one of the most difficult winters in a very long time.

The RCoA is also seeking rapid development of cross-speciality ‘reservist’ health and care teams for deployment in the event of a surge in COVID-19 patients.

Professor Ravi Mahajan, President of the Royal College of Anaesthetists, said:

“As the NHS begins to return to a new ‘normal’ service, the findings of our survey clearly emphasise the reality facing anaesthetists working in the NHS. Worsening staff morale is certainly a concern.

“We saw the NHS deliver outstanding care for COVID-19 patients at the start of the pandemic, however this involved cancelling thousands of planned surgeries. In the event of a potential second surge of infections, it is imperative that the NHS does not again return to a COVID-only health service.

“If we are to maintain a high level of elective surgeries through any subsequent surge, Government and other stakeholders need to provide more detail on their commitment to increase capacity.”

Key recommendations:

  • NHS Improvement should publish a new People Plan, with the investment and teeth needed to support staff welfare and wellbeing, build resilience and address inequality.
  • NHS Improvement should identify, train and maintain the skills of cross-specialty ‘reservists’ who can support COVID-19 surges, with the support of the Medical Royal Colleges.
  • The Government should make a commitment to additional, and sustainable, investment in the resources, facilities and staff needed to support a return to pre-COVID-19 activity.
  • Hospitals and trusts may need to cohort specialist surgery on a regional basis; and there is merit in a ‘clean hospital’ approach. Other locations for managing planned surgery or COVID-19 care should be considered, with sufficient resources made available, separate from the NHS.
  • Efforts should be made to support hospitals in ensuring that sufficient numbers of anaesthetic, theatre, perioperative care and ward staff are free to return to their routine work activities.
  • A transparent, flexible, approach to re-scheduling assessments and teaching should be developed, with clear guidance on how missed learning opportunities will be delivered.
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