Care + COVID = crisis continues

Wilma Brown reports on her experience of an overstretched and under-resourced NHS in Scotland

We know staff in the NHS are suffering from years of being underpaid and overworked, even before COVID. Despite this, we have seen a huge effort from NHS staff over the past 19 months to meet the needs of the public who have accessed NHS Services. They’ve demonstrated adaptability and versatility working in new and different ways and have embraced the use of technology. They have gone above and beyond the call of duty to ensure patients, communities, and their colleagues have been supported. But this does not come without a huge cost.

Staff are suffering on a daily basis, being deployed and redeployed across the service to fill staffing gaps in many wards and units, quite often at last minute with no time for physical or mental preparation. They are being asked to undertake duties without adequate training and are working in different specialities that they have no experience in. The pre-COVID mantra of ‘having the right staff in the right place at the right time’ appears to have been forgotten or even to be important. They are constantly asked to work their days off as well as often working extra hours after their normal finishing time. Staff feel helplessly frustrated at the poor quality of care for patients.

This is causing high levels of stress, burnout and in some cases post-traumatic stress disorder (PTSD). The pandemic weighs heavy on our colleagues and with winter pressures looming, there is no let up, there is no cavalry coming over the hill to rescue them from what many describe as a working nightmare. Never before have I heard so many colleagues indicating their intention to leave at their first affordable opportunity, putting further strain on those left behind and we simply cannot afford to lose any more of our colleagues.

This leads us to the big question on the mind of every member of NHS staff: ‘How much longer can we continue sustain this level of pressure?’. Pressure on the NHS is not new as we have seen this level of pressure every winter – so it is a problem which has been growing year on year for many years now. But the ‘winter’ period has grown from the worst of the cold weather months, namely, November to February, into a problem lasting at least 7 or 8 months every year.

Of course, the fundamental point now is that since the winter of 2019 there has been no let up. Staff got through the tough months from around November 2019 hoping for let-up in spring 2020 but COVID prevented any period of relief. March 2020 saw the country go into lockdown and hospitals preparing for the impact of patients with COVID. This means that for almost two years staff have been working in unprecedented times under enormous pressure.

Years of austerity have led to situations within Health Boards of having high vacancy levels in professional roles, particularly nursing. Managers a few years ago were strongly encouraged to hold onto or freeze vacancies in an attempt to meet savings targets set by Scottish Government. This was a practice usually called upon toward the last quarter of the financial year to assist Boards reaching their financial balance.

Some Boards have hundreds of nurse vacancies with very little, or no, prospect of filling them due to the reduced numbers of student nurses qualifying. The Scottish Government tells us it is increasing the numbers of students, but the increase does not meet the attrition rate of the previous year. How will we recruit nurses if we don’t train them?

My role as Employee Director, Staff Side Chair, usually finds me in endless meetings and office based but I’ve cut back on a number of meetings and I’ve gone back to my roots as a nurse to offer whatever assistance I can. I’ve worked in the Vaccination Clinics and Acute Wards and Departments of my local hospital. This has given me a dramatic insight into the impact this pressure is having on staff, many of whom feel they are already at the end of their tether. The relentless ask of them is a real cause for concern. I have witnessed many, many staff in tears, heads in hands, stating they cannot take any more, can’t cope with the pressure being put upon them. They frequently forego their breaks to ensure patients receive the care they require. The biggest concern I have is that many staff do not want to speak to managers about how they are feeling because they may be seen as weak or not resilient enough. This is a very nasty problem which is multi-factorial in seeking solutions and assistance for these staff. I worry about the ‘normalisation’ that is creeping in and the paralysis this brings to staff who are feeling more and more helpless without escalating their issues and concerns. What this does tell me is that I must continue my work on the floor getting the true picture of what is going on, because I will, and do, escalate the issues. I will and do stand up for these amazing people, and with the backing of UNISON we will not give up on them.

Nurse, Wilma Brown, is Chair of UNISON Scotland Health Committee. She has worked in the NHS for 35 years and been the Employee Director in NHS Fife for the past 12 years.