BURNOUT: Pressure on NHS staff is relentless

IT HAS BEEN A NIGHTMARISH 18 MONTHS FOR HEALTH WORKERS

DERBYSHIRE NHS staff are fatigued, stressed, “burned out” and morale is low, due to what has been an unrelenting and nightmarish 18 months.

Staff are dealing with the level of pressure which they would normally only see in winter in what is supposed to be the period in which NHS services usually experience their quietest period.

Much of this pressure is for services which patients could not access in lockdown and it is also patients presenting to health professionals with conditions which have symptoms similar to Covid.

Throughout the pandemic, staff have had to or chosen to put off annual leave and much-needed breaks, and the mental and physical strain they have been through is having a significant impact.

NHS leaders in Derbyshire have encouraged staff not to cancel leave and this has now been reiterated, saying “they need this time to recover”.

In Derby and Derbyshire Clinical Commissioning Group papers ahead of a meeting this week, leaders have mentioned the welfare of staff.

Leadership at Chesterfield Royal say their emergency department is under “significant pressure” and that staff feedback showed two themes – fatigue and increased sickness.

At the Derby and Burton hospitals trust, “continued” pressures have been cited, with staff speaking of “burnout, stress and increased sickness”.

The CCG says staff morale is a concern across all NHS organisations in the county and city.

Gavin Boyle, chief executive of the University Hospitals of Derby and Burton NHS Foundation Trust, said: “Usually, August is a quieter time in hospitals with lower emergency demand than at other times. But this year it’s different.

“We’ve seen urgent and emergency demand at levels we would normally experience in November and December and at the same time, we’re at full speed trying to recover the backlog of patients from wave three.

“Add into that many of you (trust staff) have rightly taken a hugely deserved break in August, so it’s an uncharacteristically challenging time.

“It’s not just the hospitals either, our GP colleagues, the ambulance services, NHS111 and Out of Hours providers have seen a big increase in demand too.”

He also said: “We’re close to 50 inpatients with Covid-19 now, a level not seen since mid-March and with a Bank Holiday and schools returning, it isn’t hard to imagine that that figure will rise during September.

“It’s also important to realise that hospitals and healthcare facilities are different because of the nature of our work. There are inevitably more people here who are clinically vulnerable in some way – so we must take extra care.”

In Derbyshire, there are thousands of patients who have been waiting more than a year for treatment for elective surgeries and treatments – deemed optional in terminology but not in practice for many.

There usually is not a single patient in the county or city who has to wait longer than a year for care.

In Derbyshire as a whole, as of June 21, the latest figures, there are 6,199 residents in the county and city who have been waiting more than a year for treatment.

In late July, Derby and Burton hospital chiefs – who oversee the lion’s share of this waiting list – predicted the staggeringly-high number of patients waiting a year for treatment may peak again next spring and take up to four years to quash.

The total waiting list for Derbyshire patients totalled more than 84,000 people towards the end of June – the most recent figures – with more than 27,000 waiting longer than four months.

CCG board papers show that staff sickness through Covid and other causes has impacted the ability to keep the urgent treatment centre on the Royal Derby Hospital site open 24 hours a day.

Leaders also say pressure at the children’s emergency department at the Royal Derby has seen a huge increase in attendances. These have been linked to concerns over RSV, a common respiratory virus that usually causes mild, cold-like symptoms, and bronchiolitis, typically causing mild respiratory illness.

Type one attendances (the most urgent) at the children’s emergency department at the Royal Derby were up to an average of 125 per day during July, compared to 94 in July 2019 – the last comparable year.

On July 8 alone the department saw 163 attendances.

This week’s CCG board reports also detail research into Derbyshire health services which stresses that they “must avoid blaming patients” when talking about pressure on the NHS. It says that “patients are trying to do the right thing”.

The report says: “Patients report a ‘wait

and see’ approach before deciding to come for help from the NHS and the choices of the service they seek help from are grounded in good faith.

“Patients understand the pressure of urgent care services and don’t use them lightly.

“Equally, patients don’t come to A&E simply because they struggle to access primary care.

“We must remember that the NHS system is complex, and we don’t make it easy, with indistinguishable terms such as ‘urgent’ and ’emergency’ meaning different things from an NHS service perspective, when the dictionary defines them very similarly.

“When children are involved, there are fewer risks taken by their parents when seeking care.”

We’ve seen urgent and emergency demand at levels we would normally experience in November and December. Gavin Boyle