Nursing staff must get support they need in this second wave
AFTER a short period of recovery, it is now clear that we have entered a second phase of the Covid-19 pandemic. The greater restrictions which have been brought in may be slowing the rise in new confirmed daily cases in Scotland. However, the number of new cases remains extremely high.
After an initial concentration amongst young age groups, these cases are now affecting older and more vulnerable people and cases and deaths in our care homes have returned. The pattern we saw in March and April of wards filling up, ICUS reaching capacity and staff absence increasing is already being repeated. In some Tier 3 areas we are hearing reports of up to 25 per cent of staff already off sick or isolating as we enter November.
This second phase is different to the spring for several reasons.
Our health and care staff have already been through the first crisis; they are exhausted, emotionally drained and significantly, this time they know what is coming.
Winter brings the added pressure of seasonal infections, such as flu and norovirus, and significant additional demands on health and care services.
Urgent non-covid and elective services are being maintained and there is an increased flu vaccination programme to be delivered.
Within care homes the movement of staff is to be restricted and agency staff will need to selfisolate for 14 days when moving between homes.
In addition, NHS boards are also gearing up to deliver a mass vaccination programme for an expected Covid-19 vaccine.
Workforce shortages were having a major impact on staff morale, mental wellbeing and patient safety before the pandemic and in our last member survey showed a third of nursing staff were considering leaving the profession.
Staff are being spread more thinly with a reduction in skill mix within nursing teams
All of this leads to serious questions over where the workforce is going to come from to care for increasing numbers of Covid-19 patients, to cover staff sicknesses, to support care homes, while at the same time delivering an enhanced flu vaccination and potential Covid19 vaccination programme.
Additional funding announced for the NHS and social care in the winter preparedness plans is always welcome but funding alone is not the solution and these plans are coming too late, the pressure is already on and staff shortages are a daily reality.
Staff are being spread more thinly with a reduction in skill mix within nursing teams – at a time when the acuity of patients in hospital wards is high and the clinical skills and expertise of registered nurses are essential to meet the complex needs of these patients.
Mass vaccination cannot be delivered by already over-stretched nursing staff alone. A multidisciplinary workforce, that doesn’t impact on other essential services, needs to be identified and trained to support the increased flu vaccination programme and the Covid-19 vaccination programme currently being planned.
NHS boards must have the flexibility to prioritise services, rather than dilute the skill mix of nursing teams. Care homes need to have access to workforce support.
It must not be forgotten that the Health and Care (Staffing) (Scotland) Act 2019 should ensure that the NHS and care homes are supported to deliver safe, quality care. We are calling for work on implementing the Act to get under way again. This legislation is urgently needed to address the workforce crisis across health and social care in a sustainable way and to ensure the needs of patients and residents are met.