Matter for Discussion: COVID-19

Members can view a recording of the debate here.

COVID-19 is casting a shadow over the health and social care workforce. Not only are we having to cope with the emergence of long COVID, but we are also seeing an increase in mental illness and a high prevalence of infection and deaths among people from Black and ethnic minority backgrounds. 

There is growing resentment among nursing staff who volunteered - or were voluntold - to work with COVID-positive patients, including staff who are now facing redeployment as a legacy of contracting the virus. 

The UK was ill-prepared to cope with the spread and impact of COVID-19, with scandal after scandal and shocking decisions around the procurement, provision, and quality of personal protective equipment (PPE). In particular, the lack of suitable respiratory protection left staff at risk of infection from breathing in particles dispersed by COVID-positive patients. 

The UK Government’s attitude to social care in England during the pandemic has been particularly lacking. Its decision to announce a reorganisation of the English NHS while still not addressing the ‘Cinderella’ of social care is beyond belief. 

To add insult to injury, the UK Government introduced mandatory vaccination for staff working in care homes in England, rather than seeking to influence and encourage take-up. Further, the government expanded the now-repealed mandate to include all premises in England regulated by the Care Quality Commission. 

Now, despite the removal of restrictions, COVID-19 is still with us, and the risk of reinfection is ten times higher with the Omicron variant than with Delta. In the week ending 19 March 2022, the Office for National Statistics estimated that more than four million people had tested positive for COVID-19. 

The commonality of international travel surely means that the risk of future pandemics is increased. Furthermore, The Guardian (Spinney, 2021) reported that antimicrobial resistance will potentially be devastating in the future. 

Matthew et al (2021), in the Lancet, say that time will be needed to draw any conclusions about how the pandemic, lockdowns and economic instability will have adversely affected the mental and physical health of the UK population. But in Northern Ireland, an RCN publication (RCN Northern Ireland, 2021) laid bare the wide range of emotional responses to the pandemic among nursing staff. 

We need to learn from and reflect on the changes and decisions made in health and social care practice, and address any further changes needed as a result of COVID-19. As an RCN Scotland paper on the nursing workforce put it (RCN Scotland, 2022), not only must harms caused by the pandemic be repaired, the fundamental issue of under-resourcing of the workforce must be tackled head on. The point was also forcefully made by RCN Wales (RCN Wales, 2022), in its policy response to the Welsh Government’s recovery plan for health and social care. 

In particular, we need to be prepared for any future pandemics and ensure all government guidance is unambiguous and clearly aligned with the World Health Organization. All health care employers must ensure suitable and sufficient risk assessments are carried out and robust control measures implemented, including access to relevant PPE. With high numbers of nursing staff leaving the profession owing to long-COVID, burnout or low pay and morale, what can the RCN do to help stem the loss?

Reading lists for each agenda item can be found here.

References

The Guardian (Laura Spinney 15 February 2021) The next pandemic? It may already be upon us. https://www.theguardian.com/commentisfree/2021/feb/15/creating-conditions-next-pandemic-antibiotics

Office for National Statistics Coronavirus (COVID-19) Infection Survey, UK: 25 March, 2022

Matthew et al (February 2021) The Lancet

RCN Northern Ireland (2021) SenseMaker. The Lived Experience of Nursing in Northern Ireland During a Pandemic 2020/2021. https://www.rcn.org.uk/professional-development/publications/sensemaker-nursing-in-northern-ireland-during-a-pandemic-2020-2021-uk-pub-009-870

RCN Scotland (2022) The Nursing Workforce in Scotland https://www.rcn.org.uk/-/media/Royal-College-Of-Nursing/Documents/Countries-and-regions/Scotland/2022/Nursing-Workforce-in-Scotland-Report-290322.pdf