{"id":49793,"date":"2021-03-11T14:34:07","date_gmt":"2021-03-11T13:34:07","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49793"},"modified":"2021-03-17T18:01:58","modified_gmt":"2021-03-17T17:01:58","slug":"what-is-being-done-to-look-after-doctors-during-covid-19-and-beyond","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/03\/11\/what-is-being-done-to-look-after-doctors-during-covid-19-and-beyond\/","title":{"rendered":"What is being done to look after doctors during covid-19 and beyond?"},"content":{"rendered":"<p><span style=\"font-weight: 400\">Covid-19 has brought disruption, uncertainty, and pressure for doctors. In the first wave we were at least galvanised by feelings of community and pulling together. But it is different now.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The second wave has brought new challenges. As the caseload of sick patients accumulates, doctors are concerned about patients whose care has been postponed as well as \u201cmissing\u201d patients\u2014<\/span><span style=\"font-weight: 400\">those who don\u2019t present at all.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In October 2020, we concluded <a href=\"https:\/\/www.scotlanddeanery.nhs.scot\/your-development\/scottish-medical-education-research-consortium-smerc\/research\/covid-19-wellbeing-study\/\" target=\"_blank\" rel=\"noopener\">phase one of a Scotland-wide study on doctors\u2019 wellbeing<\/a>, funded by the Chief Scientist\u2019s Office (Scotland)<\/span><span style=\"font-weight: 400\">.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">We interviewed and received longitudinal audio-diaries from over 100 doctors across Scotland. The data crosscut the first wave and the start of the second (June-October 2020) to form the first national level evidence base regarding doctors\u2019 experiences during the pandemic. It has allowed us to identify priorities and develop empirically informed wellbeing interventions.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Unsurprisingly, covid-19 has magnified existing challenges to doctors\u2019 wellbeing, across all sectors and grades.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The doctors we studied experienced<\/span><span style=\"font-weight: 400\"> many <\/span><span style=\"font-weight: 400\">changes at work, at home and in their educational contexts, which have impacted on all aspects of their lives.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">GPs as a group are usually reluctant to participate in this sort of study. However, a significant proportion took part in ours. They reported finding the new working practices and reduced direct patient contact during the pandemic highly challenging.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Hospital doctors too highlighted significant changes to their working practices and patient pathways, as well as increased complexity of decision-making. The cancellation of elective work and the effect this has on patients has exacerbated concerns.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Trainees also reported disruption in their educational and training environments (e.g. redeployment, cancellation of rotations and exams) and faced continued pressure in meeting curricular milestones.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Doctors across all career grades spoke of uncertainty about the future and told us they felt burnout, stressed, and anxious.<\/span><\/p>\n<p><span style=\"font-weight: 400\">However, they also reported poor access to both formal and informal support, along with a perceived stigma around their use.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">From our findings it appears that NHS employers have failed to demonstrate how much staff are valued and appreciated, especially senior doctors, who feel responsibility for trainees and other colleagues as well as patients.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The lack of being valued is amplified by the perceived removal of rest and relaxation spaces and catering which had been provided early in the pandemic.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Doctors also report reduced access to informal psychological support, after those delivering it returned to their \u201cnormal jobs\u201d and receiving less communication from senior managers.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Different doctors have different needs when it comes to accessing support, which means that a range of interventions will be required.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">However, key priorities should include institutional support for doctors; supporting psychological safety; and supporting physical safety.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">We urge for the reinstatement of rest and relaxation spaces where they have been removed and making access easier where they have not.<\/span><\/p>\n<p><span style=\"font-weight: 400\">There is clearly a need to support doctors in pandemics. It is interesting that government plans for such events miss this component.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">There is now potential for one legacy of covid-19 to be lasting support for doctors. Healthcare staff are people who should be valued, cherished and supported through difficult times. Is that too much to ask?<\/span><\/p>\n<p><em><strong>Peter W Johnston<\/strong><span style=\"font-weight: 400\"> on behalf of the <a href=\"https:\/\/www.scotlanddeanery.nhs.scot\/your-development\/scottish-medical-education-research-consortium-smerc\/research\/covid-19-wellbeing-study\/\" target=\"_blank\" rel=\"noopener\">SMERC Scottish Doctors\u2019 Wellbeing Study<\/a>.<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\">PWJ is the Interim Director the Scottish Medical Education Research Consortium (SMERC) comprising the Universities of Aberdeen, Dundee, Edinburgh, Glasgow, St Andrews and NHS Education for Scotland.<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\">The SMERC Scottish Doctors\u2019 Wellbeing Study<\/span> <span style=\"font-weight: 400\">has representation from the Universities of Aberdeen (K Gibson Smith, KA Walker), Dundee (L Gordon, GA Scanlan), Edinburgh (G Aitken), Glasgow (L Pope), St Andrews (P Cairns, JE Cecil, KB Cunningham, A Laidlaw, TR Tooman) and NHS Education for Scotland (J Ferguson, PW Johnston, J Wakeling).<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\">Funding for the Study is from the Chief Scientists Office (Scotland) and NHS Education for Scotland.<\/span><\/em><\/p>\n<p><em><strong>Competing interests<\/strong>: none declared.\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Covid-19 has brought disruption, uncertainty, and pressure for doctors. In the first wave we were at least galvanised by feelings of community and pulling together. But it is different now. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/03\/11\/what-is-being-done-to-look-after-doctors-during-covid-19-and-beyond\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":421,"featured_media":49795,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223,18907],"tags":[],"class_list":["post-49793","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers","category-wellbeing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What is being done to look after doctors during covid-19 and beyond? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/03\/11\/what-is-being-done-to-look-after-doctors-during-covid-19-and-beyond\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What is being done to look after doctors during covid-19 and beyond? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Covid-19 has brought disruption, uncertainty, and pressure for doctors. 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In the first wave we were at least galvanised by feelings of community and pulling together. But it is different now. 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