The rise and fall of our NHS heroes

Photo of @alitwyThe current Covid-19 pandemic has highlighted the impact of the health care staffing crisis. As of June 2021, there were 38,952 registered nurse vacancies across the health service in England. In addition, nurses are the largest occupational group impacted by Long Covid. Given this, you might imagine appropriate support would be in place to support these colleagues to return to work. However, with Long Covid Facebook groups full of horror stories it is clear support is dependent on your postcode. For nurses and midwives this is particularly unfair, or even immoral, as most caught covid at work, often due to inadequate PPE.

Long Covid terms and conditions vary across the four UK nations but until Autumn 2021 most NHS employees were on full pay while on covid related sickness and not subject to standard sickness absence management procedures. However, towards the end of 2021 this changed in England and Wales with staff no longer being guaranteed full sick pay for a prolonged period. In England, NHS England guidance states that Long Covid sick pay remains but leaves it up to Trusts to decide how this sickness should be managed. This is resulting in a postcode lottery with huge discrepancy in how staff are treated.

Evidence Based Nursing (@EBNursingBMJ) recently conducted a survey among Registered Nurses and Midwives with Long Covid working in NHS England. One hundred and thirty-four people responded, six of whom were bank staff. Tables 1-2 present data regarding the pay status for staff on a permanent contract and those on the bank. Most staff are still on full pay but worryingly 7% of participants are now on half pay with 6% on no pay. Additionally, 4% have lost their jobs and 5% resigned.

Table 1: Pay status for registered nurses and midwives on permanent contracts

Full pay (%)

Half pay (%) No pay (%) Lost job (%) Resigned (%)
All participants on permanent contract (n=128)

100 (78)

9 (7) 8 (6) 5 (4)

6 (5)

12 months or longer (n=84)

64 (76)

6 (7)

5 (6) 5 (6)

4 (5)

Less than 12 months (n=44)

36 (82) 3 (7) 3 (7) 0

2 (5)

 

Table 2: Pay status for registered nurses and midwives working on the bank

Full pay (%)

Half pay (%) No pay (%) Lost job (%)

Resigned (%)

All participants bank staff (n=6)

1 (17)

2 (33)

3 (50)

12 months or longer (n=4)

1 (25)

1 (25)

2 (50)

Less than 12 months (n=2)

0

1 (50)

1 (50)

 

Table 3 presents data about whether participants on a permanent contract are having their sickness absence managed formally. For participants working on the bank, unsurprisingly, only the person still being paid was under formal sickness absence management. Roughly half of participants on a permanent contract are having their sickness absence managed formally. Given that 57% of participants who have been off for less than 12 months are having their sickness absence managed formally compared to 48% who have been off for 12 months or longer suggests Trusts in England are beginning to start the formal sickness management process earlier in the process. This is of concern given how little we know about the long-term outcomes of Long Covid.

Table 3: Is sickness absence being managed formally for permanent staff?

Yes (%)

No (%)

All participants on permanent contract (=n=128)

65 (51)

63 (49)

12 months or longer (n=84)

40 (48)

44 (52)

Less than 12 months (n=44)

25 (57)

19 (43)

 

In Wales, current guidance states that many NHS staff will go onto half pay on 1st April 2022. For staff in both England and Wales going onto half or no pay is devastating and often comes out of the blue:

“I’m in an absolute panic about going down to half pay next month! I don’t know what we’re expected to do?!”

“I was a bit shocked as the letter [informing me I was going onto no pay at the end of the month] came out of the blue after I spoke to HR and was told there was no change.”

“I am so petrified of losing the last of what I have, and that is what I’ll lose if I go onto half pay.”

Participants who have lost their jobs feel angry at how they have been treated and at losing their career, sometimes feeling their manager would “breathe a sigh of relief” if they resigned:

“[I’m] annoyed as NHS staff should of been more protected and shouldn’t risk losing their jobs after we put ourselves and our families at extra risk.”

“The way myself and others have been treated is appalling.” 

“The unspoken preference would be for me to just resign, but I definitely do not want to do that and waste the hard work that I have put into my career.”

To address some of these issues, I set up Long Covid Nurses and Midwives UK (LCNMUK) earlier this year as a campaign and advocacy group for NHS nurses and midwives with Long Covid. Our aims are to ensure:

  1. Nurses and midwives with Long Covid in the UK receive the support they need while off sick, when returning to work and/or when leaving work.
  2. The voices of nurses and midwives with Long Covid in the UK are heard at all levels of the health service across the four nations.
  3. Long Covid is recognised as an occupational disease across the UK.

The time has come for a national strategic approach across the four UK nations supporting nurses and midwives with Long Covid. To understand the extent of the challenge each country must publish data detailing the numbers of staff with Long Covid. Once the extent of the problem is known a national plan must be put into place to support staff back to the work. Those not fit enough to return to work must have appropriate financial support. Failure to address these issues will mean substantial numbers of staff are lost from an already depleted workforce. However, more importantly, not doing so would be a denigration of duty.

What can you do to help?

  • Follow Long Covid Nurses and Midwives UK on Twitter (@LCNMUK) and Instagram (LongCovidNursesandMidwivesUK).
  • Like and retweet content we post on social media to help spread the word.
  • You might like to follow me on Twitter too (@alitwy).
  • Watch out for our website and Facebook page – coming soon.
  • Write to your MP/assembly member – watch this space for an example of a letter you could send.
  • If you are interested in supporting colleagues with Long Covid you might like to read this blog.
  • More information about working with Long Covid can be found in this literature review and at: longcovidwork.co.uk.

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