How might COVID-19 affect health services?

In this step, we’ll refer back to Carol as a part of the healthcare workforce and Kevin as a health service user. We’ll also think about the factors impacting healthcare systems around COVID-19 and mental health, using an example from Ruth and the mental health of older adults.

Carol

Carol’s experience as a healthcare worker gives some indication of the workforce issues faced by health services (and those of other key services, such as social care).

Workforce

In practical terms, both physical illness and mental distress caused by COVID-19 and working conditions can reduce the number of people able to work. We have touched on workers’ mental distress throughout, including workplace stress and the potential of developing moral injury. Carol highlighted staff shortages, while she also mentioned having new staff members joining the workforce during a rapid redeployment programme.

Positively, many staff have been redeployed to respond to COVID-19, including those coming out of retirement or moving back to clinical roles. This presents a (good) challenge to health services – to effectively deploy these people and support them in new roles.

Overall, services must contend with deploying enough staff in the right roles, while also psychologically supporting staff to be able to stay at work and feel valued. We know that helping people feel safe and secure is best done by looking after the basics and ensuring they work in safe and supported teams.

To hear more about how these issues are affecting workforces and organisations, please watch the video below from Dr. Mary Docherty, Consultant Liaison Psychiatrist at SLaM and King’s College Hospital who has been developing organisational staff support programmes during COVID-19.

Download Transcript of Mary Doherty on Staff Support (right click or tap/hold and open in new tab)

Organisation

Staff working conditions, including the right equipment, are another major consideration raised by Carol. Globally, shortages of personal protective equipment (PPE) and ventilators present a huge problem for services. This highlights the importance of clear policies and procedures, as well as a possible tension in using and preserving equipment, which has challenged supply chains. These basic issues have an enormous impact on the mental well-being of staff – if people do not feel safe, it can exacerbate all other issues.

The structuring of staff support efforts is also essential, as Carol said she didn’t feel that there was time for staff support. How do Occupational Health, Human Resources, Organisational Development, Operations, and Clinical departments collaborate to provide a robust psychological staff support offer?

Management, including organisational communications, is highly important here. Services shifted rapidly from business as usual to command-and-control critical incident leadership. This style of managing resources and services may suit emergency response, but COVID-19 has become a prolonged issue. Leadership and management adapting to new and evolving phases of the COVID-19 response will be challenging and essential.

Kevin

Kevin’s experience can help us to think more about access to and provision of healthcare.

Access and provision

Notably, Kevin raises the issue of accessing services, with a shift towards online support highlighting that people have mixed attitudes and experiences of this.

Generally, creating new services and expanding or reducing existing services has been happening at pace. There have been whole new wards and even hospitals created, increased virtual/telephone consultations, and some services have been significantly reduced.

We know that service changes can affect how people access them, positively or negatively. Meanwhile, we know that people have been less likely to present with health needs during COVID-19, perhaps based on fear of infection or a desire not to breach lockdown circumstances. One concern is that people may present later with a higher level of need.

Coupled with cancellations and reduced activity, this may have a knock-on effect as waiting times grow. Significantly, there will also be an increased need in direct response to COVID-19, with many who have been affected physically and psychologically needing ongoing support beyond the illness.

To hear more about these issues in a particular context, Ruth talks more about older adults in this video.

Download Transcript of Ruth Cairns on More on Older Adults (right click or tap/hold and open in new tab)

We can see that health services have a considerable and complex task in providing routine care, as well as responding to physical and mental health needs arising from COVID-19.

What are the most important factors for you? Please join the discussion below.