The Shielded and The Unshielded- is COVID exposing blind shield to unpaid carers in NHS workforce?
Dear Editor
Perhaps identifying the ‘clinically vulnerable’ has been one of the kindest endeavours this year. The letters of support and guidance from NHS and the NHS Volunteer Responder Scheme have been helpful. The guidance from NHS Employers for supporting working from home (1) and supporting staff with childcare responsibilities (2) are welcome initiatives. Carers UK report (2019) stated that there are 5 million unpaid carers in the UK making 1 in 7 juggling work with caring responsibilities (3). Similar data is not available for the NHS workforce. It is not known how many are unpaid carers in the NHS and how many among them are shielding.
Those who are shielding to take care of a vulnerable family member or a child have coined their own term ‘shielding by proxy’. NHS workforce is now divided into those not shielding or frontline, those shielding because of their own medical condition and those who are ‘shielding by proxy’ to take care of a vulnerable child or a family member. Although categorising can be helpful, in times of anxiety it may lead to projection of feelings of inadequacy and helplessness onto the shielded group. In the above article (4 ) doctors in shielding or 'shielding by proxy' have cited ongoing non-clinical work, but there are specialities such as palliative medicine (5) and psychiatry, where many in shielding have continued to do significant clinical work remotely without reducing their hours. Although there may be a complex interplay of guilt (4) and determination for those in shielding to continue to work and train despite challenging circumstances, guilt may also contribute to their vulnerability to projected feelings of helplessness and inadequacy from colleagues or managers. As we prepare to return to normality, it is imperative that NHS Employers, NHS Trusts and Health education bodies look into whether the return is supported and whether return to usual business blind shields them from the ongoing caring responsibilities of this workforce.
COVID has shown us that clinical and non-clinical work as well as clinical training can be safely carried out remotely. Perhaps when we recognise unpaid NHS carers, the compassion shown to those 'shielding by proxy' will pave the way for a new normal (6) in healthcare as we prepare to return to business as usual.
Rapid Response:
The Shielded and The Unshielded- is COVID exposing blind shield to unpaid carers in NHS workforce?
Dear Editor
Perhaps identifying the ‘clinically vulnerable’ has been one of the kindest endeavours this year. The letters of support and guidance from NHS and the NHS Volunteer Responder Scheme have been helpful. The guidance from NHS Employers for supporting working from home (1) and supporting staff with childcare responsibilities (2) are welcome initiatives. Carers UK report (2019) stated that there are 5 million unpaid carers in the UK making 1 in 7 juggling work with caring responsibilities (3). Similar data is not available for the NHS workforce. It is not known how many are unpaid carers in the NHS and how many among them are shielding.
Those who are shielding to take care of a vulnerable family member or a child have coined their own term ‘shielding by proxy’. NHS workforce is now divided into those not shielding or frontline, those shielding because of their own medical condition and those who are ‘shielding by proxy’ to take care of a vulnerable child or a family member. Although categorising can be helpful, in times of anxiety it may lead to projection of feelings of inadequacy and helplessness onto the shielded group. In the above article (4 ) doctors in shielding or 'shielding by proxy' have cited ongoing non-clinical work, but there are specialities such as palliative medicine (5) and psychiatry, where many in shielding have continued to do significant clinical work remotely without reducing their hours. Although there may be a complex interplay of guilt (4) and determination for those in shielding to continue to work and train despite challenging circumstances, guilt may also contribute to their vulnerability to projected feelings of helplessness and inadequacy from colleagues or managers. As we prepare to return to normality, it is imperative that NHS Employers, NHS Trusts and Health education bodies look into whether the return is supported and whether return to usual business blind shields them from the ongoing caring responsibilities of this workforce.
COVID has shown us that clinical and non-clinical work as well as clinical training can be safely carried out remotely. Perhaps when we recognise unpaid NHS carers, the compassion shown to those 'shielding by proxy' will pave the way for a new normal (6) in healthcare as we prepare to return to business as usual.
References:
1. NHS Employers 2020. Enabling and Supporting staff to work from home. https://www.nhsemployers.org/covid19/health-safety-and-wellbeing/enablin...
2. NHS Employers 2020. Supporting staff with childcare responsibilities. https://www.nhsemployers.org/covid19/health-safety-and-wellbeing/support...
3. Cares UK 2019. Juggling work and unpaid care report. http://www.carersuk.org/images/News_and_campaigns/Juggling_work_and_unpa...
4. BMJ 2020;369:m2443 doi: https://doi.org/10.1136/bmj.m2443
5. Miller S. BMJ 2020; 369:m2443:rr. https://www.bmj.com/content/369/bmj.m2443/rapid-responses
6. Maitra R. BMJ 2020; 369:m1785:rr https://www.bmj.com/content/369/bmj.m1785/rr-1
Competing interests: No competing interests