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Covid inquiry: Caring for patients without relatives’ support caused staff “strain and trauma”

BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q2509 (Published 13 November 2024) Cite this as: BMJ 2024;387:q2509
  1. Matthew Limb
  1. London

NHS staff felt the “strain and the trauma” of having to look after patients with covid-19 whose close family and relatives could not be there to offer support, NHS England’s national medical director has told the UK’s covid inquiry.1

Stephen Powis spoke on 11 November about evolving visitor guidance in the pandemic and what was at stake in trying to prevent staff, patients, and visitors from acquiring covid-19. He said, “For many staff the strain and the trauma of having to look after patients without the benefit of having close family and relatives to aid in that was really challenging, but at the same time staff were really worried about spread of infection.

“They were really worried about catching covid themselves and about people who they cared for who didn’t have covid—and, of course, visitors and others catching covid. I think it would have been almost impossible to come up with visitor guidance that would have satisfied everybody’s concerns equally.”

Powis was also questioned about the marked reduction in March 2020 in people attending hospitals for a range of conditions and many women being unable to access their preferred maternity care for fear of coming to hospital.

“We would have preferred them to come, but quite clearly some people felt that they should let the NHS get on and manage covid,” he told the inquiry. “It’s certainly a lesson for future pandemics that we should watch out for this and ensure that the public messaging is supporting people coming to hospital or to healthcare settings.”

Powis was also asked about the extent to which the effects of the pandemic on healthcare workers, such as burnout and long covid, were a continuing barrier to NHS recovery. He said that even though it was now nearly five years since the start of the pandemic, staff were “still struggling and remembering the impact of those waves and the moral injury that we know they suffered.”

No extra beds

Also on 11 November, the covid inquiry’s module on the pandemic’s effect on healthcare systems heard how in July 2020 NHS England had sought an extra 10 000 permanent beds to deal with recovery and potential future surges. But the request was refused by Boris Johnson’s government.

Amanda Pritchard, who was NHS England’s chief operating officer from 2019 until she became chief executive in August 2021, said, “It was very disappointing, because what it meant in practice was [that] we could now be in, I think, a very different position on elective recovery. If we had had that capacity we could certainly have treated thousands more patients . . . as well as being more resilient going into the second wave and into winter more generally.”

Prichard said that the government had effectively wanted the NHS to make more use of the seven temporary Nightingale hospitals that were built in England to treat patients with covid. She was asked whether the £358.5m spent on the Nightingales had been a useful resource given that they were little used to treat covid.

“Yes, is the simple answer,” she said, adding that the beds were set up as a contingency to be prepared for a situation like that in northern Italy, where services had been overwhelmed. “So, the fact we didn’t actually need to open them at scale in the first wave was a sort of huge relief.”