Through the visor: Reflecting on member experiences of the COVID-19 first wave

Report
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Authors:
British Geriatrics Society
Dr Claire Copeland
Sally Greenbrook
Topics:
COVID-19, Education, Training and Careers, Workforce
Date Published:
01 March 2021
Last updated: 
01 March 2021

This report summarises the findings of a BGS member survey describing the experiences of working through the first wave of the COVID-19 pandemic. With respondents representing over twenty different professions working in acute, community and primary care, it is believed to be the only survey capturing the full breadth of multidisciplinary health professionals’ experiences caring for older people across the four nations. A follow-up report, Through the visor 2: Further learning from member experiences during COVID-19, is also now available.

Foreword 

Pressure on the workforce providing healthcare for older people is nothing new. We have known for many years that we are not training enough people to care for our rapidly ageing population and this is something that BGS has long been concerned about. The COVID-19 pandemic has exposed workforce shortages and challenged healthcare professionals in ways we could never have imagined. A highly contagious virus that affects older people more than any other population group has meant that BGS members and their colleagues have faced situations beyond what they could have trained for or anticipated.

When we set out to conduct this survey, we were in what has turned out to be the calm between storms. The first wave of the pandemic had come to an end and although some areas were starting to see the second wave take hold, many told us that their services were returning to normal. While many of the concerns detailed in this report are about the practical aspects of managing a pandemic such as access to personal protective equipment (PPE) and COVID testing, the toll that the pandemic has taken on the physical and mental health of our members is obvious.

The toll that the pandemic has taken on the physical and mental health of our members is obvious."

We will conduct another survey in the Spring of 2021, and we hope of course that the practical concerns will have been ironed out by then, perhaps replaced by new concerns about vaccinations, recovery and the backlog of non-COVID cases. But it is clear to us that the emotional wellbeing of our membership will be an ongoing theme.
 
Through this report, we outline what BGS members told us about their experiences of working through the pandemic and how the BGS will respond to some of the concerns raised. We are a small organisation and we can’t fix everything but we can make a start to support the needs of our members over the coming months and years. It will be important for Governments, the NHS and social care employers across the UK to take significant and sustained action over the coming years to support the recovery of the health and social care workforce. It is vital that this issue is taken seriously to mitigate the chances of a mass exodus of staff across health and social care. The pandemic also exposed years of failings by successive Governments to address the crisis in social care. While an independent taskforce on adult social care has recently reported in Scotland and the Welsh Government have published a White Paper outlining their plans for social care, despite decades of promises, there has been no progress on a sustainable solution for social care in England. It is essential that this is prioritised by the Government, especially as it is highly likely that the number of people requiring social care support will increase in the wake of the pandemic.
 
What has come out more clearly than anything in this survey is the dedication and passion of BGS members across the four nations and across disciplines in caring for our older population. We thank you for your commitment and the sacrifices that you and your families have made during this most challenging time.
 
Dr Jennifer Burns Dr Claire Copeland
BGS President BGS Vice President for Workforce

Executive Summary

As the country moved out of the first wave of the COVID-19 pandemic, the British Geriatrics Society (BGS) issued a survey to its members with the ambition of understanding more about their experiences of working through the pandemic and what their concerns are going forward. 

This is the only survey that has been carried out across the four nations of the UK which captures the views of the multidisciplinary team working with older people across various acute, community and primary care settings. The survey was carried out over a five week period in October and November 2020 and attracted 425 respondents.

Respondents told us about the practical experiences of working through the pandemic, including variable access to PPE and COVID testing for both staff and patients and the challenge of negotiating a pandemic where guidance was changing all the time. The pandemic shone a light on the challenges faced by care homes across the country, with often devastating consequences for care home residents and staff. Members told us about the difficulties faced by care homes and in particular the issues surrounding discharge of care home residents from acute hospitals back to care homes and the varying requirements for these patients to have negative COVID tests prior to discharge.

A majority of respondents reported that they were either redeployed during the pandemic or had changes made to their job plan or rota. This took a range of forms including working in a different setting, covering COVID wards, acting up to take on more responsibility or changing working hours to help respond to the pandemic. Many respondents commented that they were covering for sick colleagues. A significant number of people told us that they took time off during the first wave of the pandemic and a majority of those tested positive for COVID.

By far the most prominent theme to come out of the survey is the significant mental and emotional toll that working through the pandemic has had on BGS members and their families. Respondents told us about experiences of dealing with excessive death and the lack of escape from the pandemic outside of work as it engulfed society. Feelings of sadness and exhaustion were evident in many of the free text responses throughout the survey.

The survey was conducted towards the end of the first wave of the pandemic and respondents shared their concerns about preparing for the second wave and how BGS could support them through this period and beyond. The need for psychological and peer support for members came through strongly as did a need to provide support to trainees, in particular addressing missed training opportunities throughout the pandemic.

The actions BGS will take to address the issues coming up through the survey are set out at the end of each section of this report. We will also conduct a follow-up survey in late Spring 2021 to establish what has changed since the end of the first wave and which themes have persisted through the second wave. 

Introduction

The impact of the COVID-19 pandemic on the UK’s older population has been profound, with 90% of COVID-19 deaths occurring in those aged over 65. It stands to reason, therefore, that healthcare professionals caring for older people will be among those most affected by the pandemic. 

In order to explore and capture the impact of the pandemic on healthcare professionals working with older people, the BGS conducted a survey of its members. We believe it to be the first survey to capture the views of professionals providing health and social care for older people across the four nations of the UK and across a range of settings including acute and community hospitals, primary care and care homes. 

The survey was open to BGS members over a five-week period from 2 October 2020 to 9 November 2020. The survey was conducted through SurveyMonkey, which facilitated binary yes/no questions and analysis. Many of the questions also offered a free text option to allow people to expand on their answers and share their experiences.

We appreciate that, since conducting this survey, the situation with the pandemic has moved on, with many areas facing more challenging circumstances than they did during the first wave. These survey results are a reflection of the first wave of the pandemic. We intend to run another survey during Spring 2021 to gauge how things have changed for BGS members through the second wave of the COVID-19 pandemic.

The report outlines what our members told us about their experience of working through the first wave of the pandemic and what the BGS intends to do to address some of the concerns raised. It must be acknowledged however, that the BGS is a small organisation with limited resources. In outlining how we are going to respond to the concerns raised in the survey, we have identified action we can take which is practical and helpful while also being realistic and within our means.

About our respondents

We received 425 replies from across the four nations of the UK along with a handful of responses from countries outside the UK. Out of the UK responses, 65% were from England, 27.6% from Scotland, 4.8% from Wales and 2.6% from Northern Ireland.

The biggest group of respondents by profession were consultants in geriatric medicine (35.7%), followed by registrars in geriatric medicine (23.4%). Out of our nurse and AHP members, physiotherapists were the largest group responding (6.5%), followed by specialist nurses (6%).
 
The majority (65.8%) of our respondents reported that they worked in an acute hospital with a significant number of people (15.7%) answering ‘other’. Many of those who answered ‘other’ explained that they have roles in intermediate care or work in an integrated role working across acute and community services.
 
The majority of respondents (80.3%) identified as white or Caucasian with the second biggest ethnic group identified as Asian or Asian British (12.5%). A further 3% identified as being from mixed or multiple ethnic groups and 2.1% identified as Black, African, Caribbean or Black British.
 
68.8% of respondents stated that they worked fulltime with 26.3% saying that they worked less than fulltime. 4.6% chose the ‘other’ option and described various flexible working arrangements that they have arranged with their employers.

Results and analysis

To read the results and analysis of the survey, including direct quotes supplied by BGS members as well as actions for BGS, please download the PDF of the report here.

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