Covid-19: NHS staff need time to recover and prepare for second wave of coronavirus – Dr Lewis Morrison

Anyone impatient for the lockdown to end needs to realise that health staff may not be able to tackle a second wave of coronavirus effectively if they are exhausted and short on numbers, writes Dr Lewis Morrison

NHS staff need time to recover, not just catch their breath, with the coronavirus outbreak putting them under huge pressure, says Dr Lewis Morrison (Picture: Steve Parsons/PA Wire)

As Scotland takes its first steps towards releasing lockdown, knowing what’s next, in this time of uncertainty, is difficult. And that’s no different in healthcare.

This week does seem like a chance to pause for breath, in advance of the first tentative moves towards something that seems more like normal life. But the seemingly more rapid change in some parts of the UK, including statements about NHS services, might well raise the question why are we being so cautious in Scotland?

Two months ago, we faced a peak in Covid-19 infections, but the decline in new cases, intensive care admissions and deaths (each one a tragedy), has been long and slow. But it seems very clear now: had we not implemented lockdown it would have been much worse and gone on much longer.

We’re in a Covid-19 routine now. It’s not normal, but we’ve got used to the PPE, sporadic new cases and long recovery times. Those on the frontline have, however, been under huge pressure, and the normalising of that doesn’t diminish the cumulative impact on us. We don’t just need a pause for breath, we need to recover. This may happen again, and the NHS will not be able to tackle it effectively with an overworked, exhausted and depleted workforce.

Across healthcare, from general practices, to outpatients, X-ray departments, operating theatres and wards, thoughts are now also turning to how we start restoring those services, given how much of what we normally do isn’t being done, is postponed, or is happening more slowly. We know this is having a real impact on people who are waiting for treatment – so it is vital we try to get as many NHS services as we can back on track. But we have to do this in a balanced and cautious way. Everyone needs to understand it’s a massive task which will take several months to fully complete. That might seem strange when we completely reconfigured the NHS in general practice and hospitals in the space of a few weeks. But we can’t just turn the clock back to early March.

Remembering where we came from – an NHS with high nursing, medical and other staff vacancies, under enormous clinical pressures and with some very high-profile cases of poor workplace culture – doesn’t make going back desirable. We must do better, and aim for an NHS in Scotland which works better for patients and the workforce.

And so if there’s an answer to the “why so cautious” question, it’s all these reasons. Some of what we’ve done in response to Covid-19 must remain – we have learned how to better use technology in healthcare in a hurry for example. Telephone assessments and virtual clinics have become an everyday part of working right now and I suspect a lot of that will continue. But healthcare is by its very nature “hands on”. Restarting all those physical clinical encounters, in a safe way for patients and staff, is a truly herculean task. It’s going to be slower, with PPE in place for a long time to come, extra cleaning, extra space, and so on.

So, it’s going to take time, it will need everyone’s patience, and many will have to wait longer than we would all like for appointments and treatment. Kindness in these strange times has been so important. Saying thank you matters. Being patient is hard, but for the foreseeable future we’re all going to have to keep being patient. For those using the NHS over coming months and our staff, I thank you in advance for that.

Dr Lewis Morrison is chair of BMA Scotland

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