Abstract
To identify the experiences and concerns of health workers (HWs), and how they changed, throughout the first year of the COVID-19 pandemic in the UK. Longitudinal, qualitative study with HWs involved in patient management or delivery of care related to COVID-19 in general practice, emergency departments and hospitals. Participants were identified through snowballing. Semi-structured telephone or video interviews were conducted between February 2020 and February 2021, audio-recorded, summarised, and transcribed. Data were analysed longitudinally using framework and thematic analysis. We conducted 105 interviews with 14 participants and identified three phases corresponding with shifts in HWs' experiences and concerns. (1) Emergency and mobilisation phase (late winter-spring 2020), with significant rapid shifts in responsibilities, required skills, and training, and challenges in patient care. (2) Consolidation and preparation phase (summer-autumn 2020), involving gradual return to usual care and responsibilities, sense of professional development and improvement in care, and focus on learning and preparing for future. (3) Exhaustion and survival phase (autumn 2020-winter 2021), entailing return of changes in responsibilities, focus on balancing COVID-19 and non-COVID care (until becoming overwhelmed with COVID-19 cases), and concerns about longer-term impacts of unceasing pressure on health services. Participants' perceptions of COVID-19 risk and patient/public attitudes changed throughout the year, and tiredness and weariness turned into exhaustion. Results showed a long-term impact of the COVID-19 pandemic on UK HWs' experiences and concerns related to changes in their roles, provision of care, and personal wellbeing. Despite mobilisation in the emergency phase, and trying to learn from this, HWs' experiences seemed to be similar or worse in the second wave partly due to many COVID-19 cases. The findings highlight the importance of supporting HWs and strengthening system-level resilience (e.g., with resources, processes) to enable them to respond to current and future demands and emergencies.
Highlights
The global spread of a novel coronavirus SARS-CoV-2 since late 2019, causing the disease COVID-19, has had a profound impact on societies, healthcare systems, and health workers (HWs) across the world
The findings highlight the importance of supporting HWs and strengthening systemlevel resilience to enable them to respond to current and future demands and emergencies
Qualitative studies conducted with HWs in the UK during the early months of the pandemic identified concerns at the time; these included: inadequate access to personal protective equipment (PPE) and COVID-19 testing; rapidly changing and inconsistent guidelines; a lack of training; communication challenges; increased workload and rapidly changing work conditions [7–12]
Summary
The global spread of a novel coronavirus SARS-CoV-2 since late 2019, causing the disease COVID-19, has had a profound impact on societies, healthcare systems, and health workers (HWs) across the world. Previous research has highlighted the importance of qualitative research as a way to understand the experiences and evolving concerns of frontline HWs and patients, and help make improvements impacting on healthcare delivery [4–6]. Following the first wave of COVID-19, calls were made to learn lessons for future waves and pandemics [21–23] Notwithstanding these calls in autumn 2020 the numbers of COVID-19 cases and deaths rose again, eventually exceeding those from the first wave [3], mounting further pressure on an overburdened healthcare system and HWs. HWs are a critical workforce and understanding their experiences and needs, and how to support them, is important from a moral perspective and to enable ongoing functioning of health services
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