National Health Service Workers Research Articles

Absenteeism Among National Health Service Workers During the COVID-19 Pandemic in Portugal

By March 2020, the first COVID-19 cases were detected in Portugal. Anecdotal evidence showed that the National Health Service absenteeism rate rose. The present study aimed to quantify and characterize the absenteeism rate among these healthcare workers during the COVID-19 pandemic in Portugal. This study used data from the Portuguese National Health Service Transparency Portal for the number of National Health Service workers and absence days (2015 - 2021). Absenteeism was compared, before and after the pandemic onset, in absolute terms, and as absenteeism rates. Additionally, we performed an interrupted time series analysis, by fitting a Poisson regression model with level change. We controlled for data seasonality using Fourier terms. The results showed that, between 2015 and March 2020, the average monthly absenteeism rate was of 12.2%, rising to 14.5% in the subsequent period. This represented an increase of 19% in the absenteeism rate. The interrupted time series analysis showed an increase of 10.8% in the National Health Service absenteeism rate after the pandemic onset [relative risk = 1.10; 95% CI 1.10 - 1.11; p < 0.01]. When accounting for seasonality in the data, the interrupted time series analysis showed an increase of 11.0% in the National Health Service absenteeism rate [relative risk = 1.11; 95% CI 1.00 - 1.23; p < 0.05]. These results suggest an increased number of days of absence rate among the National Health Service healthcare workers during the COVID-19 pandemic.

COVID-19 impact on childhood vaccination attitudes in pregnant antenatal class attendants in Rome

Abstract Background The COVID-19 pandemic caused a decrease in vaccination rates, impacting vulnerable populations such as pregnant women (PW), who concern about future children’s immunisations. The aim of this study was to assess whether the pandemic led to changes in childhood vaccination attitudes among PW attending antenatal classes at the Fondazione Policlinico Universitario A. Gemelli in Rome. Specifically, it assessed the impact of the pandemic on the perceived usefulness of information sources, their trust in healthcare workers (HCWs) and the National Health Service (NHS), their perception of the risk of infection and severity of vaccine-preventable diseases (VPDs), and their vaccination intentions. Methods A repeated cross-sectional study was conducted across three flu seasons by administering an anonymous questionnaire: one before and two during the pandemic. Intention to vaccinate children was expressed as the percentage of PW who selected each vaccination from the questionnaire. Trust in HCWs and the NHS, and perception of the risk of infection and severity of VPDs were expressed as the percentage of PW who answered “quite” or “very”. For the usefulness of information sources, mean scores were calculated. To assess differences of the three periods a chi-square test was performed (p = 0.05). Results Course attendance surged from 105 to 340. Significant shifts in vaccination intentions were noted: 7.5% and 10% decreases for measles (p = 0.02) and pertussis (p = 0.004), respectively, from 2019-20 to 2020-21. Perceived contagion risk decreased, but perceived disease severity increased. A significant reduction in the proportion of PW suspecting economic interest behind NHS workers promoting vaccination, and an increase in the perceived usefulness of non-institutional websites and of the advice from non-NHS physicians were noted. Conclusions PW’s attitudes towards vaccinations might have been modified by COVID-19 pandemic, regarding risk perception and trust in NHS HCWs. Key messages • Our findings suggests that PW’s attitudes towards childhood vaccinations might be modified by the COVID-19 pandemic, in particular risk perception and trust in NHS healthcare workers. • These findings could help Public Health to develop evidence-based interventions and communication strategies, to maintain vaccine confidence and mitigate potential adverse effects.

Disrupted Candidacy: A Longitudinal Examination of the Constrained Healthcare-Access Journeys of National Health Service Workers in Scotland Seeking Supports for Long COVID Illness.

Evidence examines how persons experiencing Long COVID (LC) struggle to secure healthcare for symptoms. However, few studies examine healthcare workers experiencing LC, nor the complex and multiple difficulties faced when seeking and receiving healthcare. This study is based on two phases of longitudinally conducted qualitative interviews, 6 months apart, with National Health Service (NHS) workers experiencing LC, from different occupational roles at NHS locales in Scotland (first interviews, n = 50; second interviews, n = 44). Multiple factors restricted healthcare access, including worries about pressuring the NHS and concerns over LC being legitimised. When healthcare was sought, workers struggled to secure support, referrals and treatment. The following reasons were included: (1) context: the restrictive pandemic healthcare context; (2) illness climate: low GP knowledge surrounding LC and how this could be treated, trends for ascribing symptoms to other causes and reluctance to diagnose LC; (3) sense-making of LC: healthcare availability linked to occupational role identity. To visualise and examine healthcare barriers, candidacy theory is applied, drawing inferences between healthcare context, illness climate, sense-making and identities. NHS workers' complex journeys represent Disrupted Candidacy, intersecting challenges across candidacy domains, restricting the seeking and receiving of LC healthcare. Findings provide insights into why NHS workers resisted and withdrew from healthcare-seeking, and the barriers they faced when attempting to secure LC support. This study presents a pathway for future LC illness research to use a modified candidacy theory framework. This research focuses on amplifying and learning from lived experiences, and the voices of NHS workers in Scotland experiencing LC. Interviews represent primary data for this study; thus, participants and their healthcare journeys are centred in this research and all aspects of production, reporting and output. Explicit discussions of stakeholder group involvement are highlighted in the methods section.

Treating Tobacco Dependency in National Health Service Workers in Greater Manchester: An Evaluation of a Bespoke Digital Service

IntroductionTreating tobacco dependency in National Health Service (NHS) workers delivers substantial benefits at an individual, population, and health care system level. We report the outcomes from the Greater Manchester Integrated Care Partnership’s tobacco dependency treatment program for NHS workers which includes 6-months’ access to behavioral support and 12 weeks of treatment through a digital application. MethodsAggregate results for all participants across the program from January 1, 2022, to September 1, 2023, are reported including a deep-dive evaluation of 300 participants recruited to provide chemically validated outcomes. ResultsA total of 1567 NHS workers participated in the program within the evaluation period, completing 24,048 sessions with specialist advisors within the application, ordering 18,710 nicotine vape liquids, 6927 nicotine patches, and 297 short-acting nicotine products. Users reported achieving 89,464 smoke-free days, 1,258,069 less cigarettes smoked, and a financial saving of £622,231. The deep-dive evaluation revealed a CO-verified 12-week abstinence rate of 37% (111 of 300). ConclusionThis evaluation provides assurance of clinical effectiveness within a bespoke digital tobacco dependency treatment program for NHS workers across an Integrated Care Partnership.

Culture of presenteeism: emergent perspectives from an NHS-workforce convenience sample.

The United Kingdom's National Health Service (NHS) has been under strain for more than a decade, which has been exacerbated by the 2019 coronavirus disease (COVID-19) pandemic. According to NHS staff, this is felt especially during the winter (also called 'winter pressure'), when both absenteeism and presenteeism rates are high in the healthcare workforce. To understand the culture of presenteeism amongst NHS staff, focusing specifically on how presenteeism both persisted and changed during the COVID-19 pandemic and during periods of annual winter pressure. Data for this study were derived from 20 in-depth interviews conducted with NHS staff, drawn from a convenience sample of primary- and secondary-care services. Interviews were guided by a semi-structured interview protocol. This study contributes to an understanding of presenteeism by describing the ways in which the practice both changed and, in some ways, stayed the same during COVID-19 self-isolation regulations, with remote work arrangements enabling some healthcare workers to continue working even when unwell. Despite this, isolation guidelines threw into stark relief NHS workers' deeply held beliefs about duty, service, and commitment to the wider healthcare system, while exposing their experiences and perceptions of profound systemic challenges and a lack of wider support to carry out their work. The emergent findings from this study suggest that the culture of presenteeism is linked to wider NHS staff's identification with the institutional goals of the NHS, resulting in their motivation to continue working, even if remotely; yet, the consequences are not fully understood.

Staff well-being in UK children’s hospices: a national survey

ObjectivesPoor psychological well-being among healthcare workers can have numerous negative impacts, but evidence about levels of burnout in children’s hospice care staff is limited. This study aimed to determine the...

Critical Reflections on the COVID-19 Pandemic from the NHS Frontline

The COVID-19 pandemic fundamentally changed the way we live, work, and interact with each other. Nowhere was the pandemic more profoundly experienced than on the frontline of healthcare. From overwhelmed Intensive Care Units to shortages of Personal Protective Equipment (PPE) and clap for carers, the UK’s National Health Service (NHS) became the focal point for the pandemic response. Utilising data from online survey responses (N = 16) complemented by four online interviews and one face-to-face interview (N = 5) with NHS workers primarily during the height of the pandemic, this article offers a preliminary analysis on the challenges the UK’s healthcare workers faced through working in conditions of crisis management. The article particularly addresses NHS workers’ amplification of fear, anxiety, and exhaustion; the absence of widespread solidarity; and implications of the absence of coherent governmental messaging upon the workforce. We situate this discussion within a critical account of neoliberal political economy, the theoretical framework of social harm, and the absence to explicate the harmful conditions of the pandemic’s frontline. While the data are confined to the UK’s NHS workers, its findings are relevant to other countries across the world that enacted similar responses to deal with COVID-19.

Absence among National Health Service workers during the COVID-19 pandemic in Portugal

Abstract Background By March 2020, the first Covid-19 cases were detected in Portugal. While the National Health Service (NHS) faced an increased demand for health care, anecdotal evidence showed that the NHS absenteeism rose. This might be explained by outbreaks in healthcare units, COVID-19 infection due to close contact with patients, self-isolation and quarantines, and family challenges originated by lockdowns. The present work aimed to quantify the absenteeism among NHS workers during the COVID-19 pandemic in Portugal. Methods This study used data for the number of NHS workers and absence days (2015-2021), from the Portuguese NHS Transparency Portal and the Strategy and Planning Office. Absenteeism was compared, before and after the pandemic onset, in absolute terms, and as absence rates (number of absent days as a percentage of potential workforce days). Additionally, we performed an interrupted time series analysis, by fitting a Poisson regression model with level change. We controlled for data seasonality using Fourier terms (pairs of sine and cosine functions). Results From 2015 until March 2020, the average monthly absence rate was of 12.2, rising to 14.4 in the remaining period. This represented an increase of 18% in the absence rate. The interrupted time series showed an increase of 10.8% in the NHS absenteeism after the pandemic onset [Relative risk =1.10; 95% confidence interval (CI) 1.10-1.11; p < 0.01]. When accounting for seasonality in the data, the model showed an increase of 11.0% in the NHS absenteeism [Relative risk =1.11; 95% CI 1.01-1.22; p < 0.05]. Conclusions These results highlight the excess of absence days among the NHS workers during the COVID-19 pandemic. In future healthcare crises, health professionals should be protected, by assuring a safe workplace and making protective equipment available. Only then will be possible to reduce constraints in healthcare assistance, guarantee the adequate response, and contain the absence costs. Key messages

’We weren't checked in on, nobody spoke to us’: an exploratory qualitative analysis of two focus groups on the concerns of ethnic minority NHS staff during COVID-19

ObjectiveTo gain exploratory insights into the multifaceted, lived experience impact of COVID-19 on a small sample of ethnic minority healthcare staff to cocreate a module of questions for follow-up online...

Slip-resistant footwear reduces slips among National Health Service workers in England: a randomised controlled trial

ObjectivesAssess the effectiveness of 5* GRIP-rated slip-resistant footwear in preventing slips in the workplace compared to usual footwear (control group).MethodsA multicentre, randomised controlled trial; 4553 National Health Service (NHS) staff...

Age profile of NHS workers in occupational physician clinics

The population in the UK is predicted to increase in size and age. The National Health Service (NHS) is the largest employer in the UK and demographic changes in the working population would be expected to be reflected in the NHS workforce. Such changes may present different challenges to an NHS occupational physician (OP). To evaluate how the age profile of an NHS workforce is reflected in referral patterns, diagnoses and occupational outcomes for workers assessed by OPs. NHS workers employed by a large acute Trust who were referred to an OP for assessment during 2011-12 were identified. Occupational health data relating to their assessment were analysed to investigate relationships with age. Seven hundred and two workers were identified; they were from all staff and age groups employed by the NHS Trust. The highest referral rate to an OP was in staff aged between 41 and 60 years. There was no evidence that workers with long-term conditions assessed by an OP were likely to be older. The occupational outcome of ill-health retirement was linked to age. This study suggested that older workers, aged between 41 and 60 years, may be more likely to be referred for assessment by an OP than younger workers. The only occupational outcome linked to age was ill-health retirement, which was more likely for workers over 50 years of age.

COVID-19 confessions: a qualitative exploration of healthcare workers experiences of working with COVID-19

ObjectivesTo gain insight into the experiences and concerns of front-line National Health Service (NHS) workers while caring for patients with COVID-19.DesignQualitative analysis of data collected through an anonymous website (www.covidconfidential)...

Mixed signals about the mental health of the NHS workforce

In the past few months, media headlines regarding the mental health of the UK National Health Service (NHS) workforce during the COVID-19 pandemic have reported or predicted large-scale problems ahead—eg, “Coronavirus is whipping up a mental health storm for NHS workers”, and forecasting a “tsunami” of mental health problems having “catastrophic consequences”. A 2020 systematic review of the mental health of health-care workers during previous pandemics also suggests an increase in distress and post-traumatic stress.

Relationship between labour force satisfaction, wages and retention within the UK National Health Service: a systematic review of the literature

ObjectivesA systematic review was undertaken to understand the nature of the relationship between the UK National Health Service (NHS) labour force and satisfaction, retention and wages.DesignNarrative systematic review.Data sourcesThe literature...

COVID-19 Pandemic: Looking After the Mental Health of Our Healthcare Workers.

COVID-19 Pandemic: Looking After the Mental Health of Our Healthcare Workers.

Sedentary behaviour in NHS staff: implications for organizations.

Background Prolonged sitting is associated with an increased risk of chronic ill-health. Although high levels of sedentary behaviour are documented in desk-based workers, there are few data examining this in organizations with greater job diversity such as the National Health Service (NHS). Aims To assess the association of occupational and non-occupational sedentary behaviours with key demographic and occupational characteristics of NHS workers to help inform policy development. Methods A cross-sectional survey conducted in a large NHS teaching hospital in the north of England. Volunteer members of staff were asked to complete a web- or paper-based version of the Workforce Sitting Questionnaire. Demographic and occupational data collected included age, gender, ethnicity, educational attainment, occupational group; full-or part-time status and whether the participant reported their job as desk-based. Descriptive statistics and 95% confidence intervals were calculated to compare sedentary behaviour across demographic and job characteristics. Results Clerical and desk-based NHS workers were more sedentary at work than other colleagues. New findings identified that NHS workers aged under 30 and those without educational qualifications had high levels of sedentary behaviour outside work. After adjusting for working hours, part-time employees were significantly more likely to be sedentary. Conclusions Our results have implications for those developing strategies to reduce sedentary behaviour in the NHS workforce. Whilst standing desks have received much interest, alternative approaches may be attractive to NHS employers in reducing workplace and non-occupational sitting time. These may also be relevant to other organizations.

Preceptors' Views of Preceptorship: An Interpretative Phenomenological Analysis

Introduction: Preceptorship is a structured, supported induction period, the purpose of which is to ease the student—practitioner transition for newly qualified Band 5 National Health Service workers. The aim of this research, set in an acute hospital setting, was to explore the views of therapists on their roles as preceptors. Method: In this qualitative study, three occupational therapists and three physiotherapists participated in semi-structured interviews to identify their perceptions of the preceptor role and their thoughts on how the preceptorship programme affects preceptees' student—practitioner transitions. Interpretative phenomenological analysis identified emergent themes from the data. Findings: Three main themes emerged: valuing structured learning and reflection; the requirements of the preceptor—preceptee relationship; and the perceived impact of preceptorship on the service. Conclusion: The preceptorship programme was commended for providing a structured induction, facilitating reflective practice in newly qualified staff, and enhancing standards of clinical care for patients. It was felt that improved training in being a preceptor and ways of engaging in the process of preceptorship, along with alterations to simplify and clarify the local preceptorship programme paperwork, would benefit both preceptors and preceptees.

High performance HRM: NHS employee perspectives

The purpose of this paper is to examine National Health Service (NHS) employee perspectives of how high performance human resource (HR) practices contribute to their performance. The paper draws on an extensive qualitative study of the NHS. A novel two-part method was used; the first part used focus group data from managers to identify high-performance HR practices specific to the NHS. Employees then conducted a card-sort exercise where they were asked how or whether the practices related to each other and how each practice affected their work. In total, 11 high performance HR practices relevant to the NHS were identified. Also identified were four reactions to a range of HR practices, which the authors developed into a typology according to anticipated beneficiaries (personal gain, organisation gain, both gain and no-one gains). Employees were able to form their own patterns (mental models) of performance contribution for a range of HR practices (60 interviewees produced 91 groupings). These groupings indicated three bundles particular to the NHS (professional development, employee contribution and NHS deal). These mental models indicate employee perceptions about how health services are organised and delivered in the NHS and illustrate the extant mental models of health care workers. As health services are rearranged and financial pressures begin to bite, these mental models will affect employee reactions to changes both positively and negatively. The novel method allows for identification of mental models that explain how NHS workers understand service delivery. It also delineates the complex and varied relationships between HR practices and individual performance.

Editorial

Editorial

Electronic journal provision in a health‐care library: insights from a consultation with NHS workers

This study determines the current awareness journal reading requirements of the users of Stockport National Health Service (NHS) Trust's library. The overlap between requirements and the provision of the NHS Core Content resources, four major electronic journal bundles, and the holdings of North West health libraries is also investigated. A survey of both hospital and Primary Care Trust staff was conducted, and respondents were required to provide a list of their favourite journal titles. Each requested title was assigned a subject code, and the impact factor was noted. From 135 survey responses, 217 journal titles were identified and 33 category codes were utilized. There was little overlap between the request list and the NHS Core Content titles, but substantial correspondence existed between the request list and the print holdings of North West health libraries. Current awareness journal reading requirements will not be met by the Core Content provision alone. Bundles of titles offer value-for-money solutions, but may be at the expense of popular titles. Furthermore, the success of regional document supply schemes may be compromised if large numbers of health-care libraries replace print holdings with similar electronic journal bundles.