The Scottish Government acted quickly to prevent the NHS from being overwhelmed by Covid-19, but it could have been better prepared to respond to the pandemic, according to a new report from Audit Scotland.
Staff across the NHS and Scottish Government took early action during the first wave in 2020, including increasing intensive care capacity and pausing non-urgent treatment. Service innovation, such as a huge rise in video consultations, also happened within weeks and it is important these are learned from.
However, there is now a substantial backlog of patients, with NHS boards prioritising those in most urgent need. It will be hard to deal with this backlog alongside the financial and operational challenges already faced by boards.
The Scottish Government based its initial response to Covid-19 on the 2011 UK flu pandemic preparedness strategy. Scotland took part in three pandemic preparedness exercises in the years before the coronavirus outbreak.
But not all the actions identified in these exercises were fully implemented.
These included measures to ensure access to enough PPE and to quickly address social care capacity, both of which became significant issues during the first wave of Covid-19.
Covid-19 has caused or contributed to the deaths of around 9,000 people in Scotland so far. People from the most deprived areas, of South Asian origin, or of Caribbean or Black ethnicity are among those who have suffered disproportionately from the pandemic. Deaths from other causes were also higher than average at the start of the pandemic.
Stephen Boyle, Auditor General for Scotland, said: NHS staff have shown extraordinary commitment to treating and caring for Scotland’s people during a pandemic that has highlighted the need to deal with long-standing health inequalities.
“Getting the full range of health services back up and running will be challenging. But there are clear lessons to be learned from the pandemic, both in how the country could have been better prepared and in the innovation that we’ve seen. It’s essential that these advances are now retained and built upon.”
More than one million people at greatest risk from Coronavirus (COVID-19) in Scotland have had their first dose of the vaccine.
The landmark of one million was reached on Wednesday 10 February. 69 year old John Loch from Bearsden was among those vaccinated on the day the milestone was reached. The retired businessman received his first dose at NHS Louisa Jordan in Glasgow.
The programme has now reached more than a fifth (22%) of the 4.5 million people who will be offered a vaccine.
The biggest vaccination programme ever undertaken is now moving at pace through the 70-79 age group following the opening of new mass vaccination centres at Edinburgh International Conference Centre (EICC) and P&J Live in Aberdeen and other large sites across the country.
The programme remains on track to complete first doses for all those in this age group by the end of this week. Those aged 65 and over are also receiving invitations for their appointment.
Health Secretary Jeane Freeman said: “This is an important milestone in the biggest vaccination programme ever delivered in Scotland and I would like to thank everyone involved and all those who have taken up their offer of a vaccine.
“We have now given first doses to more than a million people in the groups which were prioritised to address 99 per cent of preventable deaths associated with COVID-19. These include elderly care home residents and staff, frontline health and social care workers and those who are at risk of serious harm and death from this virus.
“Scotland’s COVID-19 vaccination programme is delivering ahead of our expectations. Our aim is to vaccinate as many people as possible with both their first and second doses as quickly as possible but the speed at which we can do this depends on supply and we expect a dip in supplies UK wide towards the end of this month.
“We hope to see a significant drop in the disease due to the vaccination programme, however this will take a number of months to evaluate fully. In the shorter term, we are monitoring the uptake rate but we also have a comprehensive surveillance system in place to monitor outcome of vaccine efficacy and disease reduction.
“Each health board is working hard to get the vaccine into people’s arms as quickly as possible, and everyone eligible will be offered the vaccine as we work our way through the priority groups.”
“We continue to urge everyone to take up their appointment when they are offered one. The vaccination programme is one of three key ways we are working to beat this virus, along with our expanded testing programme to identify cases and break chains of transmission and the important lockdown restrictions everyone in Scotland must follow. All these measures work to greatest effect when they work together.”
John Loch said: “I am delighted to have received my vaccine, particularly on the day Scotland reached a million doses. It is exciting to be a part of this milestone moment.
“I would like to thank all the staff at the Louisa Jordan for being so reassuring and making the process so simple and straightforward.”
NHS LOTHIAN VACCINATION FIGURES
Lothian MSP, Miles Briggs, said yesterday: “It is positive that we have seen the number of people vaccinated increase by over 50% since the introduction of mass vaccinations centres last week.
“There are some concerns that NHS Lothian is behind other health boards in the percentage of people vaccinated, but it is important that we keep up the momentum.
“The sooner the people who are most vulnerable to Covid-19 are vaccinated the sooner we can get pupils back to school and reopen the economy with confidence.
“A huge thank you to all NHS Lothian staff working tirelessly in getting the vaccine rolled out and to members of the public for keeping social distanced to suppress the virus, whilst vaccines are rolled out.”
The first people will receive the Oxford University/AstraZeneca Covid vaccine today as the NHS expands COVID-19 vaccination programmes across the UK.
The NHS is the first health service in the world to deploy the life-saving jab, which has been authorised by the Medicines and Healthcare products Regulatory Agency (MHRA) after meeting strict standards of safety, quality and effectiveness. It is the only approved vaccine which can be stored at fridge temperatures.
The Government has secured access to 100 million doses of the vaccine on behalf of the whole of the UK, crown dependencies and Overseas Territories.
More than half a million doses are available today, with tens of millions more to be delivered in the coming weeks and months once batches have been quality checked by the MHRA. More than 730 vaccination sites have already been established across the UK and hundreds more are opening this week to take the total to over 1,000, helping those who are most at risk from Covid-19 to access vaccines for free, regardless of where they live.
UKHealth Secretary Matt Hancock said: “I am delighted that today we are rolling out the Oxford vaccine – a testament to British science. This is a pivotal moment in our fight against this awful virus and I hope it provides renewed hope to everybody that the end of this pandemic is in sight.
“Through its vaccine delivery plan the NHS is doing everything it can to vaccinate those most at risk as quickly as possible and we will rapidly accelerate our vaccination programme.
“While the most vulnerable are immunised, I urge everybody to continue following the restrictions so we can keep cases down and protect our loved ones.”
The first Oxford/AstraZeneca vaccinations will be delivered at hospitals for the first few days, as is standard practice, before the bulk of supplies are sent to hundreds of GP-led services and care homes later in the week.
More than a million people in the UK have already been vaccinated with the Pfizer/BioNTech vaccine and its roll out will continue at pace.
The Oxford/AstraZeneca vaccine can be stored at fridge temperatures, between two to eight degrees, making it easier to distribute to care homes and other locations across the UK. The vaccines will be deployed through:
hospital hubs for NHS and care staff and older patients to get vaccinated
local community services with local teams and GPs already signing up to take part in the programme
vaccination centres across the country, ensuring people can access a vaccine regardless of where they live
An army of current and former NHS staff have applied to become vaccinators, with tens of thousands having already completed their online training. These are being processed as quickly as possible and volunteer vaccinators will be deployed as more vaccine supplies become available. GPs and local vaccination services have been asked to ensure every care home resident in their local area is vaccinated by the end of January.
The MHRA, Joint Committee on Vaccination and Immunisation (JCVI) and the four UK Chief Medical Officers agreed to delay the gap between the first and second dose of vaccines to protect the greatest number of people in the shortest amount of time.
In line with the recommendations of the JCVI, the vaccine will be rolled out to the priority groups including care home residents and staff, people over 80 and health and care workers, then to the rest of the population in order of age and risk, including those who are clinically extremely vulnerable.
82 year old dialysis patient Brian Pinker received the first vaccination at Oxford’s Churchill Hospital at 7:30 this morning. The foundation hospital is barely a mile from the research labs where the breakthrough vaccine was discovered and developed last year.
There are more than 730 vaccination sites across the UK – and all will be rolling out the new vaccine over the coming days.
Patients in Tayside have been among the first in Scotland to receive the Oxford/Astrazeneca coronavirus (COVID-19) vaccine.
The vaccine was approved for use in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA) on 30 December and is being made available to distribution centres through the country.
NHS Tayside is rolling out the vaccines through GP practices in the community, while continuing to vaccinate elderly residents and staff in care homes.
The Astrazeneca vaccine was procured on behalf of the four nations by the UK Government, who have ordered 100 million doses, of which Scotland will get 8.2% based on its population.
As with the Pfizer vaccine, this second vaccine provides an important additional layer of protection to all adults but particularly those most at risk from serious illness and death from COVID-19. With age as the greatest risk factor, the Joint Committee on Vaccination and Immunisation (JCVI) have retained the same phase 1 priority list for both vaccines.
The priority now is to vaccinate as many people with their first dose as quickly as possible, working through that priority list and the advice that the second dose for both vaccines can be given up to 12 weeks after the first means we can maximise this protection quicker than planned. The second dose remains critical for longer term protection and to complete the course.
Health Secretary Jeane Freeman said: “Seeing the Astrazeneca vaccine being administered to people in the community aged over 80 is a good way to start the New Year and I’m grateful to everyone in NHS Tayside and boards across the country for their work in preparing for the delivery of this newest vaccine.
“Oxford AstraZeneca has the advantage of being much easier to store and transport, which means it is easier to administer in local settings. We are also expecting to receive it in significantly larger quantities than the Pfizer vaccine.
“When it is your turn to be vaccinated you will be contacted by your local health board and I urge you to please take up the offer.
“While vaccination is one of the most important tools we have as we work our way out of this pandemic, we must all continue our work to suppress the virus in Scotland. This means rigorously complying with the restrictions where we live and making sure we continue to wear face coverings, maintain 2m distance from others outside our own household and wash our hands regularly.
“These three strands – following all we need to do to suppress the virus, using our expanded testing programme to identify cases and break chains of transmission and rolling out vaccination as fast as supplies allow – are the three critical actions that will see us move, step by step, to a brighter year ahead.”
Associate Director of Public Health Dr Daniel Chandler, Immunisations Co-ordinator, who is overseeing the roll out of the COVID-19 vaccination programme in Tayside said:“The efforts of our vaccination teams have been amazing and it is testament to a real whole team approach that sees the first over-80s in the general population have their jabs today in Tayside.
“The availability and mobility of the Oxford Astrazeneca vaccine gives us the opportunity to start to roll out the biggest vaccine programme that the UK has ever seen across our communities. Over-80s are the first priority group and patients will be contacted directly to attend a vaccination session.
“Today’s commencement of the community roll-out marks an important next phase in our response to COVID-19. It will act to suppress the virus in our communities to protect those who are most vulnerable, but the plea from all of us in the NHS is keep sticking with all the guidance.”
James Shaw (82), who was one of the first to be vaccinated alongside his wife Malita, also 82, said: “My wife and I are delighted to be receiving this vaccination. I have asthma and bronchitis and I have been desperate to have it so I am really pleased to be one of the first to be getting it.
“I know it takes a little while for the vaccine to work but after today I know that I will feel a bit less worried about going out. I will still be very careful and avoid busy places but knowing I have been vaccinated will really help me.
“All of my friends have said they are going to have the vaccine when it is their turn and I would encourage everyone who is offered this vaccination to take it.”
Edinburgh’s Hogmanay presents a fantastic Torchlight Moment pyro show as part of this year’s online celebrations
The dazzling Torchlight Moment is a stand-alone tribute to thank all of Scotland’s NHS and key workers who have worked so tirelessly and selflessly in 2020
The Torchlight Moment will be followed by Fare Well, the UK’s largest ever swarm drone show , narrated by an array of Scottish voices including David Tennant
After an unprecedented year, in which Covid-19 has impacted every part of society in Scotland, Edinburgh’s Hogmanay kicks off the celebrations with a heartfelt thank you from Scotland’s capital city to NHS staff and key workers throughout the country.
Opening this year’s series of virtual celebrations, the stunning multi-coloured flare display was ignited on the Esplanade at Edinburgh Castle. Historically the launchpad for thousands of fireworks lighting up the sky at midnight on Hogmanay, this year pyrotechnics came to life in a flaming tribute to NHS staff and key workers for their continued efforts throughout 2020 in keeping everyone safe and well.
Each letter depicts a different rainbow colour, taking inspiration from the rainbows Scotland the rest of the UK placed in windows and homes across the country during the past year to show support for NHS and key workers.
Over 193 custom-made flares were used to create the moment, which was facilitated by Titanium Fireworks, who have historically delivered Edinburgh’s Hogmanay firework midnight moment.
Forming part of a week-long programme of remarkable online celebrations, the Torchlight Moment will be followed by a three-part film, titled Fare Well, to be released in the three days leading up to Hogmanay.
Fare Well brings together the words of Scots Makar Jackie Kay, the music of NiteWorks from the Isle of Skye, the voices of acclaimed Scottish talent including David Tennant and the pioneering drone technology and filming of Celestial to create the UK’s largest swarm drone display.
Taking inspiration from Scotland’s land and air, the new work takes viewers on a breath-taking visual journey with the help of 150 individual drones from the Scottish Highlands to the capital city, Edinburgh – a journey that closes the year on 2020 and looks forward to a more hopeful year of 2021.
We swing aroon and turn tae the day.
We give thanks fir solidarity; Drap parcels tae food banks. Clap oor haunds frae balconies
fir the gift o’ nurses.
Jackie Kay, Fare Well, Edinburgh’s Hogmanay 2020
Charlie Wood & Ed Bartlam, Directors of Underbelly who produce Edinburgh’s Hogmanay, commented: “At the end of a year no one could have imagined, it was important that we started our week of Edinburgh’s Hogmanay celebrations with a heartfelt thank you to those across the UK who have worked so tirelessly to keep us safe during 2020.
“The NHS and our key workers have provided an immeasurable level of help and support and this Torchlight Moment sings Scotland’s gratitude with flaming torches in front one of our greatest national monuments, Edinburgh Castle.”
City of Edinburgh Council Leader, Councillor Adam McVey, said: “Edinburgh is the home of Hogmanay and this year’s digital celebrations will continue, albeit very differently.
“This is a fantastic and innovative way to pay tribute to all of our front-line workers – both in Scotland and across the globe – that have done so much to support us and keep us safe throughout this year.
“To our NHS staff and key workers – for those in the labs working on vaccines, those in food preparation and delivery, for our refuse collectors, postal workers, supermarket workers, police and so many more – we thank you all from the bottom of our hearts and hope that 2021 brings with it positive change as we battle to suppress and eradicate this virus.
Depute Leader, Councillor Cammy Day said: “We all clapped for carers and put up rainbows in our windows over the summer and now we light rainbow torches to show our enormous gratitude at the end of this year of tremendous strain on all of our communities.
“It’s wonderful to see this excellent online programme coming to life so that the undisputed Home of Hogmanay can still reach so many people around the world. It will serve as a virtual invitation for everyone to look forward to visiting us again when we’re all able to travel and live more freely in the future.”
Culture Secretary Fiona Hyslop said: “Scotland is the world-renowned home of Hogmanay and every year thousands of people, right across the globe, look forward to the spectacular of Edinburgh’s Hogmanay to welcome in the New Year.
“Although we’re not able to come together physically to bring in the bells this year, we can enjoy a fully digital programme that continues the tradition of celebrating Hogmanay with poetry, music and performance. I encourage everyone to take part in this year’s series of virtual events and celebrate Hogmanay safely at home.”
Paul Bush OBE, VisitScotland’s Director of Events, said: “The Torchlight Moment is the perfect way to kick off Edinburgh’s week-long programme of online Hogmanay celebrations while also recognising the incredibly work of our NHS and frontline workers in keeping us safe and well this year.
“By taking this year’s celebrations online, audiences around the world will still be able to enjoy the magic of Edinburgh’s Hogmanay while staying safe at home.”
NHS 24 has welcomed the appointment of new Chief Executive Jim Miller, who will join Scotland’s digital health and care service in the spring of 2021.
Mr Miller, is currently Director of Procurement, Commissioning and Facilities at NHS National Services Scotland. He will take up his appointment with NHS 24 on 5th April 2021 and over the coming months will work closely with current CEO Angiolina Foster to ensure an effective transition.
NHS 24 Chairman, Dr Martin Cheyne said: “We are delighted to be welcoming Jim Miller as our new Chief Executive to NHS 24. His appointment follows a detailed interview process which was carried out with a selection of highly experienced candidates for this senior position.
“Jim has worked in management and leadership for over 20 years and prior to joining the NHS, he led technology, data and resilience programmes in the construction and aviation sectors. He leads national organisations delivering a range of services across acute, primary and community based health and social care.
“He has also recently led strategic responses to the COVID 19 pandemic, including the building and equipping of the Louisa Jordan and establishing PPE routes across the system. I am delighted that he will be bringing this experience and talent to NHS 24.”
Health Secretary Jeane Freeman said: ”I want to congratulate Jim Miller on his appointment as the new Chief Executive of NHS 24. As the current Director of Procurement, Commissioning and Facilities at NHS National Services Scotland, Mr Miller is respected for his collaborative leadership and professionalism.
“I look forward to welcoming him into post and am confident NHS 24 will continue to deliver a high quality service under his leadership, working in partnership across the health and care system to ensure NHS 24 is fully prepared for future challenges.
“I am pleased Mr Miller will be working closely with current CEO Angiolina Foster in the coming months as he familiarises himself in his new role. I would like to thank Angiolina for the leadership she has provided and the many achievements and improvements delivered during her tenure as Chief Executive over the past four years. I wish her the very best for her retirement.”
Jim Miller said: “Joining NHS 24 is an exciting move and one which I am greatly looking forward to. NHS 24 has delivered exceptional services to the public and to the wider health and care system with its range of telephone and digital services during 2020.
“It has provided critical support to the public and the health system during the COVID pandemic and is helping to transform services through the delivery of 24/7 urgent care.
“I am delighted to have been given the opportunity to work with colleagues across NHS 24, and am looking forward to continuing to build on this success and to further develop the role of NHS 24 with colleagues and partners across Scotland.”
To protect the NHS, the UK government must abandon ‘rash’ plans for household mixing
Two leading medical journals – the British Medical Journal and the Health Service Journal – have joined forces to warn that the UK’s plan to ease Covid rules over Christmas is a “rash decision” that will “cost many lives”:
Since the UK’s first lockdown in March, the government has had one (perhaps only one) consistent message—protect the NHS.
Now, with the number of hospital patients with covid-19 again on the rise, and a third wave almost inevitable, the New Year is likely to see NHS trusts facing a stark choice: be overwhelmed or stop most elective and non-urgent work. Rather than lifting restrictions over Christmas as currently planned, the UK should follow the more cautious examples of Germany, Italy, and the Netherlands.
By and large the NHS has coped well with the additional caseload from covid-19 patients during the autumn. The second wave began to hit hospitals at the start of September. Government figures report 451 inpatients with covid-19 in England on 2 September.1 Over the ensuing 10 weeks, the numbers rose steadily and then rapidly, peaking at a reported 14 712 inpatients in England on 23 November.
If the third wave turns out to be of the same order of magnitude as the second wave, the health service should manage. But this will be the case only if the third wave starts with a broadly similar extra caseload of covid-19 inpatients as at the beginning of the second wave: around 450.
With current restrictions failing to control the virus, extrapolation suggests that the actual figure is likely to be more than 40 times higher, as we explain below. The planned relaxation of restrictions over Christmas will boost the numbers further as the NHS also struggles with the additional demands of winter.
England went into lockdown on 5 November, and the number of inpatients with covid-19 began to fall, down to 12 968 on 5 December.1 If this rate of decline had continued, the English NHS would have been on course for just under 11 000 covid-19 inpatients on 31 December.
However, in the past two weeks, despite most of the country being in tiers 2 or 3 of restrictive measures, numbers of inpatients have started to rise again. By 14 December (the latest data available) the covid bed occupancy had climbed back to 15 053.
Unless something happens to change this trajectory, hospitals in England will have just short of 19 000 patients with covid on New Year’s Eve. This figure, derived by extrapolating a straight line from 5 December to 14 December through to 31 December, would be almost exactly the same as the 18 974 peak of the first wave on 12 April.
The NHS currently has around 95 000 general acute beds. It is operating with around 10% fewer beds than a year ago as a result of infection prevention and control measures introduced to try to stop the spread of covid in hospitals.
The main effect of a further surge in covid-19 inpatients is likely to be felt most by those with other conditions. The NHS has learnt from the first and second waves and has robust plans to rapidly increase intensive care capacity, including through the Nightingale hospitals. But how are these to be staffed? A large influx of patients with covid-19, similar or greater than that seen in the autumn, can only be managed if staff and other resources are diverted from treating non-covid patients.
Having recovered much of their capacity for elective and non-urgent care during the autumn, NHS trusts in the most pressured regional health systems are already having to cancel almost all such activity because of the resurgent virus.
A substantial third wave could wipe out almost all the reductions in waiting times for elective procedures achieved in the past 20 years. Average waiting times will reach 12 months by March next year.
This will take years to recover from, at the cost of much suffering and loss of life.
The coming months are also likely to see the NHS under intense winter pressures from seasonal outbreaks of norovirus, increased admissions of frail older people, and the peak of staff absence. The NHS will also be in the middle of delivering the largest vaccination programme in its 72 year history, through already overstretched general practices and hospitals.
Even if NHS England succeeds in vaccinating all those “at risk” by Easter, this won’t be in time to prevent hospital admission and death for many during the next few months. NHS Track and Trace, which in fact has almost nothing to do with the NHS, continues to squander money on failure.
So too does the mass testing of asymptomatic people using lateral flow tests that are not fit for purpose.
London and many neighbouring counties will enter tier 3 on 16 December. However, other areas such as Kent, which has been in tier 3 since 2 December, are still seeing strong increases in hospital admissions. These measures are clearly inadequate.
Ministers are meeting on 16 December to review current restrictions for England. When they devised the current plans to allow household mixing over Christmas they had assumed the covid-19 demand on the NHS would be decreasing. But it is not; it is rising, and the emergence of a new strain of the virus has introduced further potential jeopardy.
Of particular concern is the effect on staff, many of whom have already worked through the hardest nine months of their professional lives. Levels of burnout and sickness absence are likely to exceed those already experienced.
What should be done
Members of the public can and should mitigate the effect of the third wave by being as careful as possible over the next few months. But many will see the lifting of restrictions over Christmas as permission to drop their guard. The government was too slow to introduce restrictions in the spring and again in the autumn.
It should now reverse its rash decision to allow household mixing and instead extend the tiers over the five day Christmas period. In order to bring numbers down in advance of a likely third wave, it should also review and strengthen the tier structure, which has failed to suppress rates of infection and hospital admission.
This joint editorial is only the second in the more than 100 year histories of The BMJ and the Health Service Journal. We are publishing it because we believe the government is about to blunder into another major error that will cost many lives.
If our political leaders fail to take swift and decisive action, they can no longer claim to be protecting the NHS.
At the start of 2020 there was a gathering momentum to conversations about the role of kindness and compassion in health and social care in Scotland. When COVID-19 happened, the healthcare system entered a period of rapid transformation in which many of the previously insurmountable ‘barriers’ to kindness appeared to fall away. In this context, it felt important to capture what was happening.
The courage to be kind draws on a series of reflective conversations, conducted between April and September 2020 with five medics working in different parts of NHS Scotland.
The conversations reflected on what can be achieved when there is a common purpose, and when work is underpinned by relationships and collaboration. But alongside the opportunities presented by changes in practice and a renewed focus on wellbeing, there was concern that these may be lost amidst a focus on remobilising and ‘getting back to normal’.
The voices in this report offer a particular perspective. But the depth of reflection, and the clear message about the need to ease some of the pressure in the system in order to ensure the wellbeing of staff and patients is one that resonates with many other conversations and is relevant and urgent right across the health service.
At the end of a year that has demanded so much from our health service, we hope that this report adds to our collective understanding of the impact of COVID-19.
As we look to develop this work, we would really value your thoughts and reflections, which you can share withben.thurman@carnegieuk.org or by joining the debate on twitter @CarnegieUKTrust.
Survey reveals pride in service and achievements, despite challenges
Health and Social Care staff feel a strong sense of pride in their work, a new survey has found.
The survey found that despite concerns about challenges in both their work and personal lives, staff expressed satisfaction with their lives and the majority of health and care staff continue to say they would recommend their place of work to others.
The Everyone Matters Pulse Survey, which was carried out in September saw responses from across all of Scotland’s 22 Health Boards and 30 Health and Social Care Partnerships, with more than 83,000 staff members taking part.
The survey heard about the impact of the Covid-19 pandemic on staff and their loved ones, with one in four stating they were supporting a vulnerable relative while, prior to the schools going back, one in four had school aged children at home. One in six had a family member who had been furloughed.
The survey also heard accounts of a range of measures for wellbeing support put in place around the country and staff’s appreciation of this. Initiatives included comfort zones and wellbeing packs, e-cycles so staff could travel to work without using public transport and online huddles and blogs.
Cabinet Secretary for Health, Jeane Freeman said: “We all owe a huge debt of gratitude to our health and social care workers, which is why we announced a £500 ‘thank you’ payment for NHS and care staff.
“The challenges that have been faced in our emergency response have been substantial and Health and Social Care staff have continued to remain our biggest most valuable asset in delivering excellent care and quality services. As such, now more than ever, it has been vital that we hear from staff about their experiences of work during this period.
“I have been deeply affected by the stories of some of those who have experienced change and hardship in their role and personal life. Like many of us this year, NHS and care staff have had personal worries and difficulties, but they have continued to go above and beyond in the face of these challenges to ensure that fellow colleagues and the people that they care for feel supported, safe and recognised, throughout the pandemic period.
“The commitment and pride felt across the service is truly remarkable. I expect senior leaders and managers across health and social care to reflect seriously on this report, and show appreciation and value for the efforts made by staff and their achievements.”
The 2020 Everyone Matters Pulse Survey commenced on 1 September and closed on 23 September 2020. All 22 NHS Boards and 30 Health and Social Care Partnerships (HSCPs) took part and a total of 83,656 respondents participated in the survey, accounting for 43% of the Health and Social Care Partnership workforce.
The Everyone Matters Pulse Survey was carried out by Webropol Ltd, an independent company commissioned by the Scottish Government.
Many student midwives are struggling under the weight of financial concerns, poor mental health and an unpredictable job market, according to new findings by the Royal College of Midwives (RCM).
Student midwives in England, who must pay tuition fees and take out maintenance loans to cover living costs, will have, on average, a debt of £41,000 when they qualify. Even for those who receive a training bursary, the financial future is bleak.
A staggering 91 per cent of student midwives in Scotland, Wales and Northern Ireland said their training bursaries were not enough to live on.
Gill Walton, Chief Executive of the RCM, said: “Our student midwives should not be facing a triple threat of debt, worry and an unpredictable job market Unlike other students, the demanding nature of their course mean they have little opportunity to seek part-time work to supplement their income.
“They have a longer academic year, they work nights, weekends and bank holidays, and are often on-call to go in a at a minute’s notice. They show incredible dedication to their chosen career and there is an overwhelming case to give them better financial support, and to ensure they get jobs in our NHS when they qualify.”
The pandemic’s impact on student midwives cannot be underestimated. The RCM found that 96 per cent of student midwives reported having mild or moderate mental health problems since the pandemic began.
Our survey shows that by the end of July just 36 per cent of students in their final year of midwifery training had been offered a job in the NHS. At the same time, midwifery educator numbers are not keeping pace with the rise in student midwife numbers, potentially leaving students less supported throughout their training.
Gill Walton added: “Throughout the pandemic student midwives have made enormous efforts, working in our maternity services while also continuing their studies. At the same time the pandemic has disrupted midwifery education heavily.
“Some UK governments and institutions are doing better than others, but most are selling our student midwives short. They need to step up and ensure we continue to have the best educated, best prepared new midwives in the world. They are the future carers of mothers, babies, and families and we must invest in them.”
In the midst of the pandemic, nurse Lindsay Macdonald reassures little Hannah as she carries her to the operating theatre at the Royal Hospital for Children in Glasgow. This moment was captured by Lisa Miller, photographer with NHS Greater Glasgow and Clyde’s Medical Illustration team.
It has been selected as one of 100 photos to be displayed in the National Portrait Gallery’s new exhibit: Hold Still which captures a collective portrait of the UK during lockdown and the pandemic over the past six months. Lisa’s photo was chosen out of 31,000 submissions.
Lisa Miller, photographer NHS Greater Glasgow and Clyde’s Medical Illustration team, said: “I took this shot during the height of the pandemic and it shows that in the middle of what was and still is a scary time for everyone, the comfort of a nurse to a young patient.
“I’ve been working in our hospitals throughout the pandemic and have been able to capture moments no one else has been able to. We’ve had to wear full PPE which has made it hard to focus and frame the images through the viewfinder of the camera properly but I’ve been able to expand my skill range and take portraits alongside medical photographs.”
Lisa was only allowed to submit one photograph to the National Portrait Gallery and after much deliberation sought the opinion of her mum because she would look at the image from a mother’s perspective.
She added: “We’re always in sensitive situations, dealing with patients so it’s important to build up a rapport with them to make sure they feel safe and comfortable.”
Lisa has also been shortlisted for a Sky Arts TV photo competition, with another photo of Lindsay.
The National Portrait Gallery exhibit is available to view online: Hold Still.
Nurse Lindsay said: “The picture was taken during a time, right in the middle of lockdown and staff were all adjusting to new ways of working. At that time we were not using the anaesthetic rooms to put children under an anaesthetic and parents were not able to come with children into theatre. Because seeing staff wearing the full PPE could be quite scary for some children, especially young children who can’t see your face.
“That day I was going to meet the patient at reception and bring them to theatre. That way everyone who was already in all the PPE could stay in the theatre room and cause as much little distress for the child before she went to sleep.
“I still remember Hannah, she was such a lovely little girl. I was walking up the corridor to theatre with her in my arms, as she wanted to be there rather than on the trolley. Lisa was also there waiting to go into theatre when she took the photo.
“As a nurse I believe the patient feeling safe and happy is crucial to our role, as they are going into an unknown place with people that are complete strangers to them. I am a parent myself and I completely understand that when parents are handing over the most precious thing in the world to them, they have to believe and put their trust in us that we will absolutely take care of them and make sure that they are in safe hands.”
Lisa has also been shortlisted for a Sky Arts TV photo competition, with another photo of Lindsay.
The National Portrait Gallery exhibit is available to view online: Hold Still.
