Over one third of anaesthetists have low confidence in preparedness for restoring non-COVID-19 NHS services

Access to testing has improved, but significant concerns remain around personal protective equipment and anaesthetic drugs availability

The negative impact of the pandemic on anaesthetists’ wellbeing persists and must be addressed

More resources are required to enable anaesthetists to return to normal clinical work in the future

Over one third (34%) of anaesthetists have low confidence in their hospitals’ preparedness for the restoration of non-COVID-19 NHS services, according to the latest membership survey conducted by the Royal College of Anaesthetists. The survey also indicates that concern remains around sustainable supplies of personal protective equipment (PPE) and anaesthetic drugs, and access to testing, all of which will be critical to restoring NHS services.

In addition, the COVID-19 pandemic continues to significantly affect anaesthetists’ welfare and wellbeing, with over four in ten (42%) of respondents experiencing mental distress and a third feeling physically unwell during the past month.

These findings highlight the need for a measured approach to restoring non-COVID-19 NHS services in a safe and sustainable way. As the largest single hospital speciality, anaesthetists are not only at the frontline of COVID-19 care but are also integral to many other clinical services. As outlined in the recent strategy document on restarting planned surgery, sufficient resources must be guaranteed and staff and patient safety ensured before services can resume¹.

The College surveyed its full membership during a 24 hour period between 13 and 14 May 2020, and received approximately 1,500 responses from anaesthetists at all stages of their career and from across the UK. This follows on from a previous survey run in April². The new survey findings highlight areas of progress from a month ago, while still revealing some concerns among anaesthetists.

Access to testing for staff and patients has greatly increased over the last month and over three quarters of respondents are now confident that they can access testing as needed. However, it is concerning that some uncertainty remains about the ability to access testing for patients (17%), themselves (18%) and household members (31%).

Despite efforts to stabilise PPE supplies over the last month, 56% of respondents continue to feel concerned around stocks and nearly 13% are finding themselves in a position where patient care is delayed due to a lack of access to PPE. Combined with concerns around sustained supplies of anaesthetic drugs – 27% are concerned about stocks in the coming month – these findings indicate that more resources are required in restoring non-COVID-19 services.

The percentage of respondents reporting having felt mental distress in the last month remains similar to in April (which was 40%), while 21% report team morale to be low or very low, illustrating the sustained toll the pressures of COVID-19 are taking on the well-being of anaesthetists. Despite this, 31% of respondents have reported difficulties in taking annual leave during the pandemic. This raises concerns over the capacity of anaesthetists to resume normal clinical work without time to rest and recover.

Responding to the findings of the survey, Professor Ravi Mahajan, President of the Royal College of Anaesthetists said:

“As we move to the next stage of the COVID-19 pandemic, it is concerning that over one third of our members don’t feel that their hospitals are ready to resume non-COVID-19 services for patients. As outlined in our recent strategy document, anaesthetists will be key to restoring these services but this cannot be done safely if there is not enough staff capacity or resources to return to more normal clinical activity. As well as feeling exhausted and burnt out, it is clear that anaesthetists are anxious around the long-term availability of PPE and drug supplies, despite the government taking positive steps to bolster stocks in recent weeks. Access to testing for staff, patients, and family members also remains a worry. Although some anaesthetists feel ready to return to normal clinical work, we cannot ignore these continued concerns that doing so may risk the safety of healthcare workers and patients. The College continues to encourage transparent communication on these issues so that healthcare workers are fully informed when making decisions around planned patient care.

“Our members, alongside all NHS and care staff, have continued to deliver outstanding care to very ill patients while under tremendous pressure, and we recognise that their wellbeing must be prioritised before we can hope to return to a more ‘normal’ way of providing healthcare.

“While we fully agree that NHS services must resume, it is vitally important that we do this in a way that maintains staff and patient safety. We call for a greater investment in resources to facilitate this process and address staff well-being. More broadly, the College also recognises that this is a timely opportunity to re-shape the NHS so that it meets the requirements of a truly 21st Century healthcare system.”

Key survey findings: 

• Over a third (34%) of respondents have a low degree of confidence in their hospital’s preparedness to restart some planned activity. 
• Over half (56%) continue to feel concerned about the impact on their health from a lack of PPE (with nearly one fifth very-concerned, 17%). Nearly one in ten (10%) are still not confident that they can access the PPE they need, and over one in ten (13%) are still delaying patient care due to a lack of PPE.
• More than one in six (17%) continue to have a low or no degree of confidence in their ability to access the testing they need for their patients, rising to nearly one in five (18%) when considering access to testing for themselves, and rising again to nearly one third (31%) when considering access to the testing they need for members of their household with COVID-19 symptoms.
• Over one in ten (13%) are still unable to access the anaesthetic drugs they normally use, while over one in four (27%) are still not confident they will be able to access these drugs over the next month. 
• More than one in four (42%) reported feeling mental distress over the last month, while over one in ten (12%) feel at risk of burnout.
• Nearly one third (31%) of respondents reported difficulties taking annual leave during the pandemic, despite nearly one-third (33%) working considerably longer hours.

References: 

1. Joint strategy document from the Royal College of Anaesthetists, Intensive Care Society, Faculty of Intensive Care Medicine, and Association of Anaesthetists 
2. View from the frontline of anaesthesia during COVID-19, April survey results