New Zealand has been at the centre of the world’s attention for its response to COVID-19. On 26 March, just over a fortnight after the World Health Organization declared it a pandemic, the whole nation went into lockdown.

After 16 years with the NHS, I [Dr Sircar] had a new start with an obstetrics and gynaecology department in New Zealand. The unit is similar to many district general hospitals in UK with an annual delivery rate of around 2200. There are eight SMOs (senior medical officers – consultant-level doctors), nine specialty trainees and eight house officers.

During the pandemic, it was felt that ‘normal’ working would no longer be tenable, so some new working models were put to the team. After considering various options, a ‘pandemic rota’ consisting of two teams was created.

Each team had a week ‘off-site’ and week ‘on-site’. The ‘off-site team’ SMOs would be engaged with virtual clinics, admin work, whereas the ‘off-site’ junior doctor team would be rested except some administrative work. The main benefit of this rota was the flexibility to allow people taking time off for personal, health or operational reason. This special rota lasted for six weeks.

A survey was carried out, nearly a month after lockdown ended, to find out the effects of the pandemic on work-life balance. Twenty-one out of the 25 available doctors responded.

Some findings were:

• Nearly 80 per cent felt they could work safely and flexibly within the rota
• 67 per cent had access to proper personal protective equipment
• 54 per cent (and nearly 80 per cent of junior doctors) worked less than usual – the reason stated being the off-site week
• 95 per cent said they had sufficient rest, and 85 per cent said there was enough physical and psychological support at work
• 60 per cent of SMOs said the rota had a positive effect on their family lives
• More than 90 per cent said there had been better team working.

The last of these findings was perhaps the most important of all. It suggests that the initial hard work around flattening the hierarchy level, giving daily communication briefs, and promoting coherent team working paid off when needed the most. This was supported by the free-text comments, which were largely about teamwork, excellent communication and flexibility.

The survey was a rare insight into working lives of highly skilled professionals during the testing time. It should be seen in the context of studies of healthcare workers from Wuhan, China and northern Italy which found levels of anxiety, stress, loneliness or nervousness ranging between 17 and 77 per cent.

It suggests that with available clinical and non-clinical support one could create and maintain a team with a high rate of work satisfaction even during the pandemic. More importantly, timely preparatory work with a flattening of the hierarchy is an essential part in planning process.

Preparation remains the key. As per the adage, si vis pacem, para bellum – if you want peace, prepare for war.

Sikhar Sircar FRCOG is a consultant SMO in obstetrics and gynaecology with the Midcentral District Health Board, New Zealand. His co-author, Sarah Machin FRANZCOG, is the acting department lead