The BMA conducted what is believed to be the biggest survey of frontline NHS doctors since the coronavirus crisis began – with more than 16,000 doctors giving their views on PPE provision, wellbeing and drug shortages.
The survey revealed that 57 per cent of GPs and 34 per cent of hospital doctors have sourced their own PPE for personal or departmental use.
BMA council chair Chaand Nagpaul said the survey showed how ‘resourceful’ doctors had been – but also provided a ‘damning indictment’ on the Government’s failure to provide life-saving kit.
Dr Nagpaul said: ‘The survey shows that, overall, there has been an improvement in the provision of PPE, but if almost half of all doctors report that they had to resort to purchasing PPE themselves or rely on donations, then there is still a lot for the Government to do to protect its front line. Doctors are still reporting shortages in gowns, with one in three not having enough gowns in settings where they are most at risk with the most poorly of COVID-19 patients.’
The survey also reveals that one-in-four doctors either failed or had not been fit tested for a FFP3 (filtering face piece 3) mask at all – a mask of this type is used when performing highly infectious medical procedures and which if not properly fitted means a healthcare worker remains at significant risk of becoming infected.
One doctor said: ‘The PPE situation is an outrage for all staff. Lives lost for want of plastic visors, masks, and eye protection.’
Another said: “Adequate PPE supply in terms of gowns and visors would reduce stress within the team as almost all of our patients are COVID positive.’
Dr Nagpaul added: ‘Thirty per cent of doctors told the BMA they wouldn’t bother to speak up about an issue such as PPE or drug shortages, as they didn’t think anything would be done about it. That’s a terrible state of affairs and the BMA calls upon NHS England and the Government to remind employers to encourage and support staff to speak out and be heard.’
Anxious and burnt out
The survey also reveals that 65 per cent of doctors felt only partly, or not at all, protected from coronavirus, in their workplaces. And one in four report worsening mental distress during the pandemic including depression, anxiety and burnout.
The findings come at a crucial time for the Government as it reviews its five tests for easing lockdown ahead of the 7 May deadline – the first of which is ‘making sure the NHS can cope’.
Dr Nagpaul said: ‘The Government has five tests it has said must be met to ease lockdown – the first of which is ‘making sure the NHS can cope’. Six weeks into this crisis, how can the Government be confident that this condition is anywhere near being met, or that the pandemic is under control, when the very people on the front line are not being made safe?’
Further results from the survey reveal thousands of doctors are unable to offer patients the desperate care they need as a result of the pandemic.
More than half of doctors said that prioritisation of confirmed and suspected COVID-19 patients was worsening the care available to those without the condition. Almost a third of doctors responding said it was having a significantly worse impact.
The biggest concern raised by doctors is the long-term effect on patient clinical demand, with 40 per cent saying this is their greatest worry. Hospitals have been repurposed into prioritising COVID-19 patients, with a halt put on a range of other services for patients – including for those with chronic conditions.
Wards and facilities have been adapted to cope with the demand of patients with the coronavirus infection at the expense of other patients. Referrals from GPs are not being accepted unless for a serious medical conditions and routine investigations to aid diagnosis are not available in many cases.
Prior to the COVID-19 outbreak the NHS was already suffering record waits in general practice, emergency care, hospital and cancer services. Doctors have raised serious concerns that some patients may have deteriorated and possibly died as a result.
The survey also finds that more than a quarter of doctors were experiencing shortages of vital medicines, gases or therapeutics, with almost a third saying such shortages – or anticipated future shortages – have forced them to offer less effective treatment than they ordinarily would. Inhalers, antibiotics, HRT medicines, anaesthetic drugs, oxygen and painkillers were among those referenced as experiencing supply issues.
One cancer surgeon told the BMA in their response that the number of referrals they were receiving was as low as a quarter of normal levels, and that they feared how this delayed care will affect patients and that they would be hit with a large wave of referrals once the COVID-19 situation eases – and with more advanced cases and worse outcomes. The effect on general practice will be significant when patients who have delayed seeing their doctor decide to seek care.
Another said: ‘I’m struggling with being a surgeon but not being able to offer operations.’
And one doctor said they felt ‘no one cares in the slightest’ about parts of the NHS not dealing with COVID-19 patients, leaving staff ‘drowning’ as they try to keep services running.
BMA patient liaison group chair Lesley Bentley said: ‘The findings of the BMA survey are of concern, so it’s important that the message that the NHS is open for business is clear and reinforced.
‘Even at the time of the COVID-19 pandemic, it is vital that patients continue to get the care and treatments they need and feel confident in doing so.’