On the ground: how doctors have been supported through COVID

Doctors’ working conditions have been put under intense pressure during the pandemic. BMA staff tell how they have continued to support them, often adapting to changes in their own lives.

Location: UK
Published: Monday 14 September 2020

‘I’m absolutely impressed by the members’ resilience and sheer determination to continue to care for their patients and their colleagues.’

And Clare Kellett should know. From a union background and a BMA employment adviser for two years, she is one of a UK-wide network of advisers who work both individually and collectively for BMA members, often during their most stressed and vulnerable moments.

To give an idea of the range of work, recently a group of junior doctors had inferior working conditions imposed which left them demoralised and exhausted, a consultant desperate to return to his patients found himself stranded abroad, and a doctor working nights with inadequate PPE (personal protective equipment) was forced to choose between a patient at serious risk or exposure to COVID-19.

All were resolved with the input of the advisers, who often need to show immense persistence and ingenuity through dozens of calls, emails and face-to-face meetings to resolve members’ problems.

Evolving issues

As with every part of the BMA, they have changed with the pandemic. Perhaps the most obvious change is that they are even busier. New cases were up 12 per cent, calls up 11 per cent, and emails up 48 per cent between January and June. Opening hours expanded to 24 hours a day for urgent COVID-related enquiries.

But there have been other changes too.

Ms Kellett says: ‘When COVID started, the cases were very much about rota changes, pay changes and PPE; now I’m seeing issues with incorrect pay following those rota changes and changes to job plans which are being made without due process being followed.

‘My sense is that everyone worked incredibly hard to deal with the immediate concerns, to cover the rotas and to protect those who were vulnerable but there wasn’t any precedent to follow in terms of changes to rotas and pay, and guidance was constantly being issued and amended. Inevitably, though, that all has to be worked out in time, which is what we’re doing now.’

She and other advisers have also been giving a lot of advice to members on shielding, now that the guidance for those with certain conditions to stay at home has been lifted.

Other cases, such as long-running pay disputes or difficult professional relationships, have not gone away, even if the members agreed to put them on hold at the start of the crisis.

‘There just isn’t time’

Working lives of staff have also changed. Ms Kellett, like many of her colleagues, was already home-based and finds virtual meetings efficient, but misses the human contact of team and one-to-one meetings. George Milne, a team manager with the BMA’s first point of contact team, also misses the social interactions, and had to adjust from office working to being at home.

‘I have a small one-bed flat, but have managed to make a great office set-up in my living room and have kitted it out well.’

‘Who needs a dining table?’ he jokes. While meetings can often be easier to arrange, thanks to the now omnipresent Zoom and Teams, the pandemic has made some of advisers’ work more difficult to resolve.

‘The cases that are definitely taking longer are the ones that involve investigations and speaking to colleagues; there just isn’t time for in-depth meetings it seems,’ says Ms Kellett.

She says there are often long delays in obtaining occupational health appointments, which can determine whether, for example, a member’s application for early retirement or a change in working conditions is successful. This adds to members’ stress and anxiety at this difficult time.

An empathetic ear

More than ever, it’s a job that requires empathy.

Mr Milne says: ‘This has been a very difficult time for members and many have faced challenges with either their working or personal arrangements. We’ve had many difficult conversations with our members around issues such as self-isolation/quarantine rules if having to see sick family members abroad. Being able to provide an empathetic listening ear has been crucial.’

Working so closely with doctors and medical students, often at their most vulnerable times, allows BMA staff to identify with them. This has, if anything, been enhanced by the experience of the pandemic.

Ms Kellett says: ‘Although there are stresses and difficulties, not least of which must be the incredible discomfort of working in full PPE in the summer heatwave, members have shown huge resolve to keep going – whether on-site or from home, coming back early from maternity leave, moving into hotel accommodation for weeks on end, returning from retirement or clinical research, or remaining in their training placements when they had expected to be moving on.

‘I can only say that whatever difficulties and frustrations I’ve felt in doing my job, it’s as nothing compared with our members’ daily experiences and I’m very proud to say that I can support them by working for the BMA.’

 

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