Risk assessments are more important now than ever

by Anil Jain

More protection is needed for doctors: especially in the face of a looming, harsh winter

Location: UK
Published: Tuesday 10 November 2020
anil jain

2020 has been a hugely stressful year for everyone – but we know that the disproportionate effect of the pandemic on BAME (Black, Asian and minority ethnic) communities and healthcare workers has meant additional stress for BAME doctors.

As we enter a second wave, prioritising the health and safety of the workforce is more important than ever.

In April, in the midst of the first wave, we highlighted that nine of the first 10 doctors who were named as having died of the virus in the UK were from an ethnic minority background. Furthermore, all but two were IMGs (international medical graduates). Overall, 44% of medical staff in England are BAME, 95% of doctors who have died were BAME.

We still don’t fully understand why this happened but know that PPE (personal protective equipment) shortages and delays in undertaking risk assessments likely played a part in this tragedy.

In May 2020 I highlighted the need for better protection for IMG doctors. The BMA has been lobbying extensively on this issue. This included securing a risk-assessment framework to ensure all doctors, but particularly those more vulnerable, are protected.


A difficult winter is approaching

Now, in the second wave, we are concerned about whether people from BAME backgrounds are any better protected from the effects of the virus?

The data shows they are not. The latest ICNARC data shows that more than a quarter (27.4) of those admitted to intensive care are not white – showing little change since the first peak. Meanwhile, the latest REACT data shows there is a continuing disproportionate likelihood of people from BAME backgrounds being infected.

I’m also troubled about a recent BMA survey of more than 6,500 doctors in England, which shows that 65% of doctors are quite or extremely anxious about work in the coming months, and more than 40% say their levels of stress, anxiety and emotional distress had got worse since the pandemic began.

Furthermore, our latest tracker survey shows many doctors still haven't had risk assessments. Only 49% of 4,610 respondents have had a risk assessment and are confident that appropriate adjustments have been made – 12% said appropriate adjustments had not been made and another 12% said that their risk assessments needed to be updated.


What is the BMA doing?

The BMA is calling for more tangible action to protect doctors, noting the potential disproportionate effects on doctors from BAME backgrounds.

This includes:

  • More work to ensure PPE meets diversity of need
  • There should be culturally competent risk assessments, and people who are vulnerable supported to self-isolate and work remotely where appropriate, wherever they are based in the UK
  • Work environments must be safe and support doctors no matter their ethnicity. Doctors should be able to speak up if their safety, or the safety of their colleagues or patients, are at risk
  • Doctors who are extremely clinically vulnerable need to be supported to work from home
  • Any wellbeing support must be inclusive, accessible and meet the needs of a diverse workforce
  • Occupational health services should be accessible and have capacity to provide timely support.



Don’t suffer in silence

Last year the BMA set out a vision for the future of the NHS in our Caring, Supportive and Collaborative report. We emphasised the need to develop ‘a learning culture where staff feel able to raise concerns without fear or blame’. COVID-19 has highlighted how important this is.

I am also proud that the BMA has sponsored the Melanin Medics initiative ‘Mind Us’ which will work to support the mental wellbeing of Black African and Caribbean medical students and doctors who have been adversely affected by COVID-19. BMA Giving has also given grants to MIND and Doctor in Distress charities for better support for doctors.

If you don’t feel safe at work, you are feeling stressed, or you need someone to talk to, please know that you are not alone. We’ve brought together tools to help you understand your risk. You can undertake your assessment using a self-assessment template and seek mitigation if you are at high risk. Our guidance and support services can help you look after your wellbeing and if you are affected by bullying or harassment, the BMA has a range of resources that can help you.

Don’t suffer in silence, the BMA is here to support you.

Anil Jain is a consultant radiologist in Manchester, a member of member of BMA council, BMA consultants committee and equality, diversity and inclusion advisory group.

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