The recent case of Toombes vs Mitchell made legal history and the medical profession have been considering the potential implications ever since.

read the piece by DAUK, The On-Call Room, NHS Million and GP Survival here

After more than a year of lockdowns and stringent Covid-19 rules, England has lifted most remaining restrictions.

‘Freedom Day’ saw nightclubs reopen their doors, with maskless people flocking to bars and dance floors to make the most of the ease in restrictions.

Although many members of the public were ecstatic to reclaim some normality after months stuck indoors, experts and NHS medical professionals have condemned “Freedom Day” and shared concerns over rising case numbers and pressures on health staff.

Oxford-based palliative care doctor Rachel Clarke​ criticised Prime Minister Boris Johnson during a radio interview, saying it was “ludicrous” that people were able to go to nightclubs on Monday (Tuesday NZ time) but in September they would need vaccination passports to be able to enter these venues.

Defending the reopening on July 19, Johnson said that “this is the right moment, but we’ve got to do it cautiously”.

He argued that mass-vaccination had weakened the link between infections and severe illness and deaths in England, and that easing restrictions now would avoid a rise in cases in peak-winter, while also helping to get the economy back up and running.

Following the reopening, Johnson announced that from September full vaccination would be a condition of entry to clubs and other venues with large crowds.

In a tweet online, Clarke said Johnson had “given up”.

“There isn’t a person in the country who doesn’t long for this nightmare over. Everyone has lost so much. Loved ones. Jobs. Homes. Peace of mind. Social contact. Confidence. But we can’t make it go away by closing our eyes [and] declaring ‘Freedom’.”

A number of other NHS staff posted on Twitter reminding the public to wear their masks because Covid-19 “is not over” and cases were rising.

The UK Doctor’s Association also said online that the disease would not simply disappear on ‘Freedom Day’. “Covid-19 will remain a significant risk to the public’s health and healthcare workers.”

Speaking on Good Morning Britain, Clarke said that they were treating unvaccinated people in their 20s and even teenagers who were in ICU with the virus. She begged people to get vaccinated, saying it took just minutes to protect yourself.

England Public Health reported on Monday (UK time) that there were 39,950 new Covid-19 cases, and 19 deaths within 28 days of a positive test reported across the UK.

The day prior, there were 48,161 new cases, and 25 deaths within the 28 day period.

Read the full article here.

Some of those surveyed may have decided to return to their country of origin. However, the research also suggests a degree of frustration with the NHS among doctors. Reasons cited included red tape, workload, burnout, reorganisation, poor management, and tax on pensions.

Dr Samantha Batt-Rawden is an intensive care doctor and president of the Doctors’ Association UK. She says she’s not surprised that so many doctors are thinking about leaving the NHS.

Making Exit Plans 

“Many of my colleagues are actively making exit plans, whether that be retiring early, looking for jobs in other countries, or indeed leaving medicine altogether.

“Whilst most of us will have suffered moral injury and moral distress to varying extents during the pandemic, when you really listen to people about why they want to leave this is actually rarely mentioned. Instead, most people talk about deteriorating work conditions, and how this has made them feel,” says Dr Batt-Rawden.

Work-Life Balance 

“I think the need to feel valued as a doctor is what attracts so many to move abroad to practise medicine. Many doctors I have trained with over the years have left for Australia or New Zealand. It has been a real shame to lose so many talented and dedicated doctors, but they all seem so much happier there,” says Dr Batt-Rawden.

“There seems to be much more of a focus on work/life balance in the Antipodes. The hours are limited, there is a heightened awareness of burnout and fatigue. On-call accommodation is plentiful and it is often described as a much higher standard than what we have here (if we have it at all!). Trainees are given months of paid study leave for exams, the cost of which is also covered. Many doctors describe having thousands of pounds of a study budget a year which they are actively encouraged to use to broaden their horizons. The pay is much better too. All the doctors I know who have left for Australia for just one year have not returned, and it’s easy to understand why,” she adds.

The Future Post Pandemic

Dr Batt-Rawden believes the pandemic has unmasked many deep-seated problems or legacy issues.

“It’s become abundantly clear that there was very little practical support for frontline healthcare workers on the ground. These are simple things that are hugely damaging for morale – not being able to park at work, having nowhere to buy hot food overnight, not having a staff room because it has been turned into an office,” explains Dr Batt-Rawden.

She goes on to say: “I believe that there now is a desire to change these things, to reverse the slow erosion in working conditions that has happened so insidiously over many years. With many of my colleagues considering leaving the NHS, or indeed hanging up their stethoscopes for good, I can only hope that this isn’t too little, too late.”

The full article can be read here.

“The fact that politicians stood on the doorsteps of No 10 clapping while treating NHS staff with such contempt has angered even the most mild-mannered of my colleagues.
And it is this deep, impassible feeling of betrayal which has made people feel they have no option but to leave. A mass exodus from the NHS is no longer a case of if, it’s a case of when.
Staff morale will probably never recover fully. But there is a small window of opportunity now that, if lost, will never be regained. If we don’t start caring about our staff now, there will be no one left to care for our patients.”

– Dr Samantha Batt-Rawden, DAUK founder

Read the full article in The Guardian

During the pandemic, doctors came together to push for political change. We must continue to use our newfound voice, says Samantha Batt-Rawden

This time last year the UK’s covid situation was in freefall, with our prime minister hospitalised by the virus, intensive care beds filling up, and the number of deaths rising sharply. As we fought to save lives, the spectre of what had happened in Italy weighed heavily on all of us. It was every intensivist’s worst fear: that we might have to ration care if our resources became overwhelmed. 

Despite all they had faced, our Italian colleagues had taken the time to reach out to the intensive care community in the UK. In February 2020 I had sat in on Zoom calls and listened to their stark warnings about what would come to pass if the UK did not act quickly. We were a few weeks behind Italy, we heard. In that moment, the UK had a brief window of opportunity to prevent the scale of loss of life seen elsewhere. This was an opportunity we would let slip right through our fingers. 

By March 2020 it became clear to doctors just how much trouble we were in. Lockdown would continue to be delayed, even as cases rose up all around us. Instead, we heard the mantra “the NHS is well prepared for coronavirus” again and again and again. 

NHS staff knew different. The effects of years of under-resourcing had been laid bare by the toughest winter for the NHS yet. Rota gaps were numerous. Waiting times had spiralled. We were having to close ICU beds as we just didn’t have the staff to care for patients that would fill them. 

The NHS was already on its knees. As doctors, we went into fighting this virus with one hand tied behind our backs. 

Finding a voice

Doctors had been shouting from the rooftops about safe staffing levels for some time. The profession had come together to warn about the impact of the Modernising Medical Careers programme, the pensions crisis, and of course the imposition of the junior doctor contract on the faltering recruitment and retention of staff. 

The various crises that have rocked our profession have steadily been making doctors more politically aware. For me the tipping point was the case of trainee paediatrician Hadiza Bawa-Garba. It was this that pushed me to form the Doctors’ Association UK (DAUK), with the aim of giving frontline doctors back the voice they had lost.

Yet doctors’ repeated warnings went unheeded, and decisions made under the previous health secretary Jeremy Hunt came back to roost as the true scale of the pandemic was realised.

Read the full blog here

It’s 4am and resus looks like a bomb has hit it. We have had to open almost every piece of kit available to keep the patient in front of us alive. Wearily, I register there’s blood spattered across my shoes.

It’s been a long night, and there’s still another five hours to go.

“What will you do after this?” the nurse asks. I’d love to say I’ll go for a run before crawling into bed. But on night shifts it’s all I can do to eat, sleep, work, repeat.

“No, I mean after intensive care,” they say. “I think I’m going to retrain.”

It’s a conversation I am having more and more. Some days, it seems like all of my colleagues are making exit plans. I can’t blame them, really.

How did things get this bad? In truth, it was years of neglect of both the NHS and its staff. Decisions made under the previous health secretary came home to roost as the pandemic hit. Cost-cutting was a gamble, and ultimately the NHS paid the price. Months later, the UK would end up with one of the worst death rates in the entire world.

The psychological harm of this is barely talked about, but it is palpable every day in the ICU. While some people are suffering from post-traumatic stress disorder, almost everyone is experiencing some form of moral injury, our own epidemic among healthcare professionals.

There is no doubt that our jobs are hard, but they are made so much harder by things that really should have been fixed a long time ago. These are called the “legacy issues”, well known secondary stressors that exacerbate moral distress.

The fact that politicians stood on the doorsteps of No 10 clapping while treating NHS staff with such contempt has angered even the most mild-mannered of my colleagues.

And it is this deep, impassible feeling of betrayal which has made people feel they have no option but to leave. A mass exodus from the NHS is no longer a case of if, it’s a case of when.

Staff morale will probably never recover fully. But there is a small window of opportunity now that, if lost, will never be regained. If we don’t start caring about our staff now, there will be no one left to care for our patients.

Samantha Batt-Rawden, president of the grassroots campaigning organisation the Doctors’ Association UK (DAUK), told The BMJ that doctors continued to receive abuse despite “risking their lives since March 2020.” In a recent survey, DAUK’s members reported verbal and physical abuse including insults, racism, death threats, and violence. One respondent told the campaign, “Physical abuse is a regular part of being an emergency medicine doctor. I have been hit and bruised by many patients for a variety of reasons. All staff have a story to tell, and it’s rare that the patients ever have to face any consequences.”

“It is not enough simply to clap once a week for NHS staff,” as the public were doing in the first lockdown of 2020, says Batt-Rawden, DAUK president. “We have to create a protected workplace that doesn’t leave them at risk of abuse.”

Read the full article here: https://www.bmj.com/content/372/bmj.n739

DAUK’s Dr Samantha Batt-Rawden featured in Medscape’s Covid-19 roundup on 9th February 2021:

NHS ‘Nothing Special’ 

“There is nothing special about the NHS, neither during this pandemic, nor at any other time.”

Those words come from an Institute Of Economic Affairs report called ‘Viral Myths: Why we risk learning the wrong lessons from the pandemic’.

The document from the think-tank’s Dr Kristian Niemietz argues that the pandemic “has given rise to the phenomenon of ‘Coronfirmation Bias’: the tendency to interpret the pandemic as a ‘vindication’ of one’s own world view”. 

Dr Samantha Batt-Rawden, president of Doctors’ Association UK tweeted: “I am so upset by this. We have worked ourselves into the ground to save lives. We have lost hundreds of colleagues. How dare you. How dare you.”

Dr Samantha Batt-Rawden appeared on This Morning where she reacted to Conservative MP Desmond Swayne, who encouraged anti-vaxxers and said the NHS were “exaggerating”

Shaking her head, Dr Samantha replied: “I just can’t even, when you’re a member of the NHS and you are giving your all and spending 16 hours in PPE and working seven days a week, working yourself into the ground to keep patients safe.

“To hear that from somebody representing the government is really upsetting and it’s not acceptable, the pictures that you see of ambulances, queues down the road, they are real, and they have sick patients inside.

“And if the Tory MP wants to see that they are very welcome to volunteer in my ICU, where we are short-staffed, to help turn patients on to their fronts, so that they can fight for their lives.”

“And if the Tory MP wants to see that they are very welcome to volunteer in my ICU, where we are short-staffed, to help turn patients on to their fronts, so that they can fight for their lives.”

Read the report in The Mirror here: https://www.mirror.co.uk/tv/tv-news/doctor-begs-covid-sceptical-tory-23400306

She explained that: “I have had abuse on social media, I am lucky, unlike my colleagues, this has not happened in person. But this is a small but vocal minority, and we so appreciate the vast majority of the public who support us and those staying at home.”

She went on to speak about the video which recently emerged of members of the public obstructing patient care based on misinformation, adding that “They put themselves at risk. They put the staff at risk. And ultimately, what we really care about as doctors; they put the patients at risk.”

In response to a senior Tory MP saying that figures are being manipulated to exaggerate the scale of Coronavirus, Dr Samantha Batt-Rawden spoke about her dismay, and challenged the MP to volunteer in her local ITU.