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 NHS has been urged to rethink safety for thousands of frontline staff after new research suggested that Covid patients’ coughing is putting them at far greater risk of catching the virus than previously thought.

The study found that coughing generated at least 10 times more infectious “aerosol” particles than speaking or breathing – which could explain why so many NHS staff have fallen ill during the pandemic.

The research has led to fresh demands that anyone caring for someone with Covid-19, or suspected Covid-19, should be provided with the most protective equipment – including FFP3 respirator masks – and that hospital ventilation should be improved.

Health workers are up to four times more likely to contract coronavirus than the general population, with infection rates among those on general hospital wards approximately double those of intensive care unit (ICU) staff – who do have access to the most protective PPE.

This access to higher-level PPE was based on the assumption thatICU wards are more dangerous because treatments such as continuous positive airway pressure (CPAP), used to support patients’ breathing, generated large amounts of aerosols – which linger in the air and can be breathed into the lungs.

Staff working in other hospital areas, GP surgeries and care homes are issued with looser-fitting surgical masks, which afford little protection against these tiny particles, but block larger virus-carrying droplets.

The new research, which has not yet been peer-reviewed, turns these assumptions on their head.

The research may also boost efforts to force a public inquiry into Covid-19 deaths among NHS staff and care workers. In December, Doctors’ Association UK (DAUK), which represents frontline medics, escalated its threat of judicial review against the government. “Inquiries must be initiated to investigate any factors that may have led to healthcare workers’ deaths,” a spokesperson said.

“We feel that there would be fewer infections among healthcare workers, and fewer deaths, if people had proper masks,” said Dr Katie Sanderson, a junior doctor and committee member of DAUK. “Acute medical wards and A&E, which is where most Covid patients are being cared for, have much lower standards of ventilation than intensive care units, and generally people are coughing all the time.

“This issue affects GPs as well, because most GP commissioners have refused to let GPs have access to proper masks.”

Read the article in full here: https://www.theguardian.com/world/2021/feb/03/covid-coughing-study-suggests-nhs-staff-at-far-greater-risk-than-thought

The High Court has ruled “The Secretary of State acted unlawfully by failing to comply with the Transparency Policy” and that “there is now no dispute that, in a substantial number of cases, the Secretary of State breached his legal obligation to publish Contract Award Notices within 30 days of the award of contracts.” We have won the judicial review we brought alongside Debbie Abrahams MP, Caroline Lucas MP, and Layla Moran MP.

In handing down the judgment, Judge Chamberlain brought into sharp focus why this case was so important. “The Secretary of State spent vast quantities of public money on pandemic-related procurements during 2020. The public were entitled to see who this money was going to, what it was being spent on and how the relevant contracts were awarded.”

The Judge went on to say that if Government had complied with its legal obligations we “would have been able to scrutinise CANs and contract provisions, ask questions about them and raise any issues with oversight bodies such as the NAO or via MPs in Parliament.”  When Government eschews transparency, it evades accountability. 

Government’s behaviour came under criticism in the judgment. If it had admitted to being in breach of the law when we first raised our concerns, it would have never been necessary to take this judicial review to its conclusion. Instead, they chose a path of obfuscation, racking up over £200,000 of legal costs as a result.  

We shouldn’t be forced to rely on litigation to keep those in power honest, but in this case it’s clear that our challenge pushed Government to comply with its legal obligations. Judge Chamberlain stated that the admission of breach by Government was “secured as a result of this litigation and at a late stage of it” and “I have no doubt that this claim has speeded up compliance”. It begs the question, if we hadn’t brought this legal challenge, what other contract details would have remained hidden from view? 

And whilst Government always sought to dismiss our challenge by claiming we needed to be an ‘economic operator’ to have standing, the judgment states that it is unrealistic that economic operators would have challenged Government’s breach of the law in these circumstances. In other words, if we hadn’t taken this case, there are not many others who could have done so. 

This judgment, which can be found here, is a victory for all of us concerned with proper governance and proof of the power of litigation to hold Government to account. But there is still a long way to go before the Government’s house is in order. We have now written to the Secretary of State for Health and Social Care detailing what needs to be done to improve procurement processes and ensure value for British taxpayers.

But for now, we can take a moment to celebrate this win. Thank you, as ever, for all your support.   

Read more here: https://goodlawproject.org/update/the-judgment-is-in/

DAUK (working in partnership with Messly) logged >1500 reports nationally highlighting inadequate access to PPE; 220 reports frontline doctors being warned, threatened, disciplined, or made to feel bullied or unsupported for raising issues about PPE

COVID-related HCW death: 
Katie Sanderson (DAUK), “We know that the appalling death toll of 882 frontline health and social care workers will continue to rise if no action is taken. “The investigation of these deaths has been piecemeal and inconsistent.”

PHE guidelines on PPE: 
Jenny Vaughan, “We do not feel that the PPE currently mandated by Public Health England offers healthcare workers an acceptable level of protection, and we are calling for the guidance to be urgently revised to ensure that all staff exposed to covid-19 have access to high level respiratory protection.

“There is also a clear lottery among hospital trusts: some are defying Public Health England rules to give their staff the protection they deserve due to concerns about hospital spread of the virus.”

Read the full article here: https://www.bmj.com/content/372/bmj.n442?utm_source=twitter&utm_medium=social&utm_term=hootsuite&utm_content=sme&utm_campaign=usage

Pregnant women should be included in coronavirus vaccine trials, experts have urged, as those in priority groups wrestle with whether or not to have the jab.

Doctors are considering emerging evidence that pregnant women may face greater risks from Covid-19, although they are not at present a priority group.

Professor Lucy Chappell, spokeswoman for the Royal College of Obstetricians and Gynaecologists (RCOG), said that it was not asking for this status to change but that it would discuss any risk with the Joint Committee on Vaccination and Immunisation.

DAUK’s Dr Ellen Welch said:

This is a very personal decision, for me it was important to have the vaccine in pregnancy
In pregnancy there is very little safety data for any medications&for something this new,there is clearly no long term data.However there is no current evidence of harm. Whereas there is plenty of evidence of the harm covid can do in pregnancy
for me the risks of either ending up on icu while pregnant, or having long covid with 2 small children clearly outweighed the minimal risks of having a new vaccine.
Pregnant women safely have the flu vaccine every year

Find out more- watch the MacDonald Obstetric Medicine Webinar on the topic https://www.obstetricmedic.org.uk/moms-webinar-archive/
Read the RCOG leaflet https://www.rcog.org.uk/globalassets/documents/guidelines/2021-01-12-covid-19-vaccine-info-sheet.pdf

The full article can be accessed here: https://www.thetimes.co.uk/article/pregnant-women-should-be-included-in-covid-19-vaccine-trials-n23ndqjv6

Dr Katie Sanderson, part of the DAUK committee, talks to Sky News about her concerns about the next few weeks as a frontline hospital doctor.

“We’ve all got to think really carefully about what we do over the next couple of weeks, otherwise we are not going to be able to offer good quality medical care to everybody who needs. It’s not just about looking after patients who have coronavirus. We want to be able to do our best by everybody, but we can’t control how you behave.”

In a letter to the health secretary, the groups say that there is no legal protection for doctors faced with “surges in demand for resources that temporarily exceed supply”.

Doctors fear that they could face prosecution for unlawful killing because of decisions they are forced to make in such a situation, they add.

In November Boris Johnson gave warning that should the NHS be overwhelmed “the sick would be turned away because there was no room in our hospitals”, with doctors and nurses potentially “forced to choose which patients to treat, who would live and who would die”.

This month the chief medical officers said that the NHS was at high risk of being overwhelmed within weeks.

The Medical Protection Society co-ordinated the letter, which has been signed by the Doctors’ Association UK, British Association of Physicians of Indian Origin, British Medical Association, Hospital Consultants and Specialists Association, Royal College of Surgeons of Edinburgh and Medical Defence Shield.

They say that although doctors had a range of guidance to follow when administering and withdrawing treatment “this guidance neither provides nor claims to provide legal protection”.

They add: “It also does not consider Covid-19 specific factors such as if and when there are surges in demand for resources that temporarily exceed supply. There is no national guidance, backed up by a clear statement of law, on how clinicians should proceed in such a difficult situation.

“The first concern of a doctor is their patients and providing the highest standard of care at all times. We do not believe it is right that they or other healthcare professionals should suffer from the moral injury and long-term psychological damage that could result from having to make decisions on how limited resources are allocated, while at the same time feel vulnerable to the risk of prosecution for unlawful killing.”

A survey this week of 2,400 doctors found that 61 per cent were concerned about facing an investigation as a result of a clinical decision made under pressure, with 36 per cent concerned about being investigated should they decide “to withdraw or withhold life-prolonging treatment due to capacity and resource constraints”.

The letter says healthcare professionals “should not be above the law” but they should be protected over “decisions made in good faith, in circumstances beyond their control and in compliance with relevant guidance”.

Any emergency law should apply retrospectively from the start of the pandemic, they add.

Read the rest of the article here.

“We see extremely high numbers of what you would recognise as psychological burnout. The problem is that, you know, you might say that we’re in the peak of this in a week or a couple of weeks from now, and perhaps things will start to get better. But in terms of the work for the NHS, it certainly won’t stop there, and we have long backlogs of planned care that has been cancelled that we’ll need to catch up on.

And then obviously we will need to come to terms with what’s happened. But we won’t be able to just stop, we won’t be able to give everybody a break. They will need to continue on, and that’s when I think that we will really see the real surge in problems with mental health.”

Dr Natalie Ashburner, DAUK Vice-Chair

“I am not in the process of blame. That is not what I am about. There are many members of the public who are doing their absolute best. Their livelihoods are at risk. They have not had enough support from the government. There are homeless people on the streets, where there were clear efforts made in the first wave to get them off the streets. And there are many people who depend – we have over 10 million key workers in this country. Many of them have been told by their employers that actually they can’t work from home. It is not their fault. I am not blaming them. What I am saying is there is not enough government support to actually support people when they have to socially isolate when they have to. And so many of them feel they have to go out because their lives and livelihoods depend on it.”

“[Healthcare workers] are under such strain. They are scared, they are fearful, and their jobs at the moment are almost unbearable. But they are stepping up and doing the best they can. We do think that they should be more protected…. We are calling for a full review of the personal protective equipment guidelines because so many of them are getting sick“

Dr Jenny Vaughan, DAUK Vice-Chair

“I think [healthcare staff] are working in horrible conditions now, seeing horrible things, looking after patients in really appalling situations, often looking after multiple members of the same family and having repeated conversations about the fact that people are not going to survive.”