The inquiry report, which looked at the impact the pandemic had on staff and the “overwhelm” of the system, found the NHS did ultimately cope through the crisis.
But it coped “only just” - and only because “so many healthcare workers made enormous sacrifices”. In a reminder of exactly what those NHS staff did for the country, Baroness Heather Hallett described how these heroic health workers “put their work before their own well-being and family life”.
Many healthcare workers will go into their job because is it their vocation and because they want to help others. In the face of a crisis, that drive will be stronger. That was demonstrated during the pandemic when workers faced a war-like “call to arms” and did all they could to meet the crisis.
But the inquiry pointed out that this is not a premise on which to build a sustainable national health service. In a stark warning, Baroness Hallett said the government may not have an NHS workforce “willing or able to” work through another pandemic - unless huge changes are made.
“I urge the governments of the UK to implement my recommendations and to do so as a matter of urgency,” she said. “When the next pandemic strikes, there may not be a workforce in the healthcare systems able or willing to work under the conditions that arose during the Covid-19 pandemic.”
Among the issues raised was the profound mental health impact on workers who were facing a scale of death and suffering not seen before as they suffered from “moral distress.”
A major factor in this was the inability to give people care in the way they would want. Research from the inquiry found that, during the first two waves of the pandemic, 80 per cent of healthcare professionals who responded to a survey reported having to act in ways that conflicted with their values.
And staff on the NHS frontline still face that today amid worsening demands, skyrocketing trolley waits and services stretched to the brink.
Experts agree with the warnings in the report. Dr Vicky Price, president of the Society of Acute Medicine, said that, while staff pulled together during the Covid-19 pandemic, she feared staff would have less capacity to do this again as “people are just that bit more burnt out... they are absolutely burnt to the ground already.”
On Wednesday, The Independent revealed warnings from doctors that the NHS is not prepared for another pandemic should it hit now, as overcrowded hospitals buckle under even day-to-day demands.
‘Leaky pipeline’
In the NHS staff survey published last week, more than one third reported feeling burnt out, while only 32 per cent said they had enough staff in their organisations to do their jobs properly.
Thea Stein, chief executive of the Nuffield Trust, and a former NHS trust chief, told The Independent it would be wrong for the government or public to assume the NHS workforce “remains permanently on standby to be pushed to the absolute limit.”
She said that, if the NHS were to withstand this same pressure again, staff must be listened to. Steps must also be taken to put the workforce in the best position to deal with a crisis, she said.
Pointing to NHS staff survey data which showed workers aged 21-30 are much more likely to feel burnt out than their older colleagues, Ms Stein said there is “a worrying generational divide” which could affect “how robust the workforce is going into a crisis.”
She warned: “If the NHS wants to back up its commitment to develop enough staff trained within the UK for a stable workforce, this needs to change, and the forthcoming workforce plan is an important opportunity to address this.
“Successive governments haven't taken NHS staff retention seriously enough, so for many healthcare professions we're left with a leaky training pipeline.”
Dr Price said resident doctors' training is also “hugely affected” by the current state of services. “Under the pressures, it's really hard to actually train people and teach people.
“It's hard for them to know what good can look like, which is really sad.”
‘Depleted’ nursing levels
Since the pandemic, the NHS has faced widespread strikes from staff over pay and working conditions, including nurses and doctors, with the continued threat of strikes from resident medics still hanging over ministers.
The NHS is facing job gaps of more than 100,000, with more than 22,000 nursing posts needing to be filled. There are more than 7,000 empty doctor posts.
Official NHS figures show the number of nurses in the NHS is up 31 per cent compared to 2010; however, this comes amid a backdrop of much higher demand.
Professor Nicola Ranger, chief executive and general secretary of the Royal College of Nursing, told The Independent: “The most important legacy of this inquiry must be to ensure our health and care services are not devastated by the next national emergency.
“However, the sad reality is that it will be impossible to increase capacity in hospitals while the nursing workforce remains so severely depleted.”
She added: “It should cause great alarm that this report finds the NHS workforce is in such a state that it may not be able to work under the conditions of another pandemic. The time to invest in and listen to nursing is now, if we are to save lives in the future.”
The Department for Health and Social Care said the Covid-19 inquiry report "makes for sober reading.”
It said: “This government is committed to learning the lessons of the Covid Inquiry — we are investing in and reforming the health service to make it fit for the future, so it's there for people when they need it. We will consider Baroness Hallett's findings and recommendations carefully and respond in full in due course. We thank her and her team for their thorough and serious work."
Only time will tell whether or not the government learns the lessons of this inquiry. But time might not be on our side - which is why ministers must act now.
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