Covid 19 time for reflection 

 4th June 2020 

I can’t believe it’s now nearly four months since I developed COVID-19 – which I picked up during a short stay in New York. To say that the world has changed is an understatement. The first morning I returned to work after nearly a month away felt like the opening scenes of John Wyndam’s post-apocalyptic novel – The Day of the Triffids when the streets of London were devoid of cars and people, as they were, were wondering around blind and confused. That morning as I made my normal journey to work, everything had changed. The normal traffic jam around Vauxhall Cross was reduced to a few delivery vans and police cars and commuters were no longer pouring out of the tube station. Lockdown had not even been imposed by then, but people were voting with their feet (or rather not) and staying at home.  As we say, the rest is history and 16 weeks later we are just emerging from our collective lock down – and not sure what others feel, but I feel a little dazed by it all. Even though the streets are busier, parks packed and queues outside shops, longer, there is still that ‘holiday’ feeling, though of course we are not on holiday, we’re all working as hard as ever, only in cyberspace.

I am proud of my Practitioner Health team, our network of 200 therapists, 100 clinicians, our administrators, managers and other staff employed across England.  In the space of only a few days, everyone had moved their care on-line, rapidly having to learn how to use the various digital platforms and systems. Almost effortlessly patients, clinicians and therapists have carried on as normal and are offering care to doctors, dentists and now clinical medical students during these troubling times.

In the last two months we have run more than 150 online events, webinars and reflective spaces, for staff from across the NHS to come and talk about their experiences, listen to others and share ideas on how to support themselves and others. We have had wonderful offers of support and expertise from yoga and choir masters to psychologists and professors willing to share their knowledge and facilitate these spaces for staff wellbeing.

In the early days of lock down, we saw our referrals drop by almost half – I suspect doctors were too busy to think about their own needs. Four months on, numbers are back to pre-lock down and I suspect they will steadily rise from now onwards. We know that experience from previous epidemics (fortunately pandemics are rare) that health care staff suffer from more mental health problems – in particular, depression, anxiety, post-traumatic stress symptoms and also from what is known as ‘moral distress’.  The latter being disturbing emotions (guilt, fear, shame) brought on through having to make decisions not based on the best interest of the patient (for example, not engaging in resuscitation of the patient if the doctor does not have adequate PPE).

Not all doctors will suffer though. Some are feeling enlivened and reconnected with their work place and their role. They feel appreciated by the public and their employers, many for the first time in years. Hospitals are addressing staff well-being as never before and places to rest during busy shifts are being put in place. GPs and practice staff, many working remotely are finding ways to connect as a team despite being dispersed across localities.

As we move on to the next stage of normal, we at Practitioner Health are preparing, developing and innovating to be able to meet the needs of our current patients and those yet to come. We have a renewed focus on groups, as a space to support and connect with others, as well as plans for new digital pathways and technology, such as our app launching later this month.

As doctors and other health professionals reach out for support with their mental health and wellbeing over the coming months we will be here, ready to offer care and compassion, expertise and experience and most of all, hope, that for those who need it – they are not alone – we are here to help.

Dr Clare Gerada, Medical Director of NHS Practitioner Health and Chair of Doctors in Distress Charity