King's College London

The second round of results from a three-survey study published today highlights the ongoing concerns nurses and midwives in the UK have about COVID-19 and the risks it poses to their own physical and mental health, as well as the health of their families. A similar proportion of respondents compared to the first survey reported that training for staff redeployed to front line care was inadequate or non-existent. These survey results show the ongoing challenges faced by the UK nursing and midwifery workforce and the urgent need to provide support for the health and wellbeing of staff, and to ensure they have access to equipment and ongoing training.

The Impact of COVID-19 on the Nursing and Midwifery workforce (ICON) study is a longitudinal national survey to evaluate the impact of COVID-19 on the UK nursing and midwifery workforce. The survey is being undertaken at three time-points: prior to COVID-19 peak, during the COVID-19 peak, and in the recovery period following COVID-19. The results from each point are being reported in real time, so the findings can be used to inform workforce strategies within the NHS and social care. This summary relates to the results of the second survey. Findings reported from the first survey were reported in April. 

The ICON study is led by academics and NHS staff from across the UK, including King’s College London, University of Warwick, Cardiff University, University of Plymouth, University of Nottingham and University of Surrey. The study concept was developed by the Royal College of Nursing Research Society.

The second survey was open for responses between 28 April-12 May 2020 to capture the period during the COVID-19 peak (the first survey, prior to the COVID-19 peak, was open between 2-14 April 2020). All members of the UK nursing and midwifery workforce were eligible to complete the survey, including registered nurses, registered midwives, student nurses, healthcare support workers, nursing associates, and trainee nursing associates. The survey was distributed by social media, the Royal College of Nursing, the Nursing and Midwifery Council, and other key professional organisations.

4,063 members of the nursing and midwifery workforce participated in the survey and provided complete or near-complete data.

Initial findings of the second survey include:

• 88% continue to worry about risks to family members during COVID-19 due to their clinical role. Staff worry about the personal risks if they were to become infected.
• Respondents reported ongoing depression, anxiety, stress and emerging signs of post-traumatic stress disorder. However, few respondents have accessed services to support their health and psychological wellbeing:
  • Only 12% reported using NHS wellbeing apps (e.g. Unmind, Headspace, Sleepio, Daylight).
  • Only 17% of staff that reported having access to time out rooms had used them (7% of total survey respondents).
  • Only 1% had accessed Silvercloud (the digital mental health platform).
• Despite current challenges in delivering healthcare, 61% respondents felt that care quality for patients that do not have COVID-19 is better than or is as good as care provided before the pandemic.

Key comparative findings from the second survey compared to the first survey include:

• Since the first survey, there has been no improvement in the proportion of individuals receiving adequate training prior to redeployment. 63% either reported that their training was either non-existent, or inadequate compared to 62% in the first survey.
• PPE availability appears to have improved, but 40% reported that the correct PPE was not always available.
• Perceptions towards infection control and prevention training delivery has improved, but still fewer than 50% were confident in the training they had received.

Commenting on the key implications these results have for the nursing and midwifery workforce, Dr Keith Couper, Assistant Professor in Emergency and Critical Care at the University of Warwick and the project lead said:

'The results of our second survey highlight the ongoing challenges faced by the UK nursing and midwifery workforce as they work through the first COVID-19 peak. Our third survey during the COVID-19 recovery phase will help us understand the ongoing impact of COVID-19 on these key workers.'

Jill Maben, Professor of Health Services Research and Nursing in the School of Health Sciences at the University of Surrey said:

'Learning from previous pandemics we know that the timing of access to support and type of support available for nursing staff is crucial for their overall wellbeing; however our survey results suggest few are currently accessing such services for the stress and anxiety they are experiencing. It is important to find out why this is in order to protect the workforce. In our forthcoming interviews we will be exploring nurses experiences further - asking them what strategies have helped in these difficult times and what do they need going forward.'

The ICON research team

• Dr Keith Couper, Assistant Professor, Warwick Medical School, University of Warwick
• Ruth Harris, Professor of Health Care for Older Adults, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London
• Anne Marie Rafferty, Professor of Nursing Policy, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London
• Dr Janet Anderson, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London
• Trevor Murrells, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London
• Professor Daniel Kelly, Royal College of Nursing Chair of Nursing Research, School of Healthcare Sciences, Cardiff University
• Bridie Kent, Professor of Leadership Nursing, School of Nursing and Midwifery, University of Plymouth
• Dr Holly Blake, Associate Professor of Behavioural Science, Faculty of Medicine & Health Sciences, University of Nottingham
• Dr Julie McGarry, Associate Professor, Faculty of Medicine & Health Sciences, University of Nottingham
• Jill Maben, Professor of Health Services Research and Nursing, School of Health Sciences, University of Surrey

The ICON team acknowledges support and advice from the Royal College of Emergency Medicine Trainee Emergency Research Network CERA study team, on which parts of this study are based.

Follow-up surveys will be advertised on social media - please follow @RCNResearchSoc for updates.