Winter pressures: protecting the workforce to protect patients

This article has been written and funded by Sanofi

Respiratory infections, including Covid-19, flu, pneumonia and acute bronchitis are expected to be some of the most significant winter pressures on the NHS, with modelling suggesting patients with these conditions could occupy up to half of all NHS beds (NHS England, 2022a). It is critical to take stock of what could be driving these surges to understand how we can mitigate the most severe consequences.

The ongoing effects of Covid-19

While the lingering spectre of Covid-19 remains with us, many of the hygiene habits of the global pandemic have dissipated. Many in the Western world are no longer wearing masks inside and outside of the hospital setting, and government social distancing policies have been relaxed. As a result, respiratory disease transmission could spike, putting NHS staff at risk and contributing to additional system burden as it aims to recover from the most extreme consequences of the pandemic (The Academy of Medical Sciences, 2021).

Protecting staff and patients

One of the most concerning locations for transmission is inside healthcare settings, and healthcare workers are encouraged to take actions like washing their hands, keeping up to date on vaccines, and wearing masks to help protect themselves and their patients (UK Health Security Agency (UKHSA), 2022; NHS England, 2022b; Public Health England (PHE), 2018). If these strategies are not prioritised then there is a risk of respiratory viruses spreading to vulnerable people like infants and older people.

During the first wave of the Covid-19 pandemic, nosocomial transmission (hospital-acquired infection) in the UK has been estimated at approximately 20-25% of all cases (PHE and London School of Hygiene and Tropical Medicine, 2020).

Further, incidences of pertussis (whooping cough), a highly contagious bacterial infection of the lungs and airways (NHS Inform, 2022), linked to healthcare settings in England have also increased over recent years (PHE, 2019). With the infection more likely to present as a non-specific cough in adults, often going undetected as pertussis (NHS, 2019), higher prevalence of pertussis among health professionals poses a significant risk of nosocomial transmission to infants in their care (PHE, 2019). Unimmunised infants are at the greatest risk of severe outcomes and death following pertussis infection and so it is important that steps are taken to protect them wherever possible (PHE, 2018).

Ensuring healthcare workers prioritise hygiene control and vaccinations is also essential for protecting NHS capacity. For pertussis, for example, positive cases require staff to isolate for 21 days if not treated with antibiotics early enough, to provide time for extensive contact tracing (PHE, 2019; PHE, 2016).

Further, these protective measures can help healthcare workers to avoid extreme symptoms, potentially reducing sick leave time and therefore enhancing capacity. At a time when the NHS needs resources to be directed towards addressing the backlog, it is critical that UKHSA guidance is prioritised and followed in order to protect both the NHS workforce and vulnerable patients (PHE, 2019).

References

The Academy of Medical Sciences (2021) COVID-19: Preparing for the Future. Looking Ahead to Winter 2021/22 and Beyond. AMS.

NHS (2019) Whooping cough. nhs.uk (accessed 31 January 2023).

NHS England (2022a) 24/7 control centres among new plans to step up NHS winter preparations. england.nhs.uk, 18 October (accessed 30 January 2023).

NHS England (2022b) Coronavirus (COVID-19) vaccine. nhs.uk (accessed 31 January 2023).

NHS Inform (2022) Whooping cough. nhsinform.scot (accessed 31 January 2023).

Public Health England (2019) Pertussis: occupational vaccination of healthcare workers. gov.uk, 16 July (accessed 31 January 2023).

Public Health England (2018) Guidelines for the Public Health Management of Pertussis in England. PHE.

Public Health England (2016) PHE Guidelines for the Public Health Management of Pertussis Incidents in Healthcare Settings. PHE.

Public Health England, London School of Hygiene and Tropical Medicine (2020) Quantifying the total number of nosocomial infections in the first wave. gov.uk (accessed 31 January 2023).

UK Health Security Agency (2022) Seasonal Influenza Vaccine Uptake in Frontline Healthcare Workers (HCWs) in England Winter Season 2021 to 2022. UKHSA.

Job bag code: MAT-XU-2205325 (v1.0)                                                                                                                                        

Date of preparation: January 2023