Over two thirds of anaesthetists feel concerned for their health over a lack of PPE

Published: 23/04/2020

One quarter of anaesthetists feel pressurised to treat COVID-19 patients when they do not have adequate levels of protection

Almost four in ten anaesthetists are unable to access COVID-19 testing

Over four in ten have felt mental distress during the past month

Over two thirds of anaesthetists feel concerned for their own health and welfare due to inadequate supplies of personal protection equipment (PPE), according to a membership survey conducted by the Royal College of Anaesthetists. The survey also indicates that nearly one quarter of anaesthetists feel pressurised to treat COVID-19 patients when they do not have adequate levels of personal protection. 

These findings reiterate not only the crucial need for the NHS to maintain sufficient PPE supplies for anaesthetists, but that there is a significant and personal risk to those NHS staff who rely on this equipment to keep them safe from this virus. 16% of all hospital consultants are anaesthetists, making anaesthesia the single largest hospital specialty in the UK. Anaesthetists of all grades work at the front line of the UK’s response to the COVID-19 pandemic and undertake some of the most high-risk medical procedures within intensive care units and elsewhere. They are therefore one of the groups of doctors and healthcare workers which are at highest risk of exposure to COVID-19 when treating critically ill patients1. 

The College surveyed its full membership during a 24 hour period between 15 and 16 April 2020 to gain a snapshot of the experiences of anaesthetists on the front line during the COVID-19 pandemic. Over 2,000 responses were received from anaesthetists at all stages of their career.

The findings indicate that nearly one fifth (17%) of surveyed anaesthetists have or are currently taking time off work due to suspected COVID-19, increasing to one quarter of respondents when including other factors such as confirmed COVID-19 cases. 

However, despite this significant percentage of unconfirmed COVID-19 diagnoses, nearly four in ten (38%) respondents reported that they were unable to access necessary testing.

Respondents highlighted the impact that concerns over PPE and access to testing are having on their wellbeing. One third (33%) of anaesthetists have felt physically unwell in the past month, while four in ten (44%) have felt mental distress. Of higher concern, one in ten respondents (14%) are currently at risk of burnout. The College is concerned that the short-term and long-term wellbeing of anaesthetists is at risk due to on-going pressures they face while caring for their ill patients.

More than one in ten (14%) respondents reported that they cannot access the usual first choice of anaesthetic drug when treating patients, while four in ten (40%) are not confident they will have sufficient supply over the next month. In relation to this work, we have developed clinical guidance which supports our members to conserve supplies, switch to alternatives drugs when required and minimise waste2.

Responding to the findings of the survey, Professor Ravi Mahajan, President of the Royal College of Anaesthetists, said:

“These survey findings make for concerning reading. They highlight the immense pressures our members are dealing with as they continue to provide outstanding care to the many seriously unwell COVID-19 patients. Concerns over inadequate PPE supplies have been widely publicised in recent days, and the College again urges the government to continue to engage transparently with clinicians and Medical Royal Colleges on PPE guidance and information. There has been no greater moment at which our members need to have trust and confidence in the communications they receive from government and its arms-length bodies.  

“It is also worrying that a significant proportion of anaesthetists have been unable to access COVID-19 testing, despite uncertainty over whether they have the virus or not. Given the pressures on NHS staffing levels at this time, it is vital that anaesthetists alongside other clinicians and healthcare workers are able to be tested to confirm whether they can continue to care for their patients, or whether they need to self-isolate.

“The high numbers of anaesthetists reporting physical and mental exhaustion is also concerning, and I urge our members to access all available resources to help with their wellbeing. Given the continued pressure on anaesthetists, there is a real risk that some clinicians may suffer from long-term effects to their health, such as PTSD. It is vital that we – the Medical Royal Colleges, government, and public – work to support our clinicians through this difficult time.”  

 Key survey findings 

  • 17% of respondents have or are currently taking time off work because of suspected COVID-19, rising to nearly a quarter when including confirmed cases of COVID-19 and those self-isolating because they are in a high risk-group or suffering from COVID-19 related stress.
  • Nearly 40% of respondents are unable to access the testing they need for themselves, while over 50% don’t have the testing they need for household members, and one in five are unable to access the testing they need for their patients. 
  • Over two thirds of respondents (73%) reported feeling concerned for their health because of a lack of adequate PPE, with nearly one third (28%) very concerned, while over one quarter feel pressurised to treat patients without adequate PPE and nearly 17% are unable to access the PPE they need. 
  • Over four in ten of respondents have worked outside of their usual area of practice during the last month 
  • One in ten respondents can’t currently access all the usual anaesthetic drugs they use for their patients; 40% aren’t confident they will have sufficient supply over the next month. 
  • During the past month, over 40% of respondents have felt mental distress as a result of additional COVID-19 related stress, while over a third have felt physically unwell. 

Reference:
1.    Joint statement in response to updated PPE guidance: https://icmanaesthesiacovid-19.org/news/joint-statement-from-uk-anaesthetic-and-intensive-care-bodies-in-response-to-updated-ppe-guidance
2.    Drug demand supply guidance: https://icmanaesthesiacovid-19.org/drug-demand-supply-guidance