REPORT: Voices from the Frontline of Critical Care

19 November 2020

In October the Faculty surveyed our Fellows and Members about their experiences and feelings during the first wave of the COVID-19 pandemic. We are pleased to publish Voices from the Frontline of Critical Care based on the results of this survey. Thank you to those of you who contributed. 

Key Findings from the report include: 

  • 45% of respondents have seen a permanent increase in the critical care capacity of their directorates. However, when asked if they consider any increase in capacity to be adequately staffed only 18% of respondents agreed.
  • 60% of respondents reported that their units are still attempting to follow the Guidelines for the Provision of Intensive Care Services (GPICS) but 54% of respondents have seen some relaxation of those standards including to their medical staffing.
  • 80% of respondents increased their working hours, and 71% report covering sick consultant colleagues. Future uncertainties affect the wellbeing of the Faculty’s fellows and members. How hospital structures support those working in critical care is vitally important for both recruitment and retention.
  • 88% of respondents had leave cancelled. Work/life balance is extremely important. Whilst the vast majority of respondents were happy to deliver the needed increase in work in the first wave, to do this over subsequent waves of the pandemic becomes increasingly difficult for individuals and their family. Supporting professional activities and agreed job plans will be even more important in subsequent COVID-19 waves.
  • Faculty fellows and members understood the impact the first wave of COVID-19 had on non-critical care staff, and hugely appreciated their response to the crisis. The flexible increase in staffing was so important for care, although the drop in GPICS standards underlines the need to increase the underlying critical care capacity, and the multi-disciplinary workforce.

Dr Alison Pittard OBE, Dean, Faculty of Intensive Care Medicine, said:

People are our most valuable resource, and it is important to listen to what they have to say. We must support our staff, to help them stay well and therefore able to care for patients, not just during the pandemic, but in the long term.

Dr Jack Parry-Jones, the Faculty’s Workforce Chair, said:

The Voices from the Frontline of Critical Care speak with pride on making it through the first wave, but also with concerns on how subsequent waves will impact them, the wider NHS, their colleagues, and family. Many were battered but few were broken. It’s very important that we listen to these voices. There are lessons to be learnt on managing and supporting intensivists. It would be foolish to assume just because we made it through the first time, we will make it through a second time without changes to how we work and are supported.

Key Recommendations from the report:

  1. GPICS standards exist for reasons of best care, safety and governance. Units should be attempting to adhere to them or working towards achieving them.
  2. Inability to meet GPICS standards needs to be brought to the attention of management structures within hospitals and plans for addressing deficiencies identified and implemented.
  3. Supporting and maintaining the wellbeing of critical care staff is vitally important. Not only for recruitment by attracting multi-disciplinary team members in, but also for their retention in the specialty. Staff must not be taken for granted and listening to the voices from the frontline is only the start of this process.
  1. Enhanced Care recommendations, written and promoted by the Faculty, will allow for greater flexibility in future responses to surges in demand as well as safer care for those needing a higher level of care. Critical Care Directorates should make the case widely within their hospitals for enhanced surgical and medical care.

You can view the full report here