Long Covid

Baroness Watkins of Tavistock Excerpts

Thursday 17th November 2022 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

It is a pleasure to follow the right reverend Prelate the Bishop of Exeter, whom I know well and whose speech I completely concur with. Happily, mine does not completely reflect it. I also acknowledge the work of the noble Baroness, Lady Thornton, in getting this debate for us to consider today.

I will particularly highlight the challenges of long Covid on mental health services, healthcare staff and children’s education and health, and therefore need to declare my interests as a registered nurse and president of the Florence Nightingale Foundation.

I note that the lack of consistency on the definition of long Covid makes it difficult to measure and analyse the emerging evidence. Despite this, the NIHR estimates that 1.8 million people in the UK—as others have said, 3% of the population—are experiencing symptoms of long Covid. Its studies published in 2021 showed that up to one in three people who have had Covid-19 report long Covid symptoms, and up to one in seven children. The scale of chronic ill health and disability after Covid-19 has been described as the next big global health challenge. I am not sure that it is the next big one; I think it is the immediate one.

According to the NIHR’s survey of 3,286 people with long Covid, 71% said it was affecting family life and 80% reported that it affected their ability to work. The Ulster University survey of 3,499 healthcare staff demonstrated that 49.3% felt overwhelmed by pressures of the pandemic, with social work and nursing the most impacted.

NHS Check, a study by King’s College London—where I must declare I have a visiting chair—looked at 18 partner NHS trusts and found high levels of distress and symptoms of anxiety in staff working in healthcare. A concerning finding was that there was a high prevalence of PTSD symptoms and self-harm. This has caused long-term absence of staff due to Covid-related sickness, resulting in people at work carrying out jobs out of their skill set and/or being overworked. It is reported that these issues have directly impacted the quality of care and waiting times and, in extreme situations, have led to unsafe practices. Dissatisfied patients have resulted in increased abuse towards healthcare workers, exacerbating their exhaustion and anxiety levels. Those on long-term sick-leave have suffered isolation and financial difficulties, intensified by the recent soaring cost of living, leading to further distress and longer absences from work, and some healthcare workers have lost their jobs due to long Covid.

The impact of staff shortages from long Covid has also led to a breach in some patients’ human rights: namely, the illegal detention of patients. Last week, the Independent reported that mental health patients were being held “unlawfully” in A&Es due to shortage of staff to undertake timely mental health assessments. I must stress that I believe that that has been to protect their safety, but none the less it is a severe problem.

The effects on our children are highlighted in Ofsted’s second report on the impact of the pandemic and school closures. It demonstrates that children have regressed in basic skills, physical fitness and learning, particularly those whose parents were unable to work flexibly—including, of course, health workers. Children were found to show increased signs of mental distress, including a rise in eating disorders and self-harm.

Social isolation and greater exposure to family conflicts have added to children’s mental ill health, leading to an increase in the number of referrals to CAMHS, which has not been matched by an increase in investment in children’s services. A large study by the NHS in 2020 found that mental health conditions among children had risen by 50% compared to three years earlier. I think that will be even higher in the next piece of work on that issue. It is sad that Baroness Sally Greengross is not here to argue for intergenerational fairness on this issue.

These academic studies have shown major organisational changes across the NHS, with substantial physical and mental health challenges for NHS staff and other care workers during the pandemic. Results also indicate the importance to support staff so that they can contribute to service recovery. Therefore, can the Minister explain the Government’s position regarding the implementation of the proposed 10-year mental health and well-being plan for NHS staff and, in particular, the investment to support staff with long Covid?

Will the Government make further contributions to NIHR for global collaborative research to increase our understanding of long Covid and its impact and, in particular, to generate evidence-based interventions that may enable the health recovery and mental resilience of staff impacted by long Covid and support them to return to work, thus ensuring their retention in healthcare practice?