Impacts of the COVID-19 pandemic on training, morale and wellbeing among the UK renal workforce

Hannah Beckwith; Paul Cockwell

doi:10.7861/clinmed.21-2-s62

Introduction

The impact of COVID-19 on training, morale and wellbeing has not yet been determined. Using the UK renal workforce as a study population, we explored these issues.

Methods

An online questionnaire (incorporating the Maslach Burnout Inventory score¹) was developed in SurveyMonkey and sent to all members of the Renal Association.

Results

Overall demographics (195 respondents): 68 consultants, 52 trainees, 3 clinician scientists, 43 nurses, 11 allied health professionals (AHPs) and 18 ‘other’.

Wellbeing:

Overall, levels of burnout seen in the first wave of the COVID-19 pandemic were low.
Place of work during the COVID-19 pandemic (renal vs general / acute medicine vs intensive care) had no effect on burnout scores, neither did ethnicity or working pattern (full vs less-than-full time (LTFT)).
Differential burnout scores were seen among workforce groups (Fig 1). The highest levels of emotional exhaustion were seen in registrars and clinical research fellows (CRFs) (although this did not reach statistical significance), with CRFs also experiencing low levels of personal accomplishment (p=0.01). Concerningly, gender differences were seen, with significantly lower levels of personal accomplishment found among female physicians (p=0.003).

Fig 1.

Burnout scores within the renal workforce.

Medical workforce: 86% of the medical workforce were working full time and 14% LTFT during the pandemic. 46% were living with a child or children under 18 years old and 15% were living alone.

Shielding: 10% of medically trained respondents were shielding (4% of trainees) and 64% were able to work remotely. 90% felt tasks allocated were suitable for their role although 50% of trainees felt they did not have appropriate supervision.

Impacts on working patterns and educational opportunities: Over half of all medical job roles were changed (Table 1), with most reporting an increased workload. Disappointingly, over a quarter of trainees and 13% of consultants did not feel supported by their department during the pandemic.

View this table:

Table 1.

Effects on working patterns and educational opportunities for consultants and trainees

Effects on training:

77% of trainees felt their training has been affected – the majority citing lack of access to specialty outpatients, transplantation and procedures.
14% will need training length extended or are unable to receive their certification of completion of training (CCT) as planned.
23% stated the pandemic had impacted on their immediate/future work plans, largely surrounding research grants, ability to go out of programme for research (OOPR) and cessation of penultimate year assessment (PYA).
All felt that some aspects of training improved, particularly access to remote working/education and discussions surrounding prognosis / end-of-life care.

Other impacts of COVID-19: Flexibility around home working and subsequent better work–life balance was noted, as well as a ‘reduction in wasteful interactions, particularly outpatients'. Lack of leave, constant rota changes and high frequency / work intensity were highlighted negative effects.

Conclusion

This is the first description of the effects of COVID-19 on the renal workforce. Uniquely it includes nursing and AHP staff, vital to the pandemic response. Findings may be generalisable to all medical specialties. Pleasingly, low levels of burnout were seen overall, but differential scores seen in female physicians and trainees needs further exploration. Significant impacts on working patterns, educational opportunities and training were described, although COVID-19 improved some aspects of working life.