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In the midst of the recent Covid-19 crisis, like many of us, my head has been unremittingly absorbed with the impact it is having to countless people. My thoughts have obviously been with our NHS staff on the frontline and our key workers but more so recently with the (perhaps) overlooked NHS 111 staff.

Having formerly (and proudly) worked in the NHS 111 service for 6 years in the roles of Clinical Advisor, Clinical Network Manager and Clinical Lead, I would like to say a heartfelt thank you to my former colleagues, and other 111 teams, on the Covid-19 frontline. Yes…my mind is in a whirlwind trying to comprehend the effect it is having on the call centres that I frequented as well as on the staff that I worked alongside, managed or led in my various posts. A pandemic. This puts our previous flu seasons into a completely different league. The latter were more than hectic…non-essential work and CPD training put on hold until the summer months with all clinical (and non-clinical) hands on deck to hit the ground running. Add a splattering of snow to the situation and that fuelled the fire rather than put it out! So, now I can only imagine what the clinical and operational teams are going through in the situation of where we have suddenly found ourselves.

From my experience wearing different hats in the service, I can only speculate on the likely impact to each of these roles – or do I?  This morning was time to reach out to some of my previous colleagues to get their feedback on how it has been.

As a Clinical Advisor, I envisaged there obviously being a huge increase in the sheer workload of calls, the panic and extreme emotions of the callers and the patients but also actually of the health care professionals themselves. The anxiety about their own situation, their colleagues and families – especially if working from the call centres. Those fortunate to be already set up from home will have other anxieties…less of a support network and a feeling of working in silo.

Feedback from my welfare check with Clinical Advisor (A) reflected this:

“It has been incredibly stressful, we have had to learn as we go along and never before have I appreciated the support of my colleagues as much as I do now. If I was lone-working, it would be so much more stressful but, here, we are all in it together. It has, however, actually been good knowing that I will get some adult conversation at the weekends at work as it is just me home-schooling the children during the week!”

As a Clinical Network Manager, my mind has been blown just contemplating the stacks of patient calls, the stress involved with managing the never-ending queue of clinical call-backs and tirelessly trying to keep on top of risk assessing the said queues when also juggling the queries, concerns and demands from clinical and operational teams. This, in an already pressured role.

Feedback from my welfare check with Clinical Network Manager (B) reiterated this:

“It is incredibly busy and fast paced in terms of guidelines changing literally daily! New measures are being implemented to accommodate the increased call volume which has risen massively and continues to do so regardless of the repeated government message advising the online facility. This leads to hugely delayed call-back times when the caller could have had an instant response…! 

In the Clinical Lead role, managing and leading these huge teams of clinical staff, I imagine that the HR and Clinical Governance would be paramount at these times. There would be extra pressure due to staff sickness (because of the virus or due to stress) as well as the need to fill the resulting shortfall in shifts. To have absolute assurance that the work carried out in this pandemic is still meeting the high standards expected by the CQC, of adhering to the SOPs and that auditing is still being carried out would also be essential.

Feedback from my welfare check with Clinical Lead (C) echoed this:

When this all kicked off, we had 500 calls queuing at the front-end trying to access the service – just to get through to speak to someone. This was routine for a while – it is now around 50 but this is still unheard of. The calls have increased in number also due to the worried well. Staff sickness due to symptoms, or self-isolating due to family having symptoms, is hitting our shifts being covered. On a positive note, responses from other NHS organisations have been great – GPs offering to take calls here, CCGs getting involved and medical students being fast-track trained in Pathways to be Health Advisors. The call centres are set-up so that staff sit at every other desk, hand gels are plentiful and staff are thorough in cleaning their desks, chairs, phones and computers before and after shifts. The cleaners are working tirelessly in disinfecting all surfaces, door handles etc 3 x a day and a lot of staff are picking up overtime shifts as well as being set-up at home”.

….The hats I ‘wore’ in the 111 service?…they definitely ‘go off to’ all the 111 staff.  The media hasn’t always been kind to the service – let’s hope this now changes.  Well done ladies and gentlemen – hand on heart that I can say – those calling the 111 service in these desperate times of need are in the best possible hands!

Written by Jane Charman (ECG, Clinical Governance Lead), Friday 3rd April 2020

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