By Dr Minh Alexander retired consultant psychiatrist 29 December 2022
There is secrecy about the numbers of NHS staff who have been affected by long COVID.
NHS England and NHS Digital publish overlapping datasets on staff productivity relating to COVID, but this is only framed as faceless statistics on days lost to COVID absence amongst NHS staff.
The failure to count the numbers of NHS staff affected by COVID and long COVID is dehumanising.
It may relate to official reluctance to embarrass the government about PPE and other infection control failures and/or avoidance of legal liability for COVID injuries suffered by NHS staff.
NHS trusts have disclosed by FOI that NHS England does not require them to report the numbers of trust staff affected by long COVID.
However, it appears from other FOI information that NHS England has been asking providers who operate long COVID assessment services (termed post COVID assessment services) to report the numbers of NHS staff who are referred to these specialist services:
“The trust are required to include the number of NHS Staff assessed, as part of a regular nationally mandated Long Covid Assessment Sitrep to NHS England.”
| Post COVID assessment services commissioned by NHS England Post COVID assessment services were announced by NHS England in October 2020. NHS England has published their activity data from July 2021 onwards. NHS England guidance to the providers of these services sets criteria as follows: “Ongoing symptomatic COVID-19: signs and symptoms of COVID-19 lasting from four to 12 weeks. Post COVID-19 syndrome: signs and symptoms that develop during or after an infection consistent with COVID19, continue for more than 12 weeks and are not explained by an alternative diagnosis. It usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body. Post COVID19 syndrome may be considered before 12 weeks while the possibility of an alternative underlying disease is also being assessed.” Most of the providers of post COVID assessment services are NHS trusts, but some are private organisations. The providers are listed here. I have asked for the operational policies governing these assessment services. |
Despite the fact that NHS England has been collecting data on the numbers of NHS staff referred to long COVID services, it does NOT publish these numbers.
NHS England’s published data on post COVID assessment services activity includes only the characteristics of sex, ethnicity, age and deprivation group.
There is nothing published about occupation or the sectors in which referred patients work.
This is troubling as all the characteristics of patients referred to post COVID assessment services are clearly of public health interest.
NHS England and the government acknowledged at the outset of establishing services for long COVID patients that research on long COVID was essential:
“Sir Simon said new network will be a core element of a five-part package of measures to boost NHS support for long covid patients…. (4) National Institute for Health Research (NIHR) funded research on long Covid which is working with 10,000 patients to better understand the condition and refine appropriate treatment. (5) The NHS’s support will be overseen by a new NHS England Long Covid taskforce which will include long covid patients, medical specialists and researchers.”
“Health and Social Care Secretary Matt Hancock said: “Long covid can have a huge impact on people affected….. Combined with further research and the new NHS England Long Covid taskforce, these additional services will ensure people get the care they need, improve lives and aid in the fight against this global pandemic.”
It is also possible that in addition to suppressing the numbers of NHS staff who have contracted long COVID, NHS England is withholding other sensitive data about people suffering with long COVID.
NHS England’s data requirements for providers of post COVID services are not public.
This published NHS England commissioning document refers to these data requirements but does not disclose what they are. The document instead refers providers to an NHS website for details of mandated data collection, that is not open to the public.
I have prepared a summary of the data that NHS England has so far shared with the public about post COVID assessment service activity, spanning the period 5 July 2021 to 23 October 2022:
Some of the referred patient characteristics information is incomplete, but based on what is available, females and BME people are over-represented compared to the general population.
The female to male ratio was 1.8 and the BME to white ratio was 0.24.
Referred females are also over-represented compared to ONS’s data from its coronavirus infection survey, which is based on scaling up community sampling. ONS data published on 1 December 2022 estimated that 1,101,000 females had long COVID versus 802,000 males (a ratio of 1.37 women to men).
The over-representation of females and BME people amongst those referred to the post COVID assessment services may reflect the fact that a significant number of NHS and ex NHS staff are amongst those referred.
The NHS workforce comprises 25% ethnic minority staff and 76.7% women some of whom are distributed as follows:
- 88.6% of the 342,104 nurses and health visitors are women
- 42.5% of 18,509 ambulance staff
- 77.6% of 172,267 scientific, therapeutic and technical staff
- 62% of 22,552 managers
Additionally, 43% of doctors are women and the majority of medical trainees are women.
The RCN also reported in 2019 that 81% of all UK nursing auxiliaries and assistants are female.
I have asked the CEO of NHS England if NHS England will from hereon publish the numbers of NHS staff who are unwell enough to be referred to long COVID services, and copied this to the UK COVID public inquiry.
Meanwhile, injured NHS staff and other long COVID sufferers may be waiting months for assessment. The most recent NHS England data (for the period 23 September to 23 October 2022) showed that 24% of people referred waited for more than 15 weeks to be seen, with London struggling the most at 34%.
LETTER TO AMANDA PRITCHARD 28 DECEMBER 2022:
“BY EMAIL
Amanda Pritchard
CEO NHS England
28 December 2022
Dear Amanda,
Publication of data on number of NHS staff referred to post COVID assessment services
I am concerned about the lack of published data on the number of NHS staff who have been affected by long COVID.
So far, this information has only been available through FOI requests.
As far as I can see, the data collected from post COVID assessment services that is published by NHS England includes no data on the occupation of patients referred or the sector in which they worked:
https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-post-covid-assessment-service/
The parameters from these services, that is shared by NHS England with the public, are limited to:
Total numbers of referrals
Numbers of referrals that are accepted
Numbers of assessments and follow ups
Ethnicity
Sex
Age group
Deprivation category
Waiting times
However, I now understand that NHS England in fact requires the post COVID assessment services to report to NHSE the number of NHS staff who have been referred.
One of the participating NHS trusts has informed me:
“The trust are required to include the number of NHS Staff assessed, as part of a regular nationally mandated Long Covid Assessment Sitrep to NHS England.”
May I ask if NHS England could now kindly publish these numbers as part of its activity data on the post COVID assessment services?
This information is of great public interest not only with regard to the risks and harms suffered by NHS staff during the pandemic, but it is also important information as regards the spread of nosocomial infections.
I copy this to the UK COVID public inquiry.
Many thanks,
Minh
Cc Baroness Heather Hallett & the UK COVID public inquiry
Dr Minh Alexander”
RELATED ITEMS
An NHS England director is also CEO of an NHS mental health trust, which has failed to collate data on long COVID amongst its staff:
NHS England Mental Health Tsar’s trust does not collect data on long COVID affecting its staff
I asked if the trust would start collecting this data and whether NHS England would start requiring this data from NHS trusts.
The reply: the first will be considered, the latter should be referred to NHS England.
EMAIL RECEIVED 20 DECEMBER 2022
“Dear Dr Alexander,
We have asked Pam Duke, our Occupational Health Lead to respond to your first point.
The second point will need to be directed to NHSE. If you would like to follow this up with them, here is the link to their web-site and the contact details:
https://www.england.nhs.uk/contact-us/
Telephone: 0300 311 22 33
Email: england.contactus@nhs.net
Thank you and kind regards
Sam Leathers
Sam Leathers
PA to Claire Murdoch, CEO &
Professor Dorothy Griffiths, Chair
Central & North West London NHS Foundation Trust”
It seems that counting long COVID in NHS staff is an unpopular and possibly career-hampering topic amongst the NHS brass.
NHS leavers during the pandemic and number of staff infected with COVID
NHS England Mental Health Tsar’s trust does not collect data on long COVID affecting its staff
NHS England does not want to know about long COVID in NHS staff
Alexander's Excavations 