Covid inquiry: NHS workforce ‘neglected’ in run-up to pandemic

Module 3 of the UK Covid-19 Inquiry, which began earlier this week, is focused on the impact of the pandemic on healthcare services, the healthcare workforce and the people being cared for by them.

“There were signs going into the pandemic, for the few years in the run-up, that the workforce had been largely overlooked and neglected”

Sara Gorton

Sara Gorton, national secretary at Unison, appeared as a witness to Module 3 of the inquiry on Thursday, 12 September.

At the time of the pandemic, Ms Gorton was head of health at the union which represents various NHS staff including nurses and healthcare support workers.

As well as this, she was co-chair of the NHS Staff Council and NHS Social Partnership Forum and was involved with the Trades Union Congress (TUC).

Counsel to the inquiry Nick Scott interviewed Ms Gorton about the impact of the pandemic on staff, their resilience and the expectation versus reality of the response to such a health emergency.

He asked Ms Gorton if there were any plans in place for how nurses and other NHS staff would be used in the event of a pandemic.

Ms Gorton pointed to a statement, published by the NHS Staff Council on which she sat, in January 2020.

This statement, Ms Gorton judged, contained the “key principles” of how nurses, doctors and other clinical staff should have been deployed should Covid-19, as it later did, hit the UK health system.

However, she said that this plan was not necessarily followed.

“I think the question is to what extent those principles were able to be put in place,” she said. “And how these were interpreted at a localised level was the major difficulty.

“You can see they focussed on making sure that people who are looking after Covid patients, who are working with PPE, have access to lots of rest, the link between fatigue and burnout, and you know from your own experience of the pandemic, that the situation… didn’t come to pass in the way people were expected to work.”

Mr Scott asked: “You’ve got the principles, how much [was] then delivered is a different matter?”

Ms Gorton responded: “That’s right, and all the guidance that might need to sit behind it.”

Ms Gorton, in her evidence, gave further context about the difficulties the NHS workforce was facing even before the pandemic hit.

“There were signs going into the pandemic, for the few years in the run-up, that the workforce had been largely overlooked and neglected in favour of a government and policymakers who seemed to be obsessed with structure, system architecture, rather than addressing the needs of the workforce,” she said.

Ms Gorton later added: “Ahead of a major crisis, you want people to feel well motivated and well rested and able to deal with it, and the signs were there… that this was not the condition of the NHS workforce.”

Mr Scott also asked Ms Gorton if, in her view, enough had been done to “rebuild” the trust of minority ethnic nurses and other healthcare staff, who had been disproportionately impacted by the pandemic due to issues of support and personal protective equipment.

Ms Gorton said that, having spoken with staff at a TUC event recently, “the feeling… was clearly that not enough had been done”.

Earlier in the week, the inquiry heard from Diya Sen Gupta KC, representing the Frontline Migrant Health Workers Group, about the impact on minority ethnic, in particular Filipino, nurses.

Ms Sen Gupta asked Ms Gorton if she was aware of any action taken by NHS management at the time of the pandemic to “address or monitor” this inequality, and if Unison or the TUC raised the issue with the NHS.

In response, Ms Gorton said: “I do remember us talking about the disproportionate impact on [minority ethnic] staff in general, and I remember specifically in relation to the issue of the helpline discussions about impact on Filipino nurses, and other Filipino workers. But beyond that, I can’t recall specifics.”