Table 2

Summary of findings from all three workstreams

Emerging findings from all three workstreamsExamples from media analysis (including social media)Representative quotes from the interviewsContent from UK policies
Concerns about changing and inconsistent guidelinesStaff used social media to share guidelines among colleagues.‘A protocol a day for every single step(…)becomes obsolete after 24 hours’Policies related to PPE, for instance, changed over the course of the pandemic, with one major change being the allowance of PPE reuse.
Lack of training (for redeployed staff but also in relation to PPE)Newspaper articles indicated that HCWs felt that advice, information and training were insufficient.We had training on a specific kind of face mask but other than that have not really had training.’
‘In ICU the non-specialist nurses change every day and have to relearn skills.’
Lack of streamlined and inconsistent testing of NHS staff‘Many healthcare professionals are questioning why they, as front-line NHS staff, are continuing to be denied testing for COVID-19 while an MP (Member of Parliament) has not’ (News article, 12 March 2020).Staff are jeopardising the life of their own families.’
‘At one point we were told we might not get tested even though one person in the team had confirmed COVID-19 which seemed to go against previous suggestions.’
Policies and the infrastructure for testing HCWs increased throughout the study.
Difficulties with PPE use (size, overheating, dehydration)HCWs tweeted about dehydration and the challenges of PPE use when fasting during Ramadan.Claustrophobic, even for half an hour. You can’t breathe, it is hot and heavy. Can’t interact properly.’
‘Even the small-sized masks are designed for small men rather than women.’
Guidelines urged HCWs following Ramadan, and their NHS colleagues, to support their need to take breaks and stay hydrated while fasting and wearing PPE.
Good well-being supportWe’ve got a whole well-being group that we’ve set up…there’s been a lot of focus on trying to help staff through this.’
‘We are busting a gut to do what we can for staff morale.’
National guidelines have included more information on revised methods of delivering mental health services than on their availability and use by health workers.
Solidarity among colleaguesOn social media some HCWs affirmed pride in doing their jobs on the front-line despite challenges and fatigue.‘The way people come together in a crisis has been a very enjoyable part of it…staff have formed new connections which I think they’ll strengthen our network at work and strengthen the way we work together.’
Demonstration that quick changes are possible in the healthcare system‘'We would not expect our system to be overwhelmed but would expect it to be radically changed (News article, 05/03/2020).’Demonstrated that change can be done quickly, what normally takes a year can be done in week (red tape). We are able to do more in a short time.’
‘Some of what we’ve had to do will be the catalyst for changes that we thought we would make at some point in the future but hadn’t had the means to do.’
Rapid establishment of 3 laboratories to develop COVID-19 testing kits to test HCWs.
  • HCW, healthcare worker; ICU, intensive care unit; NHS, National Health Service; PPE, protective equipment.