CBS’ Groundbreaking Research Makes Headlines Across the Nation

03 September 2020

August was another busy month at the Confederation of British Surgery, and for members and non-members alike the work on the front lines of the C-19 pandemic has not subsided. As have previously noted, the challenges of meeting a ‘new normal’ are more complex since they are compounded by many members of essential hospital staff suffering the effects of illness and burnout (see the June blog, Mutual Support and Limiting Moral Distress in the Time of C-19), as well as facing hospitals’ pressing backlog of delayed operations.

In last month’s blog, How Knock-On Effects Challenge “the New Normal,” we noted our dismay at the inadequate protections and provisions that have been made as of yet for the wider communities of medical professionals and healthcare support workers who continue to risk their health, as well as the health of their families, in order to diligently perform above and beyond the call of duty.

While the Government announced in July that nearly 900,000 public sector workers, including senior doctors, were given a pay rise above inflation backdated to April 2020, this left out more than 1 million NHS staff, including nurses, cleaners and care assistants who are on a different contract. CBS continues to support the protests that occurred early on in August, as thousands of nurses and NHS staff demonstrated in over 30 towns and cities across the country – including Cardiff, Edinburgh, Liverpool, Newcastle and Sheffield – in order to demand planned pay rises be brought forward from April 2021, in the wake of their service on the front lines of the pandemic.

After polling over 650 surgeons across the UK to generate groundbreaking research, the Confederation made headlines across the nation in the Daily Telegraph, the Independent, and the i, as well as on Health Business and Risks, the publication on union health and safety from the TUC.

Startling new statistics generated by the research (which can be viewed in full here) revealed views from hundreds of clinicians across the country, 85% of whom had more than 8 years’ experience as consultants, and two out of five had over 18 years’ experience. While the data was gathered from a wide range of specialist disciplines, the majority of respondents came hailing from general surgery; trauma and orthopaedics; plastic surgery; and obstetrics and gynaecology.

In ‘taking the temperature’ of the surgical community, CBS noted that there were some aspects which were perhaps unsurprising (for example, surgeons’ views on the lack of appropriate PPE guidance and provision) however, others were more alarming, and telling of a disturbing culture of suppression around the risk factors affecting surgeons and other medics. These issues are so vast that the current state of affairs even saw a significant percentage of surgeons prepared to abandon their roles.

Professor John Macfie, consultant colorectal surgeon and CBS President was quoted as saying: “The level of dissatisfaction with the lack of preparation for the crisis, and perceived disregard for healthcare workers’ safety was such, that one in twelve of all respondents are considering changing their discipline or leaving the field of surgery altogether. That, in fact, is a figure that should be horrifying to all.”

A third of respondents said PPE provision was inadequate at their hospital, painting a dire picture of how surgeons are coping across the nation. Of those who identified inadequate provisions, 80% complained of low supplies, rationing and shortages; 70% cited ever-changing or inconsistent guidance; nearly half said they’d experienced problems with the actual quality of PPE (for example, in some cases it did not fit, or single-use items had to be re-used), but equally shocking, over 10% were told by their employers to keep quiet about problems with PPE.

Surgeons across the country were divided on whether the guidance for PPE usage by UK public health authorities was adequate, but respondents cited the most pressing problem to be inconsistency, with recommendations changing daily or weekly, and from Trust to Trust or even hospital to hospital. Many surgeons complained of a lack of solid scientific evidence for the guidance with some even stating certain measures were excessive, or inappropriate/inconvenient for the work being carried out.

The press release (available in the CBS News section) also denoted respondents’ top ‘lessons’ learnt from the pandemic, with the top 5 including an urgent need for better preparation in the future; the importance of embracing new technologies; and a vociferous call for clinical/scientific leadership, rather than political leadership, as surgeons were highly critical of the Government’s response to the pandemic. Additionally, they highlighted surgeons’ thoughts on the significance of learning from other countries, and the rejection of traditional British ‘exceptionalism.’

The Confederation’s findings highlighted the urgency for investment in chronically underfunded areas – particularly within education and training. Consultant plastic surgeon and Founding CBS member Mark Henley stated, “sadly, it is impossible to ignore the scathing criticism of the Government’s pandemic response.”

Consultant plastic surgeon and Founding Member of the Confederation Nigel Mercer warned that the issues that had been raised by the pandemic were not clear cut, nor are they resolved. He said, “there is significant concern that the multiple changes made to Guidance about Covid testing, combined with the reluctance to regularly test NHS staff, significantly impact on maintaining ‘Covid lite’ pathways, which are essential to ensuring maximum safety for patients and staff. Combined with ongoing concerns about PPE and a potential second wave of Covid in the Autumn, it is clear that both patients and staff remain very concerned about post surgery Covid security. Maximising new technology and especially testing and track and trace are essential for safety in perioperative care.”

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