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15 June 2020

NHS Check study to explore the effect of the COVID-19 pandemic on NHS staff

NHS Check, led by Professor Simon Wessely, will explore how the COVID-19 pandemic disrupts the work of NHS staff to identify how best to support acute hospital staff during pandemics. It will also explore how to mitigate ethical dilemmas and moral injury of staff, caused by changes in working conditions because of the pandemic.

‘NHS Check’ study to explore the effect of the COVID-19 pandemic on NHS staff

In March 2020, King’s College London launched rapid response funding call, ‘King’s COVID-19 Response’, to address the very real challenges and hardships caused by the ongoing COVID-19 outbreak across the globe. This study is one of six projects led by the Institute of Psychiatry, Psychology & Neuroscience that was awarded funding as part of the King’s COVID-19 Response.

During the COVID-19 pandemic, many NHS staff will have to make difficult choices they have not before faced, to deliver care which they know is suboptimal and explain this to relatives. These ethical dilemmas will be new and will likely result in some staff experiencing moral injury.

Moral injury is a relatively new concept with particular relevance to the current COVID-19 outbreak. Originating in the military, moral injury describes the psychological distress resulting from actions, or the lack of them, which violate someone’s moral or ethical code.

We know that some NHS staff will unfortunately develop mental health difficulties as a result of their important work; however, others will no doubt thrive on the challenge and may experience post-traumatic growth. NHS Check is a really important way to properly understand the impact on staff and identify which of the many supportive measures that were put in place may have been helpful.

Professor Neil Greenberg (Co-investigator), Institute of Psychiatry, Psychology & Neuroscience, King's College London

The experience of ethical dilemmas resulting in moral injury can lead to negative thoughts about oneself, others and intense feelings of shame, guilt, anger, or disgust. These feelings may eventually lead to the development of mental health problems, such as depression, anxiety or PTSD.

The project will explore how a range of individual factors may influence the experience of moral injury in staff, examining everything from professional culture, organisational preparation, team leadership, quality and honesty of staff briefings, and formal training and interventions.

NHS Check has a large and defined sample; the study is specifically trying to recruit people from diverse backgrounds and roles and tries to balance both the negative and positive aspects of the current COVID-19 crisis on staff.

Professor Simon Wessely (Principal Investigator), Institute of Psychiatry, Psychology & Neuroscience, King's College London

The study research team includes Professor Simon Wessely (Principal Investigator), Professor Matthew Hotopf, Professor Reza Razavi, Professor Neil Greenberg, Dr Sharon Stevelink, Professor Rosalind Raine, Dr Sean Cross, Professor Chris Dickens, Dr Amy Dewar, Dr Mary Docherty, Dr Sarah Dorrington, Dr Sam Gnanapragasam, Professor Damien Longson, Dr Ira Madan, Dr Isabel McMullen, Dr Dominic Murphy, Dr Martin Parsons, Dr Catherine Polling, Prof Anne Marie Rafferty, Prof Anthony David, Professor Tayyeb Tahir, Dr Peter Trigwell and Dr Charlotte Wilson Jones.

You can find out more about the study on the NHS Check website.

A similar study is being conducted by the Coronavirus: Health & Experiences of Colleagues at King’s (KCL CHECK) team looking at the impact of the COVID-19 pandemic on the King’s community. The results of this study will be circulated in due course.

In this story

Simon Wessely

Regius Professor of Psychiatry