The Faculty of Intensive Care Medicine: Voices from the frontline of critical care (November 2020)

Summary

In October the Faculty of Intensive Care Medicine surveyed their Fellows and Members about their experiences and feelings during the first wave of the COVID-19 pandemic. They have published Voices from the Frontline of Critical Care based on the results of this survey.

Content

Key findings

• 45% of respondents have seen a permanent increase in the critical care capacity of their directorates. However, when asked if they consider any increase in capacity to be adequately staffed only 18% of respondents agreed.
• 60% of respondents reported that their units are still attempting to follow the Guidelines for the Provision of Intensive Care Services (GPICS) but 54% of respondents have seen some relaxation of those standards including to their medical staffing.
• 80% of respondents increased their working hours, and 71% report covering sick consultant colleagues. Future uncertainties affect the wellbeing of the Faculty’s fellows and members. How hospital structures support those working in critical care is vitally important for both recruitment and retention.
• 88% of respondents had leave cancelled. Work/life balance is extremely important. Whilst the vast majority of respondents were happy to deliver the needed increase in work in the first wave, to do this over subsequent waves of the pandemic becomes increasingly difficult for individuals and their family. Supporting professional activities and agreed job plans will be even more important in subsequent COVID-19 waves.
• Faculty fellows and members understood the impact the first wave of COVID-19 had on non-critical care staff, and hugely appreciated their response to the crisis. The flexible increase in staffing was so important for care, although the drop in GPICS standards underlines the need to increase the underlying critical care capacity, and the multi-disciplinary workforce.

Key recommendations

1. GPICS standards exist for reasons of best care, safety and governance. Units should be attempting to adhere to them or working towards achieving them.
2. Inability to meet GPICS standards needs to be brought to the attention of management structures within hospitals and plans for addressing deficiencies identified and implemented.
3. Supporting and maintaining the wellbeing of critical care staff is vitally important. Not only for recruitment by attracting multi-disciplinary team members in, but also for their retention in the specialty. Staff must not be taken for granted and listening to the voices from the frontline is only the start of this process.
4. Enhanced Care recommendations, written and promoted by the Faculty, will allow for greater flexibility in future responses to surges in demand as well as safer care for those needing a higher level of care. Critical Care Directorates should make the case widely within their hospitals for enhanced surgical and medical care.