FAQ: the long-term impact of Covid-19

Professor Harj Kaul fields some common questions about the impact of the pandemic

Consultant Occupational Health Physician and RMBF volunteer Professor Harj Kaul fields some common questions about the impact of the pandemic – covering “long Covid”, mental health, remote working and more. Read on below for his advice, as well as a wealth of links and resources.

Many medical practitioners have developed ongoing complications of Covid-19, currently recognised as “long Covid”. How should we try to deal with this issue?

The most helpful approach for people with long Covid seems to be self-education about the condition and the process of recovery, paired with access to good support systems. The links below are a good place to start on both counts.

There are more Facebook groups dedicated to supporting doctors recovering from Covid or living with long Covid. It is worth searching to see if there is a community you might find helpful to join.

Many households are struggling with their finances as a result of Covid-19. Is there somewhere to access free financial advice?

The RMBF is the UK charity for doctors, medical students and their families. We have already been able to give financial help to many medics who are struggling due to pressures caused by the pandemic. Find out more about how we might be able to help you.

NHS England and NHS Improvement partnered with the Money and Pensions Service to provide a mini series of free financial wellbeing webinars in 2020, for all NHS staff. They are still available to watch online.

Step Change and the Debt Advice Foundation are charities supporting people to deal with debt problems. They offer advice online or via phone, and they can help plan and set up a process to deal with your debts.

Charities the National Debtline and Business Debtline offer support via phone and online chat. They run on an assisted self-help model – for example, providing sample letter templates for writing to creditors, the council, etc. Business Debtline specifically covers people who are self-employed or run micro-businesses, which may be useful for GPs. Both websites have dedicated Covid-19 advice hubs.

Money Saving Expert has dedicated financial information for Covid-19, including employment advice, and help with finance and bills.

The Money and Pensions Service (MaPS) aims to help people make the right financial decisions and make the most of their money and pensions. The Money Advice Service is part of MaPS, and offers a budget tool which can be very useful, especially if you are working from home more. Remember that you may be saving money by not spending on things like transport and socialising. Factor that in when looking at your budget.

As more doctors are being advised to work from home or to explore the possibility of remote working, could you give me some ideas on how to we can do this safely and efficiently?

While the situation is complicated, especially for those who have been shielding, many medics have been remote working as part of a return to some semblance of normal duties. An important caveat is that ideally employers should take a “blended approach”, not purely 100% remote working if possible and safe, in order to keep some human contact and a changing environment.

Areas that need to be considered when setting up a work station at home include:

  • Effective VPN technology
  • IT support and digitally secure equipment
  • Home work environment that meets basic health and safety regulations, e.g. display screen equipment
  • Ergonomics of working at home (this Youtube video is a useful primer)

What advice would you give on the best use of telehealth and video consultations as a doctor?

The following sources give very practical, if generic, advice and suggestions:

If you work in primary care, perhaps part of a Primary Care Network, there is a lot of national work going on. Many commissioners are looking at the specific triage models and working with certain NHS-approved IT organisations.

What about the ethics of remote consultations?

The GMC has some useful guidance.

How can I support remote workers as a medical manager or leader?

This expert guidance from occupational psychologists is detailed and very useful:

Managing remotely: is it time to rethink how we manage our employees?

Mental Health at Work have a comprehensive toolkit on this topic:

Coronavirus: Coping with the challenges of working from home

Mind have an excellent guide focused on mental health while home working, with templates that employees can use to make an action plan:

Working from home: a Wellness Action Plan

Other useful articles on this important topic are available from NHS Employers and ACAS.

The Health and Safety Executive (HSE) has guides on protecting home workers and lone workers.

The Institution of Occupational Safety and Health (IOSH) has a guide on managing remote workers.

If you are really interested in knowing at a deeper level the wider challenges facing the NHS from a psychological perspective, it is worth browsing this article from the Parliamentary Office of Science and Technology:

Mental health impacts of COVID-19 on NHS healthcare staff

How might things pan out in the future from an NHS “back to normal business” perspective?

Things have changed because a significant number of healthcare workers, both clinical and non-clinical, have had to deliver their roles through remote working. The innovative systems and different ways of working involved have brought their own opportunities and challenges. Some of the “good stuff” needs to be embedded into your practice.

Many regional NHS organisations have had to learn to work together during the crisis. There seems to be more of an acceptance of joint working between primary and secondary care, as well as a number of NHS linked organisations, including Health Education England (and equivalent organisations in the devolved countries), NICE, AoMRC, CQC and the professional regulation organisations.

This sense of community has led in some circumstances to growth and positive opportunities.

Ultimately you need to remember why you became a medical practitioner. If you can keep that as your purpose, and focus on delivering the skills and expertise you have, we will all get through this and could even be positively changed for the better for the sake of our patients and ourselves.

There is an interesting view from the ex-chairman of ACAS talking about the world of work and how it will look different from now on.

Building back: making working lives better

There is also a view from a European research organisation about what impact the pandemic has had in the workplace.

Eurofound: Living, working and COVID-19

Professor Harj Kaul is a Consultant Occupational Health Physician and Clinical Lead at Leicester University Medical School, Leicester Partnership NHS Trust and Glenfield Hospital.