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The second phase of a UK wide study exploring the impact of providing health and social care during the COVID-19 pandemic has revealed a workforce under pressure with many staff feeling overwhelmed; dealing with increased hours of overtime and reporting lower levels of mental wellbeing.

The project team has developed 15 good practice recommendations at individual, organisational and policy level to support the health and social care workforce.

The COVID-19 Health and Social Care Workforce Study is a three-phase study led by Ulster University in partnership with researchers from Queen’s University Belfast, Bath Spa University, King’s College London and the Southern Health and Social Care Trust in Northern Ireland.

Open to social care workers, social workers, allied health professionals, nurses and midwives, the survey received 3,499 responses from across the UK. The survey was open between November 2020 and January 2021 and builds on findings from the team’s earlier Phase 1 survey (May- June 2020).

The survey measured mental wellbeing, quality of working life, burnout and ways of coping. Open ended questions enabled people to provide more detailed responses and two focus groups were held to gather experiences of both frontline workers and managers.

Overall, respondents had been working more hours overtime since the start of the pandemic compared to before. When asked about the impact of COVID-19 on their work, nearly half (49.3%) of the respondents UK-wide felt overwhelmed by increased pressures, 46.1% felt impacted but not significantly and only 4.6% reported that their service had not been impacted or had been stepped down. Social work and nursing were the most impacted occupational groups.

Responses to open-ended questions and the focus group discussions found some common themes. The over-riding themes remained consistent between the two surveys, and were Working Conditions, Connections with co-workers and employers, and Communication.

Overall wellbeing decreased across all occupational groups. Wellbeing scores indicate an increase in levels of depression and anxiety, which increased from 9% of respondents in the ‘likely’ category and 33% in the ‘possible’ category in the first survey to almost 18% ‘likely’ and a further 22% in the ‘possible’ category in the November-January 2021 survey. Wellbeing levels were lowest among staff who indicated their services were overwhelmed.  Positive coping strategies (e.g., active coping, positive reframing, acceptance, exercise) were associated with higher mental wellbeing, better quality of working life and lower burnout scores. Negative coping strategies (e.g., venting, substance use, self-blame) were associated with lower mental wellbeing, worse quality of working life and higher burnout scores. Ways of coping changed between the first and second surveys. Respondents appeared to be using positive coping strategies less and negative coping strategies more in the second phase.

Based on the survey results the project team has developed 15 Good Practice Recommendations under the three main themes of Changing Conditions, Connections and Communication. The recommendations are applicable on an individual, organisational and policy level to support the health and social care workforce.

Some examples of the Good Practice Recommendations include:

Changing Conditions

  • Putting into practice the advantages of more flexibility in employment which is appreciated by staff and should be considered if they can be permanent after the pandemic
  • Training for redeployment for skill mix and skill acquisition to equip staff with the ability to, where possible, perform multiple or new roles
  • Staff wellbeing and retention to take into account staff burnout and the need to give staff time to recover


  • Evidence-based good practice guidance on communication that meets the broad range of needs of health and social care services with strong input from the frontline
  • Increased management visibility would help workers feel valued and that work pressures are understood
  • Supportive supervision


  • Survey highlighted evidence of good signposting to support services and counselling. This should be sustained and made available to staff to manage the aftermath and emotional impact of the pandemic
  • Team support and camaraderie were noted by the workforce as critical to support their coping and wellbeing. Initiatives should include support for managers.
  • The pandemic has shone a light on the chronic underfunding of staff and infrastructure. The report recommends high level efforts to make nursing, midwifery, AHP, social care and social work sectors an attractive career option with pay and working conditions requiring sustained attention.

Principal investigator of the study Dr Paula McFadden, Senior Lecturer in Social Work at Ulster University, commented:

“The results of this UK wide study highlight that a systems level approach is required to support the health and social care workforce to rebuild, re-set and recover from the impact of prolonged exposure to work related job pressures due to the pandemic.  This will require individual, team, organizational and policy level wellbeing interventions. We hope that our research and learning from this period can be applied to ‘business as usual’ service delivery and in planning for future pandemics or disasters.”

Dr Denise Currie, Senior Lecturer in Management, Queen's University Belfast said:

"The testimonies of our participants underline that frontline health and social care workforce have been shouldering much of the burden of the pandemic as they try to meet the physical and emotional needs of the people they care for, alongside contending with their own individual circumstances. The survey responses indicate concerning levels of burnout for a large proportion of respondents, highlighting the importance of ongoing individual and organisational level interventions to help address workforce wellbeing. However more than a ‘sticking plaster’ is required - it is also clear systemic interventions are needed to enable the workforce to recover and reset for the future."

Marian O'Rourke, Interim Director of Regulation and Standards, Northern Ireland Social Care Council said:

“This research led by Dr Paula McFadden at Ulster University, is a timely and extremely valuable study from a regulatory perspective, as it provides research results in real time, as the COVID-19 pandemic has surged and retreated. The findings provide all stakeholders with timely research insights which are evidence based and accessible. The study also covers both health and social care professionals and is U.K. wide, enabling comparisons, We are keen to continue supporting this research through the next phase in May-July 2021.”

A third survey will be conducted in May-July 2021. Thanks to a collaboration with colleagues in Gavle University, Sweden, the survey will also be conducted there within 5 municipalities.  This will enable comparisons to be made between countries with very different approaches to managing the pandemic.

Read the full report here:

This research is funded by the Public Health Agency, Research and Development Division, Northern Ireland and supported by the National Institute for Health Research (NIHR) Policy Research Programme, through the Policy Research Unit in Health and Social Care Workforce. The views expressed are those of the authors and not necessarily those of the funders or the NIHR.