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The third 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, working longer hours and at risk of burnout.

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 five phase study led by Ulster University in partnership with researchers from Queen’s University Belfast, Bath Spa University and King’s College London.

Open to social care workers, social workers, allied health professionals, nurses and midwives, the third phase of the survey received 2,721 responses from across the UK. The survey ran between May and July 2021 and builds on findings from the first two phases of the study (May- June 2020 and November 2020-January 2021). Originally, the study was funded for the first three phases but additional funding has been awarded to continue this research for two future phases, November – January 2022 and May – July 2022.  Across the first three study phases, more than 10,000 workforce participants have taken part in this study.

The survey measures mental wellbeing, quality of working life, burnout and ways of coping at timepoints, following the peaks and troughs during the pandemic. Open ended questions enable respondents to provide more detailed responses and focus groups are conducted at intervals to gather accounts of both frontline workers’ and managers’ experiences.

Overall, respondents in the May – July 2021 period, have been working more overtime since the start of the pandemic compared to previously. When asked about the impact of COVID-19 on their work, more than half (62.1%) of the respondents UK-wide felt overwhelmed by increased pressures, 34.5% felt impacted but not significantly, and only 3.4% reported that their service had not been impacted and/or that it was stepped down. Social care workers and social workers were the most impacted occupational groups.

The overarching themes that emerged in Phase 3 have similarities to the themes identified in Phases 1 and 2; Changing conditions, communication and connections with an additional theme emerging around the boundary of home-work life.

Respondents reported that their services were (again) affected by staff shortages, leading to increased workloads, burnout and negative impacts on health and wellbeing. Positive developments included greater flexibility about working from home and a better work-life balance. Complexities of home- work boundaries receive critical attention in the report, showing the challenges for staff, in the context of their working lives and the overspill into their personal lives.

In terms of Communication, respondents reported that communication with employers and managers had worsened since the beginning of the pandemic. Respondents who were working from home reported both negative and positive experiences around moving from face-to-face meetings to communicating on the phone or online.

Connections were highlighted by respondents as constantly changing during the pandemic, with relationships with colleagues and managers sadly worsening as the pandemic continued. Additionally, those who had been redeployed by managers also struggled at times to maintain their routines for work life balance because of new work schedules alongside increased home commitments.

Statistical analyses revealed that both mental wellbeing and quality of working life deteriorated from Phase 1 to Phase 3 of the study. Respondents appeared to be using positive coping strategies (e.g., active coping, planning) less but negative coping strategies (e.g., venting, self-blame) more to deal with work-related stressors.

Although the trajectory is downward from Phase 1 to 3, between Phase 2 and 3 both mental wellbeing and quality of working life increased slightly. However, most respondents appeared to be still not using positive coping strategies all the time (e.g., active coping, positive reframing) and many were using more negative coping strategies (e.g., self-blame, behavioural disengagement, and substance usage). Burnout had increased between Phases 2 and 3. In Phase 3 a large percentage  of respondents were experiencing moderate to severe levels of personal (78.1%) and work-related burnout (70.9%), whereas client-related burnout remained relatively low for almost 4 out of 5 respondents (78.4%). In other words, patients/service users were rarely the reason for burnout among health and social care workers.

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.

Good Practice Recommendations

Some examples of the Good Practice Recommendations include:

Changing Conditions

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


  • Evidence-based good practice guidance on communication needs to cover 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 their work pressures are understood
  • Supportive supervision is important and should be developed for all health and social care staff.


  • This survey highlights some 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 as critical to support 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:

“Our research shows that employers and policy makers need to take an informed approach to workforce support and sustainability to maintain staff wellbeing and retention.  We have seen a clear relationship between burnout and intention to leave which threatens the human infrastructure of the health and social care sector.  The only way we can protect the workforce is to listen to them and act on the evidence. 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 John Moriarty, Lecturer from the School of Social Sciences, Education and Social Work at Queen's University, said:

"Our findings indicate that both mental wellbeing and quality of life of the health and social care workforce deteriorated from Phase 1 to Phase 3, further emphasising the concerning levels of burnout. Workplace burnout is, at its core, a health care system and organisational problem - not just an individual concern."

Professor Jill Manthorpe, Director of the NIHR Policy Research Unit on Health and Social Care Workforce at King’s College London, said:

“We are very grateful to all respondents – many of whom took the trouble to participate at very difficult times when the pandemic was at its height in settings such as care homes. There is much attention to Long Covid as affecting Covid survivors, but this study also suggests a longer-term impact of the pandemic on the health and social care workforce. The workforce was celebrated at the start of the pandemic but public support and understanding of its continued pressures are still much needed.”

Professor Jermaine Ravalier; Professor of Organisational Psychology and Social Justice, Bath Spa University said:

“Health and Social Care workers have always been key workers - not just during the pandemic, and provide a critical service to the patients, clients, and service users that they work with. Through the three phases of this project we have seen the influence that the pandemic has had on the psychological wellbeing of these frontline workers, but also that working conditions have worsened. We are also seeing that work-life balance is significantly affected. Overall, H&SC workers clearly love their job and do it in order to make a difference to the people they work with and for, but too much is expected with too few resources. I hope that the results of this third phase can be used to provide ongoing support for our H&SC workers.”

Read the full report here: