More than 200 nurses and medical staff at the Royal Free Hospital have raised "very serious concerns" over staff burnout and patient safety in intensive care wards during the second surge of coronavirus - and going forward.
Staff and union reps at the hospital have met with senior management over the last fortnight to call for shift patterns to be changed and provide "strong reassurances" about the ratio of nurses to patients in intensive care units (ICU).
Hundreds of staff - including nurses, doctors and health care assistants - have signed a letter from the local Royal College of Nursing (RCN) representative to the Royal Free's director of nursing, Rebecca Longmate.
In the letter, dated March 12, staff raise concerns that "nurse-to-patient ratios during the pandemic were unsafe for patients and have led to severe levels of burnout amongst nursing staff" and that "the hospital did not do enough to escalate or respond to our concerns about this".
It is understood that at a meeting, members of nursing staff showed hospital bosses a presentation highlighting results from an internal survey carried out among critical care nurses.
In this survey, of 251 respondents, just over 40% of nurses said they'd had to either take extended sick leave or reduce their hours due to stress.
More than 80% of 246 respondents said they had noticed mistakes they believed had been "caused by the higher ICU patient-to-nurse ratios" during the pandemic.
Others raised concerns that internal incident reports were "not investigated" and staff believe the trust did not put incentives in place to attract bank staff during the pandemic.
Nurses at the Royal Free believe the trust was left "critically short" of ICU nursing staff. One member of staff said this meant a "severe cost to patient safety".
Another told this newspaper: "There's a lot of people who are really fed up and worried about how this is going."
The nurses say staff burnout has had a negative impact on patient safety - and worry that it may lead to nurses leaving the Royal Free.
Nursing reps have raised the issue of shift patterns contributing to this burnout. Because they work shorter shifts than at other hospitals - 11 rather than 11.5 hours - they work around one extra shift each month.
Lisa Elliott, who is the RCN's regional director in London, said: “RCN members at the trust have formally escalated significant concerns with management.
"RCN London and representatives are working constructively with the trust to try and seek an appropriate resolution.
"The trust must act in good faith and not just listen to the concerns but put in place tangible actions that directly address the concerns on staffing levels, staff wellbeing and safety which our members have raised.”
A spokesperson for the Royal Free NHS Trust said: “Like all hospitals across the NHS, the Royal Free London has treated a huge volume of critically ill patients during this pandemic - opening extra beds to safely admit more than three times as many patients as we usually would - and our incredible staff have gone to extraordinary lengths under significant pressure, saving countless lives, and we are grateful for everything they have done.
"Throughout the year we have listened and acted on feedback about what we can do to improve their experience of coming to work and have put in place a range of support including access to listening services, helplines, a dedicated ICU psychologist and practical support such as food delivery and free accommodation."
The Royal Free Trust also highlighted extra provision it had laid on for ICU staff during the pandemic - including a dedicated psychologist, and free food and accommodation.
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