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Journal of Interprofessional Care
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/ijic20
Exploring the challenges faced by frontline
workers in health and social care amid the
COVID-19 pandemic: experiences of frontline
workers in the English Midlands region, UK
Mathew Nyashanu , Farai Pfende & Mandu Ekpenyong
To cite this article: Mathew Nyashanu , Farai Pfende & Mandu Ekpenyong (2020): Exploring the
challenges faced by frontline workers in health and social care amid the COVID-19 pandemic:
experiences of frontline workers in the English Midlands region, UK, Journal of Interprofessional
Care, DOI: 10.1080/13561820.2020.1792425
To link to this article: https://doi.org/10.1080/13561820.2020.1792425
Published online: 17 Jul 2020.
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EMPIRICAL RESEARCH ARTICLES
Exploring the challenges faced by frontline workers in health and social care amid the
COVID-19 pandemic: experiences of frontline workers in the English Midlands
region, UK
Mathew Nyashanu
a
, Farai Pfende
b
, and Mandu Ekpenyong
c
a
Health & Allied Professions Department, Public Health Nottingham Trent University, Nottingham, UK;
b
Learning & Development Department,
Learning & Development JoCO Learning & Development Ltd, Nottingham, UK;
c
Faculty of Health, Manchester Metropolitan University,
Manchester, UK
ABSTRACT
The rst cases of Coronavirus (COVID-19) were reported in Wuhan, China in December 2019. Globally
millions of people have been diagnosed with the virus whilst thousands have died. As the virus kept
spreading health and social care frontline workers (HSCFW) were faced with diculties when discharging
their duties. This paper was set out to explore the challenges faced by dierent frontline workers in health
and social care during the COVID-19 pandemic. The research utilized an explorative qualitative approach.
A total of forty (N = 40) in-depth one-to-one semi-structured interviews were undertaken with HSCFW
who included support workers (n = 15), nurses (n = 15), and managers (N = 10). Health and social care
workers were drawn from domiciliary care and care homes (with and without nursing services). All the
interviews were done online. The data were thematically analyzed, and the emergent themes were
supported by quotes from the interviews held with participants. Following data analysis the research
study found that lack of pandemic preparedness, shortage of Personal Protective Equipment (PPE),
anxiety and fear amongst professionals, challenges in enforcing social distancing, challenges in fullling
social shielding responsibility, anxiety and fear amongst residents and service users, delay in testing,
evolving PPE guidance and shortage of sta were challenges faced by frontline health and social care
workers during COVID-19 pandemic. The results of the current study point to a need for adequate
pandemic preparedness within the health and social care sector to protect both frontline workers and
the individuals they look after.
ARTICLE HISTORY
Received 19 May 2020
Revised 19 June 2020
Accepted 30 June 2020
KEYWORDS
COVID-19; pandemic; front-
line workers; shortage;
mental health; UK
Introduction
The Coronavirus (COVID-19) pandemic was first reported in
Wuhan, China in December 2019. Globally, more than
8 million people had been diagnosed with the virus and over
439,000 had died as of the 18
th
of June 2020 (Hopkins 2020). As
the novel virus keeps spreading, healthcare professionals across
the globe are faced with an unprecedented situation of having
to make difficult decisions and work under extreme pressures.
Many health systems were caught unaware by the COVID-19
pandemic leading to panic and confusion in efforts to fight
against the infection. This confusion led to controversial deci-
sions about who should be treated or tested with the available
scarce resources. In a country like Italy, indices such as age
were used in deciding who should get treatment and who
should not (Han et al., 2020).
Background
In the UK, Public Health England (PHE) recommended re-use
of personal protective equipment (PPE) items including face-
masks (Cook, 2020). The document further recommended
healthcare providers to consider shifting from disposable
gowns or coveralls to reusable options, retaining disposable
gowns only for high-risk aerosol-generating procedures. The
temporary guidance applied only to urgent or emergency face-
to-face contacts in a health and social care setting (Cook, 2020).
This according to PHE was to ensure that health and social care
workers were appropriately protected from COVID-19, where
items of PPE were unavailable. This recommendation by PHE
on re-using PPE created a lot of panic and confusion among
HSCFW (Grimm, 2020). Many of the healthcare workers
expressed concern over the new guidance from PHE on re-
using PPE in the face of shortages as this recommendation
directly violated the WHO guidance (World Health
Organization, 2020). The confusion, panic, and lack of PPE
items impacted negatively on the psychological and mental
wellbeing of these key workers.
While there was a daily report of total diagnosed cases
and deaths across the world, what was less known were the
challenges that HSCFW in care homes and domiciliary
care faced during this pandemic. Health and social care
workers are more vulnerable to the pandemic as they meet
different people while discharging their duties. These
workers in domiciliary care and care homes provide front-
line services and are prone to the risk of contracting
COVID-19 or even death. According to Sim (2020),
a physically and mentally healthy and well-equipped
CONTACT Mathew Nyashanu mathew.nyashanu@ntu.ac.uk 14 Abbey street, B18 5QS, Birmingham
JOURNAL OF INTERPROFESSIONAL CARE
https://doi.org/10.1080/13561820.2020.1792425
© 2020 Taylor & Francis Group, LLC
workforce is key to a country’s ability to effectively man-
age COVID-19 cases, and that lessons can be learnt from
the SARS epidemic by introducing replica novel working
measures that could help to protect healthcare workers
from infection. HSCFW is a crucial part of the healthcare
system.
As the number of cases continued to rise, the number of
HSCFW exposed to COVID-19 also increased. The Center for
Evidence based Medicine (Driggin et al. 2020) stated that
13.8% of positive cases were critical key workers in the NHS
and other sectors. By 16
th
of April, the number of positive
critical key workers had increased to 16.2%. This caused
a huge effect on the workload and stress of frontline key work-
ers thereby further weakening the capacity of the healthcare
system to cope with the problem. This situation has grave
implications for the ongoing rise in the number of HSCFW
with infection owing to COVID-19. Even in the face of perso-
nal risk, healthcare staff are often assumed to have a duty to
work. This duty is enshrined in the codes of conduct that guide
professional healthcare workers (Damery et al., 2010).
Nevertheless, an effective health system does not only depend
upon the services and skills of healthcare professionals such as
doctors and nurses; but also depends on the services of other
professionals, such as HSCFWs (Damery et al., 2010).
Considering the above claims, there is an urgent need to
explore the challenges affecting HSCFW in the midst of the
COVID-19 pandemic. In so doing deduce implications for
professionals working in these sectors and sharing lessons
learnt through first-hand experience of working in
a challenging environment.
Method
The research utilized an explorative qualitative approach
(Binder et al., 2012). The fieldwork was undertaken with parti-
cipants from across the English Midlands region during
COVID-19 pandemic.
Participants
Forty in-depth one-to-one, semi-structured interviews were
undertaken with HSCFWs who included support workers
N = 15, Nurses N = 15, and Managers N = 10. The research
participants were drawn from care homes N = 25 and dom-
iciliary care services N = 15. More than 30 organizations were
approached, and 20 organizations agreed to take part in the
study; see Table 1 for profile information. The aim was to
explore the challenges faced by HSCFWs during the period of
COVID-19 pandemic.
Participants were drawn from a sample of individuals who
self-identified under the broad umbrella of “health and social
care frontline workers”. The definition was kept broad to avoid
reductive categorization of HSCFWs (Gagné et al., 1997). The
research participants were recruited through nursing homes,
residential homes, and domiciliary care organizations in the
private sector. The researchers contacted managers of the
organizations who in turn passed the information to their
staff. Only those individuals who expressed interest in taking
part in the study had their names passed to the researchers to
organize a meeting through online platforms (Zoom, Facetime,
WhatsApp) for further information.
Data collection and analysis
All the interviews were held through these online platforms
mentioned above. This method of conducting interviews was
adopted in line with COVID-19 social distancing guidelines to
prevent infection from one person to another (Singh &
Adhikari, 2020). All the interviews lasted for 45 min. The
interviews were stopped after reaching a saturation point, i.e.,
when no more new data were being generated from the inter-
views. The interviews were held between February 2020 and
April 2020. All the interviews were audio recorded and tran-
scribed verbatim before analysis. NVivo was used to organize
the data to enhance analysis. The data were thematically ana-
lyzed, and the emergent themes were supported by quotes from
the interviews held with participants (Braun & Clarke 2009).
Ethical considerations
All the research participants were given an information sheet
prior to participating in the research study. They also had the
opportunity to ask questions. In addition, the research partici-
pants signed a consent form, which also granted them the right
to withdraw from the study at any time without giving reasons.
As this was a sensitive subject, the researchers provided parti-
cipants with information of counselling and supporting ser-
vices. Nottingham Trent University ethics committee granted
the research study ethical clearance.
Results
Following analysis of the data on the challenges faced by
HSCFWs during COVID-19 pandemic, nine themes were
identified and are presented next. Table 2 shows the themes
and number of participants by job role who discussed these.
Lack of pandemic preparedness
Almost all the research participants agreed that preparations
for a pandemic within the sector were inadequate. They also
felt that there was no clear or strategic policy dealing with
a pandemic in health and social care.
Table 1. Profile of research participants.
Occupation Male Female 20–30 Years 31–40 Years 41–50 Years 51 + Years Total participants
Nurses 7 8 3 4 4 4 15
Support workers 8 7 4 3 5 3 15
Managers 4 6 1 2 3 4 10
Total 19 21 8 9 12 11 40
2M. NYASHANU ET AL.
“No one thought that this was coming, it caught everyone at footed
without any adequate preparations and strategies to deal with
a pandemic” Female mental health nurse
“We didn’t know where to start from and what to do it was all
confusion as this was a new pandemic never to have been experienced
in a health and social care set up” Male general nurse
Shortage of Personal Protective Equipment (PPE)
All the research participants expressed that there was severe short-
age of PPE making it difficult for them to discharge their duties.
They also felt that in some instance the PPE was not fit for
purpose.
“Most of the PPE we had ran out within two days and we had to wait
for days to get some only to last for two days. Honestly, this was the
most dicult time to work in health and social care. The few PPE
available was not fit for purpose as everyone had little knowledge
about COVID-19” Female care assistant.
“This was the most dicult time to do caring in a nursing home. We
had to improvise to make sure that everyone was safe from COVID-
19. We waited for so many days with little or no PPE. Honestly in
future there is need to get it right” A male Learning Disabilities
nurse
Anxiety and fears amongst professionals
Feelings of anxiety and fear of the condition based on the
notion that it is not treatable and that some HSCFWs had
lost their lives were also reported.
“ I had this feeling of anxiety and fear every day when I wake up to go
to work . . . it is mainly because the condition is untreatable and so
many colleagues in the profession have lost their lives” Male General
nurse
“Everyone at work is fearful and anxious we really don’t know what to
do. No one has knowledge about this condition moreover, it is not
treatable. With so many people losing their lives you really don’t know
your fate” A male mental health support worker.
Anxiety and fears amongst residents and service users
The research participants also reported an atmosphere of anxi-
ety and fear among residents and service users. They felt that
some residents had so many questions about COVID-19 that
could not be addressed as this was a new condition for every-
one including the HSCFWs.
“Many service users would ask me a lot of questions about the
coronavirus and I could not even answer some of them . . .. You
could see fear and anxiety on their faces. The situation of not being
able to provide them with answers is a challenge of its own kind”
A female domiciliary support worker
“Some residents who normally have visitors found it dicult to cope
without their friends and relatives coming to visit them at the
residential home . . . . . . You could see that they were really anxious.”
A male general nurse
Challenges in enforcing social distancing
Some challenges associated with enforcing social distancing for
individuals as some found it difficult to understand the pro-
blem and respond in line with the social distancing guidelines
were also noted by the research participants.
“It is very dicult to enforce social distancing among individuals as
some of them do not understand the problem of COVID-19 and the
importance of social distancing” A female learning disability sup-
port worker
“Remember we care for people living with dierent conditions from
dementia to learning disabilities . . . it is so dicult for such indivi-
duals to stay apart from sta and their counterparts” A female
nursing home manager
Challenges of fullling social shielding responsibility
The research participants reported that they had a duty to
protect individuals they looked after in line with the notion
of social shielding responsibility. In light of this, many staff had
to live in the workplace for days to avoid going out and bring in
COVID-19 to the individuals they were looking after.
“You see we as health and social care frontline workers, we have
a responsibility to make sure that all people we look after are prevented
from any form of disease or condition . . . .I spent five weeks living at the
work place to avoid meeting other people outside and bringing the
corona virus to the residents.” A male general nurse
“Honestly, these have been the most dicult time in my career as
a nurse . . . I have to be responsible and fulfil my obligation of
protecting the residents . . . . This meant that I had to work long
hours and live in a makeshift house closer to the workplace to keep
the residents safe from coronavirus. Honestly, this can be stressing
because you don’t know what will happen tomorrow.” A female
home manager
Table 2. Themes discussed and participants by job role.
Theme Managers Nurses Support workers
Lack of pandemic preparedness 10 (100%) 15 (100%) 15 (100%)
Shortage of Personal Protective Equipment (PPE), 10 (100%) 15 (100%) 15 (100%)
Anxiety and fear amongst professionals 8 (80%) 15 (100%) 15 (100%)
Challenges in enforcing social distancing 7 (70%) 15 (100%) 15 (100%)
Challenges in fulfilling social shielding responsibility 8 (80%) 15 (100%) 15 (100%)
Anxiety and fear amongst residents and service users 6 (60%) 15 (100%) 15 (100%)
Delay in testing 10 (100%) 15 (100%) 15 (100%)
Evolving PPE guidance 10 (100%) 15 (100%) 15 (100%)
Shortage of staff 10 (100%) 15 (100%) 15 (100%)
JOURNAL OF INTERPROFESSIONAL CARE 3
Delay in testing
The research participants reported delays in testing of
HSCFWs, resulting in difficulties in knowing whether staff
had COVID-19 or not, if they started coughing or showing
other symptoms. On many occasions staff would have to self-
isolate resulting in shortage of staff.
“There was nowhere to get tested if you start coughing or have high
temperature . . . we waited for the test to be rolled out to frontline
workers in health and social care for so long you would not know
whether you had it or not.” A female mental health support
worker.
“One other big problem was that there was nowhere to get tested
when I started coughing, I had to self-isolate. I do not know whether
it was COVID-19 or just a cough. Honestly, I would have done better
with a test.” A Female general nurse
Evolving PPE guidance
The research participants reported ever evolving PPE guide-
lines from public health authorities and central government.
They reported panic among HSCFWs every time the guidelines
were changed as they feared contracting COVID-19.
“There are so many changes that are coming every day, today is one
thing tomorrow is another one what are the guidance really? It really
confuses and panics me” A female support worker
“The hygiene guidelines have changed several times since the out-
break of COVID-19. It is really confusing; you begin to think I have
been doing it wrong so I might have contracted it already.” A male
learning disability nurse
Shortage of sta
The research participants reported severe shortage of staff due
to self-isolation and unavailability of testing opportunities for
HSCFWs.
“There is severe shortage of sta due to absence of sta who might
choose to self-isolate once they have a cough not knowing whether it
is COVID −19 or not honestly, sometimes shifts are so heavy to do.”
A male general nurse.
“The morale at work is sometimes low when you think of the situa-
tion. More so, many sta members are not taking up as many hours
as they used to do due to self-isolation if any of their family members
or themselves catch a cough.” A female domiciliary support
worker.
Discussion
Pandemic preparedness is key to the control and management
of infections in workplaces and at homes (Chunsuttiwat, 2008).
The research participants reported lack of preparedness within
the health and social care sector owing to nonexistence of
pandemic control and management policy and protocols.
This caused panic and fear among HSCFWs as they could
not envisage the extent COVID-19 pandemic was going to
cause. It also brought a feeling of uncertainty among them
leading to low morale and coordination in the workplace
(Aronson & Smith, 2011). In light of the above assertions, it
is important that health and social care workplaces have viable
pandemic control and management policies to protect both
workers and individuals they look after (Roberts et al., 2007).
Such policies can provide direction to HSCFWs when they are
confronted with a pandemic like COVID-19 as opposed to the
feeling of panic and fear when a pandemic strike.
PPE is one of the most important requirements when fight-
ing an infectious pandemic like COVID-19 (Cook, 2020).
Nearly all the research participants in this study reported
a severe shortage of PPE in their workplaces. This exposed
the HSCFWs in many health and social care settings to possible
infection of COVID-19. The shortage of PPE undoubtedly
brought fear and anxiety among HSCFWs. This is also com-
pounded by the fact that COVID-19 is untreatable (Santic et al.
2020). Furthermore, the shortage of PPE posed a threat of
COVID-19 infection to individuals in receipt of care and
visitors. In light of this, there is need for all health and social
care organizations to have a clear policy on procurement of
PPE. This will ensure adequate stock of PPE and safety for all
concerned. More importantly broader policies on procurement
of PPE for health and social care organizations need to be
reflected as a national policy by central government (Grasselli
et al., 2020). This will ensure coordinated supply of PPE in
times of pandemic of this nature.
When people are confronted with a pandemic which is new
and untreatable, they are often gripped with fear and anxiety
(DeJean et al., 2013). This phenomenon is not new as evi-
denced in the early days of the HIV pandemic and COVID-
19, respectively (El Alama et al., 2020; Wheaton et al., 2012).
Almost all research participants reported that the emergence of
COVID-19 made them feel anxious and fearful, citing that it
was untreatable and many HSCFWs had lost their lives. Such
anxiety and fear can severely impact on the discharging of
duties by HSCFWs. It is important that health and social care
workplaces have established on-site supporting systems to
counter fear and anxiety in times of pandemics like COVID-
19 amongst HSCFWs (Knapp et al., 2011). Such support can
take the form of mental health and wellbeing support services
for affected HSCFWs. More importantly the initiative needs to
be part of national policies to enhance effective support and
enforcement from central government, such as through Public
Health England (PHE) and the National Institute of Clinical
Excellence (NICE) in the UK.
Nearly all the research participants from the study reported
feelings of fear and anxiety among the individuals they cared
for. Among other reasons the fear was being driven by the
absence of treatment and no clear strategies to protect them
from COVID-19 (Ho, Chee and Ho 2020). Moving forward, it
is therefore important that health and social care organizations
equip their HSCFWs with skills to support individuals they
look after during pandemic periods.
In times of any infectious pandemic, social distancing is
important in preventing infection among the population
(Fong et al., 2020). Social distancing is especially important in
preventing infections in enclosed spaces like buildings and
workplaces. Almost all the research participants reported chal-
lenges with enforcing social distancing among the individuals
they care for. Such challenges were common among indivi-
duals with severe debilitating conditions including those living
4M. NYASHANU ET AL.
with dementia (Krumer-Nevo & Benjamin, 2010). There is
greater need to prepare for such challenges when working
with people affected by different conditions. It is also important
to increase the ratio of staff to individuals during a pandemic to
make sure that individuals are helped to maintain social dis-
tancing and prevent cross-infections. Furthermore, individual
care organizations should have strategies for implementing
social distancing in times of an infectious pandemic.
Social shielding in health and social care involves an obliga-
tion to protect individuals living in care (Lustig, 2010). More
importantly the principle goes beyond mere protection of
individuals to include empathy and commitment on the part
of HSCFWs. In this study, the research participants reported
challenges with social shielding during the COVID-19 pan-
demic. During this period HSCFWs had to contend with stay-
ing at workplaces for weeks to protect the individuals they were
looking after from being infected with COVID-19 (Yu et al.,
2018). It is also important to acknowledge that the HSCFWs
underwent this sacrifice of social shielding not only for the
individuals they cared for but also for their families as travel-
ling to and from work could increase their chances of acquiring
infection from COVID-19. It would seem important for health
and social care organizations to have clear strategies to manage
the principle of social shielding without causing strain on the
HSCFWs.
Jernigan et al. (2011) suggest that testing where there is
pandemic potential is critical for prevention and public health
interventions. The research participants reported that staff
were unable to access diagnostic testing for COVID-19 at the
point of need. The rapidly evolving pandemic presented several
barriers to rapid testing of HSCFWs. Burke (202), cited accu-
racy and reliability of tests, getting the right supply of equip-
ment and logistics as challenges associated with delay in
testing. Whilst it is possible that some HSCFWs would have
tested negative for the coronavirus the uncertainty regarding
cause of disease or symptoms had an impact on management
decisions (Binnicker, 2020). Seto et al. (2011) report a phenom-
enon where care practice in unconfirmed cases commonly
leads to unprotected exposure. McMichael (2020) reported
that a care home in Washington, USA had 81 residents, 34
staff and 23 deaths following the outbreak of COVID-19. Based
on the views of participants in the current study, there looks to
be a need for a robust COVID-19 testing policy which prior-
itizes frontline workers to make sure that new cases can be
controlled (Department of Health and Social Care 2020).
However, the health and social care sector arguably remained
a blind spot in prioritization as seen by the manifestation of
COVID-19 in the UK. McMichael (2020) suggests the rapid
contact tracing and testing of care home communities to miti-
gate devastating outcomes can be key in alleviating surging
cases of COVID-19. Improvement in availability of testing at
the point of care is essential (Jernigan et al., 2011). There is
a need to improve understanding of the way in which COVID-
19 spreads in care homes, as evidence from influenza suggests
that vulnerability of residents provides a conducive environ-
ment for rapid infection (Lansbury et al., 2017).
Published guidance on PPE during the unfolding of
a pandemic are a “living document” (Patel et al., 2010). The
principle of a living document is that it can be amended when
there is scientific, reliable, and valid evidence to update the
guidance in a specific area, whilst the rest of the document can
remain intact (Kraemer, 2013). Between 10 January 2020 and
27 April 2020 Poon et al. (20202019) published 24 PPE-related
guidance all with regular updates. Only the guidance on the
27 April was specifically written for health and social care
settings (care homes and domiciliary care). Prior to that it
was incumbent on HSCFWs to stay abreast of all the guidance
to sift out what was relevant to their own situations and risk
assessments. The research participants reported ever-changing
guidelines on managing COVID-19 as confusing and worrying
as with each amendment staff were left in doubt about the
robustness of their infection control practice. According to
the participants, there is need for an appropriate national
policy on PPE procurement and utilization. Such a policy
should be cascaded down to all health and social care organiza-
tions to enable consistency and sustainability. The potential of
health and social care settings to be high attack areas should be
taken seriously and guidance made clearer and earlier before
a future pandemic outbreak. Staff would also benefit from
infection control training relevant to the pandemic outbreak.
Whilst in the UK the NHS often grabs publicity, reports
from the last decade show that the UK health and social care
sector has been blighted by a fragile workforce. Almost all the
research participants reported a severe shortage of staff wor-
sen during COVID-19 pandemic. Hurst and Smith (2011)
reported that there was a 30.8% turnover rate in adult social
care, almost 440,000 leavers annually. It also estimated that
there were 7.8% vacant roles, almost 122,000 vacancies at any
time. 58% of domiciliary staff were on zero-hours and the
sickness absence rate equated to approximately 6.48million
that year (an average 4.8 days per person). Buchan et al.
(2017) identified that the number of nurses in health and
social care is also in decline. The pandemic resulted in
increased staff absence, exacerbating staff shortages and work-
load. The study found that due to staff following “household
isolation” guidance they were absent from work for
7–14 days. Others identified as “extremely vulnerable” were
also absent due to social shielding (Poon et al. 2020). Beech
et al. (2019) described the preexisting staff shortage as severe
and hampering safe delivery of care. It is important to note
that the pandemic worsened the situation. Central to easing
pandemic staff shortages in health and social care during
pandemic times is the need for rapid diagnostic testing and
tracing of suspected cases of COVID-19.
It would therefore be prudent to act proactively to protect
frontline care workers. The current study results point to
a need to address shortages in the sector through effective
national recruitment strategies and adequate funding to the
sector. The research participants also mentioned creative stra-
tegies where staff rotas included sleepovers and live-in care
arrangements made to enable them to stay at work without
risking exposure to their families and households. The over-
head costs, e.g.,, food, accommodation, and transport were
solely borne by care providers in an already underfunded
sector (Watkins, Wulaningsih & Da Zhou 2017). In contrast,
similar working arrangements for NHS staff were substantially
covered or subsidized through publicly raised charity funding
(Sachs & Group, 2020). There is arguably a pressing need for
JOURNAL OF INTERPROFESSIONAL CARE 5
the central and local government including other stakeholder
organizations to mount a coordinated effort to find sustainable
strategies of funding to meet unprecedented staffing costs in
health and social care.
Implications for organizations and central government
Craft literacy and craft competence involve the idea that orga-
nizations are designed and operated by humans and that skill to
do each task in a way that is sensitive to the particular environ-
ment is critical in addressing challenges experienced by com-
munities (Moyo 1989). Our results suggest a need for the
central government to have clear sensitive policies to deal
with pandemics like COVID-19. Such policies will need to be
cascaded down to all sub-organizations involved in health and
social care. Craft literacy and craft competence among health
and social care organizations when designing policies to man-
age pandemics like COVID-19 cannot be overemphasized. All
health and social care organizations would benefit from
a mandatory course on pandemic management to ensure that
all staff are prepared in times of pandemics like COVID-19.
More importantly, the central government should have a clear
policy and strategy on the procurement of PPE to prevent
shortages during pandemic periods like what happened during
COVID-19 pandemic. Strong policy and practice among health
and social care organizations could provide a robust occupa-
tional health service for their staff to prevent and treat mental
health among their frontline workers during pandemic periods
like COVID-19. Public health departments should work
together with health and social care organizations to make
sure that testing of HSCFWs is made a priority during any
pandemic like COVID-19 to ensure that care of individuals is
sustained.
Limitations
This study was limited to the English Midlands region. A wider
study involving other regions in the country may need to be
carried out in future to enhance comparisons and confirmation
of challenges cutting across England. The study was qualitative
in nature only utilizing interviews. A study involving mixed
methods on these issues may need to be carried out in future to
enable the exploration of all the issues from different
approaches.
Conclusion
The results of this study regarding the impact of COVID-19
suggest that health and social care organizations are not ade-
quately equipped to deal with extreme pandemics like COVID-
19. Therefore, with a view to strengthening future pandemic
preparedness, a coordinated approach between government and
health and social care organizations in order to manage and
contain such pandemics is needed. Furthermore, greater effi-
ciency in testing and isolation of affected individuals by
COVID-19 would appear key in managing and preventing the
spread of the pandemic.
Declaration of interest
There was no funding for this research and all authors declare no conflict
of interest.
Notes on contributors
Dr Mathew Nyashanu is a senior lecturer at Nottingham Trent university.
He teaches on the MA in Public Health and supervises Postgraduates
dissertation including PhDs. Dr Nyashanu also engages in research on
different public health issues including sexual health, mental health, and
health promotion. Dr Nyashanu has published extensively in the area of
public health.
Ms Farai Pfende is a Registered nurse for over 20 years working in
frontline and leadership across a range of healthcare and health and social
care services. She is an award-winning trainer currently working as a
Learning and Development practitioner in the health and social care
sector, a Dementia Practice Development Coach and Public Health
researcher.
Dr Mandu is currently working with Manchester Metropolitan University
as a Researcher. Dr Mandu have over 7years track record of teaching and
research experience. Dr Mandu have authored and co-authored over 15
Journal articles. Dr Mandu is a reviewer for Global Health Promotion,
International Journal of Men’s Social and Community Health,
International Journal of Studies in Nursing, and Journal of Nursing
Research and Practice.s
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