COVID-19 Frontline Staff in Rapidly Formed COVID-19 Teams in the NHS: Implications for Leadership, Team-working, Career Intentions and Individual Mental Health, 2020-2022

A set of interviews with NHS COVID-19 frontline staff to investigate the influence of COVID deployment on non-technical factors for healthcare delivery (leadership, social support & cohesion, communication, shared mental models, co-ordination) and expected moderating factors (occupational background, preparedness, work-life balance and home situation, proximity, workforce allocation models) and the impact on perceived teamwork, performance, individual team member well-being, resilience and team member employment retention intentions for NHS COVID-team members. The interviews with medical staff consisted of demographic questions collecting some special category data (e.g., ethnicity, job title, living arrangements during COVID), a 12-item standardised measure of wellbeing (administered using the GHQ-12, a short form General Health Questionnaire) and an 8 item Work Life Balance Scale (Schwartz et al., 2019; Sexton et al., 2017). These are not included in the interview transcripts. The interview schedule then followed a topic based semi-structured component (informed by themes identified in our previous work (Reid et al., 2018; 2016; Schilling, 2019), the wider literature, and our preliminary conceptual framework across these four main areas: 1) the creation of teams and the experience of teamwork, social support, shared communication patterns, co- ordination and mental models; 2) the role of leaders in establishing teamwork, social support, shared communication patterns, co-ordination and mental models; 3) perceived individual and team performance, well-being, resilience and retention intentions; 4) moderating factors including occupational background, preparedness, home life, work-life balance and any other issues arising during COVID-team membership.

A key component of the NHS (and global) response to the COVID-19 pandemic has been to reinforce acute and critical care capacity, through an unprecedented re-deployment of personnel from different care pathways into fluid teams consisting of volunteers, student doctors and nurses, and in some cases military personnel [1-4]. These COVID-teams provide a unique opportunity to examine the interaction of many of the established factors for successful delivery of medical teamwork and care. Current evidence suggests that without common teamwork, shared communication patterns and clear leadership structures, the ad-hoc and fluid nature of these COVID-teams increases risk to patient outcomes, delivery of care [5-9] and team member resilience, mental-health and retention [10,11]. This project will examine how non-technical factors for healthcare delivery (leadership, social support; cohesion, communication, shared mental models, co-ordination) and expected moderating factors (occupational background, preparedness, work-life balance, home situation, proximity, workforce allocation models) impact on perceived COVID-teamworking and performance, individual team member well-being and team member employment retention intentions. It will be a mixed methods cross-sectional exploratory study of COVID-team members, clinical directors and senior hospital managers across a wide range of partnered NHS Trusts. Qualitative interviews will identify key themes and will be followed up by a more widely recruited confirmatory survey examining longer term individual well-being and retention intentions.

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