Concerns over death-in-service benefits keeping doctors from NHS frontline

Hundreds of doctors have said they are less likely to return to the frontline or increase their hours to fight Covid-19 because they fear their families will not be properly compensated if they die, the Guardian has learned.

Doctors who are no longer eligible for full death-in-service benefits have complained to the health secretary, Matt Hancock, that their families will be left not only grieving but in financial difficulty if they succumb to the virus.

Dozens have said the concern has stopped them from shifting their hours and working patterns to help in the NHS battle against the outbreak.

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More than 350 respondents to a survey by the Doctors’ Association UK (DAUK), a grassroots medics group, said loss of death-in-service benefits made them less likely to work in high-risk areas, increase their hours or return to service.

Forty people responding to the survey indicated they had declined to change their hours and working patterns as a result of a lack of death-in-service benefit, which is typically worth more than two year’s pay.

Ten days ago Hancock called on more than 65,000 former NHS nurses and doctors to consider returning to aid “a huge national effort to protect lives and protect our NHS”. Thousands responded positively. Last week he said 2,660 doctors were among almost 12,000 recently retired NHS staff who were returning.

The health secretary, who is isolating with “mild” symptoms of coronavirus, also announced a deal with the private sector to supply 700 additional doctors. But others are reluctant and say that if the death-in-service arrangements were changed they would feel more comfortable about coming back.

Symptoms are defined by the NHS as either:

• a high temperature - you feel hot to touch on your chest or back

• a new continuous cough - this means you've started coughing repeatedly

NHS advice is that anyone with symptoms should stay at home for at least 7 days.

If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.

After 14 days, anyone you live with who does not have symptoms can return to their normal routine. But, if anyone in your home gets symptoms, they should stay at home for 7 days from the day their symptoms start. Even if it means they're at home for longer than 14 days.

If you live with someone who is 70 or over, has a long-term condition, is pregnant or has a weakened immune system, try to find somewhere else for them to stay for 14 days.

If you have to stay at home together, try to keep away from each other as much as possible.

After 7 days, if you no longer have a high temperature you can return to your normal routine.

If you still have a high temperature, stay at home until your temperature returns to normal.

If you still have a cough after 7 days, but your temperature is normal, you do not need to continue staying at home. A cough can last for several weeks after the infection has gone.

Staying at home means you should:

• not go to work, school or public areas

• not use public transport or taxis

• not have visitors, such as friends and family, in your home

• not go out to buy food or collect medicine – order them by phone or online, or ask someone else to drop them off at your home

You can use your garden, if you have one. You can also leave the house to exercise – but stay at least 2 metres away from other people.

If you have symptoms of coronavirus, use the NHS 111 coronavirus service to find out what to do.

Source: NHS England on 23 March 2020

The British Medical Association (BMA) has also raised the issue, and it could affect serving doctors who have opted out of the NHS pension scheme.

At the weekend Adil El Tayar, 63, became the first known working NHS surgeon to succumb to coronavirus. He died on Wednesday at West Middlesex university hospital in London, his family said. He had been volunteering in A&E departments in the Midlands.

The BMA has said it is aware of a small number of UK doctors admitted to intensive care units requiring ventilation after contracting the virus. It was reported on Sunday that up to 50 doctors had died in Italy during the outbreak there.

Dr Samantha Batt-Rawden, an intensive care doctor who leads DAUK, said: “It is simply morally unforgivable that at this time where we ask them to put their lives on the line, those recently retired and returning to service, locum doctors and those forced out of the NHS pension scheme by a punitive tax are not eligible for death in service benefit.”

She stressed that retired doctors, senior consultants and senior locum GPs who were being asked to join the fight against Covid-19 were in a higher-risk group because of their age.

“These doctors feel a strong moral duty to do all they can to serve patients at this time of national crisis and deserve the same parity of esteem as their colleagues,” Batt-Rawden said. “We therefore ask Matt Hancock to ensure that all doctors receive death-in-service benefit. This will allow doctors to continue fighting this pandemic without the added stress of worrying about leaving their families in financial difficulty should they die in the line of duty.”

Last week the Department of Health and Social Care said it was “considering proposals to offer further support for those returning to the frontline”. It has been contacted for further comment.

Speaking on condition of anonymity, a locum GP with three young children told the DAUK survey: “It is a very real worry and threat that healthcare workers could die as a direct result of working with positive Covid patients.

“We are all here to help our patients but, weighing up everything, it would be devastating for me to die and on top of that my family be in financial difficulty. This will almost certainly mean I will do less face to face work/less hours altogether.”

Another GP said they were booking in frontline shifts for only a week at a time. “No personal protective equipment plus no death in service plus lack of clear leadership/guidance here feels like freefall to me,” they said.

A locum GP with an 18-month-old child and no death-in-service benefit said they had decided to do only virtual consultations. “Part of me is guilty that I’m not putting myself out there, but I guess the realisation that she could be left with no mother and no financial security is just awful,” she said.