This study gathers data from across England, where the intensity, duration, and frequency of heatwaves are gradually increasing due to climate change. England’s healthcare infrastructure is generally unsuited for excessive heat, as most facilities are not equipped with air conditioning; roughly 90% of English hospitals are vulnerable to overheating. This study found that depending on the facility, indoor temperature management may be further complicated by unopenable windows and different ventilation and insulation characteristics.
To assess the impacts of hot weather on frontline staff in hospitals as well as overall healthcare delivery and patient safety.
Data were collected from employees working in hospitals located within seven different regions across England. Although the data collected was concerned with these employees’ experiences during the summer of 2019, the data itself was gathered between October 2019 and January 2020. The summer of 2019 was considered warm but not extremely so, making its conditions ideal for understanding healthcare staff’s experiences under more typical summer situations
A total of 14 participants were recruited for this study, including four clinical personnel and 10 non-clinical employees of the National Health Service (NHS). Participants were invited via email for a 1-hour interview. Upon joining the study, each participant completed a short online pre-interview questionnaire using SelectSurvey software. This survey asked questions concerning adherence to England’s Heat-Health Alert action plans, which are part of the country’s broader Heatwave Plan.
Following the pre-interview surveys, each participant took part in a semi-structured interview which addressed their challenges, experiences, lessons learned, and general reflections upon working during the summer of 2019. More specific questions were asked concerning heatwave planning, impacts on participants, preparing and alerting, impacts on the working environment and colleagues, impacts on patients, and suggestions for improving future heatwave resilience. All interviews were recorded and transcribed verbatim.
All data were thematically analyzed and coded with the Evidence for Policy and Practice Information (EPPI) Reviewer software. Thematic analysis was tested and agreed upon by all members of the research team.
Thematic analysis revealed several key themes, including the impacts of heat on individual well-being and health (patient health and safety, as well as occupational health), impacts on the provision of healthcare, barriers to the delivery of healthcare service, issues with heatwave planning, and the considerations involved in adapting to climate change.
Most participants experienced overheating within their healthcare buildings, resulting in adverse effects on themselves, patients, and other staff members. Heat contributed to a lack of energy, stress, a loss of efficiency, and general distress. The heat was noted to be especially difficult on patients who were detained by law within psychological care wards, as these patients were not allowed to open their windows for fear of escaping. There was a high demand for portable fans in all cases.
In some cases, medical storage facilities that were needed to house medications at certain temperatures experienced refrigerator breakdowns. Server rooms also overheated in multiple instances, leading to difficulties in the proper function of computer systems. Intensive care units were particularly affected, as the high temperatures of operating theaters and magnetic resonance imaging (MRI) scanners caused delays in patient care. In one facility that featured an air conditioning unit, the unit itself became overburdened and began leaking condensation onto some relocated patients.
The authors note that the participating clinicians represented a limited range of specialties; future studies conducted with a similar goal might endeavor to include a wider array of healthcare workers. The fact that the interviews were conducted after a heatwave rather than during the event may have impacted participant recall. Additionally, interviews conducted via videocall or telephone may have limited participants’ ability to communicate their experiences.