The COVID-19 Clinician Cohort (CoCCo) Study: Empirically Grounded Recommendations for Forward-Facing Psychological Care of Frontline Doctors

Jo Daniels* (Corresponding Author), Jenny Ingram, Anna Pease, Elaine Wainwright, Kate Beckett , Lalitha Iyadurai, Sophie Harris , Olivia Donnelly, Tom Roberts , Edward Carlton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)
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This study aimed to develop empirically grounded recommendations and a coherent model of psychological care derived from the experiences and psychological care needs of COVID- 19 frontline doctors, using semi-structured interviews and thematic analysis. Participants were UK frontline doctors specialising in Emergency Medicine, Anaesthetics, or Intensive Care (n = 31) purposively sampled for maximum variation on gender, specialty, ethnicity, and trauma-related distress; most worked in ICU during the pandemic (71%). Four themes were derived: (1) ‘coping strategies’, participants used many, including exercise, mindfulness, and “wait until it gets really bad”; (2) ‘sources of support’, participants valued embedded psychological support, digital services, and informal conversations with colleagues or family, though there was little opportunity; (3) ‘organ- isational influences on wellbeing’, participants reported a love–hate relationship for concepts like
‘wellbeing’, seen as important but insulting when basic workplace needs were unmet; (4) ‘improving engagement with support’, analysis suggests we must reduce physical and psychological barriers to access and encourage leaders to model psychologically supportive behaviours. Doctors’ frontline COVID-19 working experiences shine a ‘spotlight’ on pre-existing problems such as lack of physical resources and access to psychological care. Empirically grounded recommendations and a model of incremental psychological care are presented for use in clinical services.
Original languageEnglish
Article number9675
Number of pages18
JournalInternational Journal of Environmental Research and Public Health
Publication statusPublished - 14 Sept 2021

Bibliographical note

Funding: This research has been carried out through funding by the Southmead Hospital Charity Research Fund (Ref: 4922) and sponsored by North Bristol NHS trust. The funders had no role in considering the study design or in the collection, analysis, or interpretation of data, the writing of the report, or the decision to submit the article for publication.

Acknowledgments: The study authors would like to extend thanks to the Clinical Advisory Group: Daniel Horner (Consultant in Emergency and Critical Care Medicine, Salford Royal NHS Foundation Trust), Robert Hirst (Emergency Medicine registrar, Musgrove Park Hospital), Tom Roberts (Emer- gency Medicine registrar, North Bristol NHS Trust), Katie Samuel (Consultant Anaesthetist, North Bristol NHS Trust), Helen Williams (HSRC Clinical Research Fellow in Anaesthetics), and Etimbuk Umana (Specialist Registrar Emergency Department, Midland Regional Hospital, Tullamore) as well as the Expert Advisory Group: Neil Greenberg (Health Protection Research Unit, King’s College London and Royal College of Psychiatrists), Katherine Henderson (President of The Royal College of Emergency Medicine), Julie Highfield (British Psychological Society, Intensive Care Society), Ira Madan (Reader in Occupational Medicine), and Olivia Donnelly (Staff Wellbeing Psychology Ser- vice Lead, North Bristol NHS Trust). Thanks are also extended to the British Psychological Society for permitting adaptation of Figure 1 © 2020 British Psychological Society; the original version is available online.


  • COVID-19
  • frontline workers
  • healthcare workers
  • qualitative research
  • trauma
  • psychological support
  • occupational heath
  • guidelines


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