The Covid-19 Clinician Cohort (CoCCo) Study: empirically grounded recommendations for forward-facing psychological care of frontline doctors

Jo Daniels*, Jenny Ingram, Anna S Pease, Elaine Wainwright, Kate E Beckett, Lali Iyadurai, Edward W Carlton

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

12 Citations (Scopus)
81 Downloads (Pure)


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) ‘organisational 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
Issue number18
Publication statusPublished - 14 Sept 2021

Bibliographical note

Funding Information:
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.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


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


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