Stress and exhaustion from the Covid-19 crisis threaten to intensify burnout among women working in the NHS just as it prepares to resume most services, according to a survey that has prompted calls for greater support for female staff. The pandemic had amplified alleged bullying, sexism and racism on the part of managers, , some workers also warned, while 26% of women said they did not feel safe sharing personal concerns with their boss. This was especially true for staff from a minority ethnic background, who also reported feeling traumatised by the disproportionate impact of the virus, said the Health and Care Women Leaders Network of the NHS Confederation, which carried out the survey. One respondent told the survey: “It has been awful to see colleagues and friends constantly berated, put down, ignored and emotionally abused. They were the same pre-Covid, but now it is worse.” Almost three-quarters (72%) of those surveyed reported that their job was having a greater negative impact than usual on their emotional wellbeing. More than half (52%) reported a negative impact on their physical health. The survey received responses from more than 1,300 women working across health and care in England, including managers, doctors, nurses and administrative staff. It was carried out in June, two months after the national peak in hospital admissions. Illustrating the longer-lasting impact the disease has had on the female health and care workforce, staff reported taking on an average of 11.22 additional hours each week of non-work caring responsibilities since the start of the lockdown. They reduced their working time to take account of these responsibilities by only 1.44 hours each week. “I am exhausted. I can’t buy food on my day off as I want to hide under the covers and sleep,” said one. “I can’t face being jolly and excited for [my] children, who are scared Mummy is going to die of Covid.” The network is concerned about burnout among female staff – who make up more than three-quarters of the NHS workforce – as previously paused services resume before what is expected to be a challenging winter. Another concern is that moves to foster an environment in which more women can progress to senior roles will be set back. A report accompanying the survey results concluded that there were “many positives” to be drawn from the unprecedented situation, such as innovation in remote care and flexible working , reports of strong managerial support and the development of support networks. But Dr Henrietta Hughes, the national guardian for the NHS, whose office supports the fostering of whistleblowing and speaking out, said the responses showing the barriers that minority ethnic staff continued to face were “particularly shocking”. The Health and Care Women Leaders Network makes 10 recommendations, included calling for managers to support workers who want to speak up about personal concerns in relation to the pandemic, while being mindful that minority ethnic workers may find it particularly difficult and should be able to go through alternative channels. It also recommended that staff should be discouraged from working unpaid overtime and encouraged to maintain good work-life boundaries, and that requests to work flexible or reduced hours should always be accommodated unless there are exceptional reasons.