This prospective cohort study was designed to assess WRS amongst clinical and non-clinical staff in a primary healthcare setting using a validated tool with a view to developing an evidence base to form a historical and comparative record during the Covid-19 pandemic.

Work-related stress (WRS) is the second most common cause of occupational ill health in the United Kingdom. Studies suggest that during the Covid-19 pandemic, an increased prevalence of stress-related disorders was reported amongst healthcare workers. WRS can be assessed using the Health and Safety Executive's (HSE) Management Standards Indicator Tool (MSIT) and is used to compare changes to WRS across six domains over time. Lower scores in domains indicate higher WRS experienced by workers. Increases in the score in subsequent assessments indicate improvements to WRS. The MSIT was distributed to 23 primary care clinical and non-clinical staff in a medical centre in Greater Manchester, United Kingdom in March, 2019. 18 responses were received from 23 staff (78% response rate), establishing a baseline. In May, 2020, the authors decided to reanalyse the effect of the Covid-19 pandemic on WRS upon the same population. The MSIT was redistributed in March 2021, with 14 responses from 20 staff (70% response rate). Microsoft Excel's data analysis was applied to the results. WRS across the practice increased by 7% in demands, 4% in control and 2% in role domains and improved by 3% in support, 3% in relationships and 2% in change domains. The results are in keeping with the global picture of evolving WRS amongst healthcare staff during the pandemic. Monitoring and addressing WRS regularly helps maintain system-wide resilience when faced with unexpected or unprecedented change. Comparing these results with WRS in other healthcare systems would be a useful next step.

Inclusion Criteria:

• Primary healthcare staff working at the Gill Medical Centre for at least two months prior to assessment.

Exclusion Criteria:

• Any staff member employed for less than two months, those who were off work due to non- stress related long-term leave or incomplete submissions.

Adult health professionals and administration staff

Sharing of collected data with researchers using the same tool to assess work-related stress.

Data available now 29/06/2021 to 29/06/2031.

E-mail: faizan@doctors.org.uk with name, contact details and study purpose.