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Background: Evidence of the deleterious mental health impact of COVID-19 on healthcare workers shows the priority need to support their psychological wellbeing. We assessed the nature, prevalence and factors associated with the psychosocial and occupational impact of COVID-19 among NHS staff during the pandemic. Methods: A cross-sectional online survey was sent to all NHS provider organisations in Northwest London in January 2021. Results: Of 1,065 participants completing the survey, 906 (85%) provided responses to the full survey. Over half (54.1%; n=543) exceeded the cut-off score for probable mental disorders, 31.1% (n=222) for probable burnout, and similarly for PTSD (28.5%; n=210). 28.6% (n=214) had experienced suicidal thoughts. 58% (n=429) scored >5 out of 10 for emotional and physical exhaustion. Over 30% (n=328) of respondents reported using some kind of staff support service. Staff in pay bands 4-6 were more likely to have common mental disorders (CMD) (OR 2.42 [1.20,4.88]) and PTSD symptoms (OR 4.18 [1.44,12.14]) than lower banded staff. Staff working in acute care settings were more likely to experience CMD (OR 1.50 [1.08,2.07]) and PTSD (OR 1.57 [1.03,2.41]) than in non-acute settings. Low social connectedness and perceived delivery of poor-quality care were highly associated with risk of all mental health problems, apart from alcohol misuse (OR range 1.56-18.34). Conclusions: Psychosocial morbidity and adverse occupational impacts on NHS staff in the second wave of the COVID-19 pandemic echoed that reported in the first wave. Social connection and perception of delivering good care were important, potentially modifiable, mitigating factors.