NHS Employers | May 2018 | NHS Health and Wellbeing Framework NHS England has worked with twelve NHS organisations to create a new Health and Wellbeing Framework and accompanying diagnostic tool to help NHS organisations plan and implement their own approach for improving staff health and wellbeing. This framework has been developed by NHS Employers, NHS England and NHS Improvement with support from partners across the NHS, voluntary sector and government to bring best practice, research and insights together in one accessible place for the first time for NHS organisations.
The Health and Wellbeing Framework in an interactive document that makes the case for staff health and wellbeing, sets out clear actionable steps for each of the 14 areas and includes guidance on how organisations can plan and deliver a staff health and wellbeing plan.
The framework and diagnostic tool have been designed to be used in a flexible way to meet the needs of your organisation. You can use these resources in total or in part to start, revise or re-launch a programme. The framework is divided into two sections, organisational enablers and health interventions.
NHS England have produced a case study looking at how a mental health service, Back on Track IAPT (Improving Access to Psychological Therapies), formed a wellbeing team to examine employees’ perceptions of their workplace and the challenges they face. Case Study Summary: Challenges such as stressful situations and day-to-day demands prompted the formation of a wellbeing team to examine employees’ perceptions of their workplace at Back on Track IAPT service, Hammersmith and Fulham. Based on feedback a range of changes were made to working arrangements to raise staff wellbeing.
The challenge: staff fed back that their wellbeing was being affected by working long hours and having to manage stressful clinical situations, particularly management of risk.
How it worked: A wellbeing team was formed and funding and study leave was arranged so that wellbeing team members could attend relevant continuing professional development . This ensured that they were able to learn from best practice in other areas. The wellbeing team then sent an anonymous survey to all team members asking the following questions:
Does Back on Track care about my wellbeing?
To what extent do you feel able to raise and discuss difficult and controversial topics?
How comfortable are you in meeting your role demands?
Am I able to adopt a healthy work-life balance?
Is my mental health good?
Is my physical health good?
Are my energy levels high?
Am I well, resilient and performing at my best?
Responses were categorised according to groups: High Intensity Therapists, Psychological Wellbeing Practitioners and administrative teams to identify themes within each group.
Next steps: Changes have been made- the service now offers a short ‘mindful walk’ for employees each week. There are also plans to use a standardised questionnaire to assess wellbeing to help benchmark the service in the future, as well as starting a small gardening project in the patio at the back of the main team base.
Burnout is caused by chronic stress in the work environment. Health care staff are particularly vulnerable because of their exposure to risk factors such as emotional interactions, exhausting shift patterns, and a lack of control over the demands placed upon them. The recent winter pressures have created the “perfect storm for burnout”.
There is strong evidence that burnout has an adverse effect on quality of care, patient safety and patient satisfaction.
Staff experiencing burnout feel fatigued and unable to face the demands of their job, or able to make a meaningful contribution.
Burnout reduces productivity and performance
Staff disengage – high levels of burnout are linked to more staff leaving their job, or walking away from their profession altogether.
Burnout is also detrimental to staff wellbeing, and linked to higher levels of relationship breakdown and suicide.
The Mayo Clinic has developed a wide range of organisational strategies to promote clinical staff engagement and reduce burnout. They argue that many of these interventions are relatively inexpensive and can have a large impact. They include:
Acknowledge and assess the problem. Regularly measure the wellbeing of staff and demonstrate that the organisation is trying to reduce burnout.
Harness the power of leadership. Develop and support clinical leaders. The Mayo Clinic found that a 1% increase in senior doctors’ leadership score brought a 3% reduction in how likely those reporting to them would be to suffer burnout.
Cultivate social connections and peer support. Invest in areas where staff can meet and relax.
Develop targeted interventions for specific clinical areas.
Align values and strengthen culture. Work to ensure shared values across the organisation, and use these for decision-making as well as recruitment.
Provide resources to promote personal resilience and self-care.
Flexible working patterns that support a better work-life balance.
This report illustrates the effect of good people management with an analysis of the NHS | What Works Centre for Wellbeing
This report found Trusts that made the most extensive use of good people management practices were over three times more likely to have the lowest levels of staff sickness absence and at least four times more likely to have the most satisfied patients.
They were also more than twice as likely to have staff with the highest levels of job satisfaction compared to NHS Trusts that made least use of these practices, and over three times more likely to have staff with the highest levels of engagement.
Health and social care undergraduate students experience stress due to high workloads and pressure to perform | Psychology, Health & Medicine
Consequences include depression and burnout. Mindfulness may be a suitable way to reduce stress in health and social care degree courses. The objective of this systematic review is to identify and critically appraise the literature on the effects of Mindfulness-Based Interventions for health and social care undergraduate students.
PubMed, EMBASE, Psych Info, CINAHL, The Cochrane Library and Academic Search Complete were searched from inception to 21st November 2016. Studies that delivered Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, or an intervention modelled closely on these, to health or social care undergraduate students were included. Eleven studies, representing medicine, nursing and psychology students met the inclusion criteria. The most commonly used measurement tools were; the Five Facet Mindfulness Questionnaire and the General Health Questionnaire.
Short term benefits relating to stress and mood were reported, despite all but one study condensing the curriculum. Gender and personality emerged as factors likely to affect intervention results. Further research with long-term follow-up is required to definitively conclude that mindfulness is an appropriate intervention to mentally prepare health and social care undergraduate students for their future careers.
Keeping medical practitioners healthy is an important consideration for workforce satisfaction and retention, as well as public safety | Journal of Patient Safety
However, there is limited evidence demonstrating how to best care for this group. The absence of data is related to the lack of available funding in this area of research. Supporting investigations that examine physician health often “fall through the cracks” of traditional funding opportunities, landing somewhere between patient safety and workforce development priorities. To address this, funders must extend the scope of current grant opportunities by broadening the scope of patient safety and its relationship to physician health. Other considerations are allocating a portion of doctors’ licensing fees to support physician health research and encourage researchers to collaborate with interested stakeholders who can underwrite the costs of studies. Ultimately, funding studies of physician health benefits not only the community of doctors but also the millions of patients receiving care each year.
‘Behind Closed Doors’ argues that the hard truths learned through the Francis Inquiry are in danger of being forgotten in the light of unprecedented, continuing, and seemingly endless service pressures | The Point of Care Foundation
The Point of Care Foundation calls on organisations to prioritise staff experience and strengthen efforts to protect staff from stress and burnout, because the way staff feel at work affects the way they care for patients.
The briefing presents evidence on current pressures and staff experience:
From 2004-16, the number of attendances at A&E increased by 18%, from 12.7 million to 15 million.
Only one in two staff feel their NHS employer values them and their work.
2% for health and social care staff suffer work-related stress anxiety and depression in the NHS compared to around 1.2% of the overall British workforce
The Point of Care Foundation wants to see every patient treated with kindness, dignity and respect all of the time, but in an environment in which staff themselves don’t feel cared about, it is hard to deliver personalised care. A positive staff experience is fundamental if staff are expected to be at their best with patients.