Why NHS Staff Health and Wellbeing Isn’t a Niche Issue

The director of staff experience & engagement at NHS England reflects on how the pandemic and the NHS People Plan have made staff wellbeing a key priority. 

John Drew

Since the pandemic, the workplace challenges and the subsequent impact on the health and wellbeing of NHS staff have come under close scrutiny.

We are committed to keeping the focus on the people that deliver services and care to patients and embedding the importance of staff wellbeing into all aspects of how organisations go about their business

The need for better and more consistent wellbeing support for NHS staff is undeniable. This is why over the past two years we have been building on the principles of the NHS People Plan to ensure health and wellbeing becomes embedded in organisational culture.

To help deliver our aspiration, we have encouraged the appointment of Wellbeing Guardians on every NHS board. These are usually non-executive directors who will advocate for staff wellbeing at board level, and ensure that wellbeing is a key consideration in every aspect of the strategic agenda.

The best way to deliver a sustainable and meaningful approach to health and wellbeing is to ensure that organisations are taking a preventive approach and ensuring their HWB offers are responsive to their local needs.

We have seen that the ethical argument for supporting staff health and wellbeing helps to gain traction, but we need to recognise that there are existing regulatory duties to protect staff health and wellbeing and that getting this right has a positive impact on organisational performance.

Our national health and wellbeing team has been deliberately shifting its focus away from offering additional wellbeing add-ons for staff towards building support into the fabric of the NHS.

Take it to the Top

We aim to anchor our work at board level in a meaningful way through the Wellbeing Guardians, supporting them in this crucial role.

One way to think of this role is that it’s a bit like putting stabilisers on a bike until they are no longer needed. Ideally, we shouldn’t need a separate Wellbeing Guardian role , but in the current context it’s helpful to have a person who is really attentive to staff recovery and health and wellbeing and advocating for this.  We want to make sure that this issue is not just discussed as a single agenda item, but built into the board’s agenda. It is by looking after our staff that they are able to care for our patients.

It’s very useful for Wellbeing Guardians to have evidence to draw on. For example, IPPO’s recent rapid evidence review demonstrates the huge cost savings to be gained by tackling poor staff mental health. That can be helpful when debating the merits of investing in the workforce in budget-constrained settings.

The more we can make the business case for particular workplace interventions, the more our Wellbeing Guardians can advocate for change. The NHS has created a wellbeing dashboard, bringing together a range of data into a comprehensive benchmarking tool. While the dashboard includes reference to attendance, this is not the sole focus – we are equally interested in looking at upstream factors that organisations have influence over to make improvements at work.

Support Makes A Difference

Research and expert advice tell us that the thing that will make the biggest difference to a person’s wellbeing at work is feeling supported by your team and your line manager. That is certainly my experience.

If you’re part of a supportive team all sorts of other things are possible, and dealing with challenges becomes more manageable. Equally, if you’re not supported it becomes much, much harder.

In 2021, we introduced professional nurse advocates (PNA) across the service in partnership with our nursing colleagues to encourage teams to support one another.

PNAs are trained to listen and understand the challenges and demands of their colleagues, and to lead support in responding to them. Importantly, they are already known and trusted by teams.

We’ve also put a lot of investment into training line managers to be good at having supportive  health and wellbeing conversations and to pick up on what people are really saying about their workplace challenges. We know that around 60%  of people in the NHS are having regular health and wellbeing conversations since they were introduced as part of the People Plan in 2020.

Specialist and Strategic Help

There will always be a proportion of staff that need particular specialist support.

We’ve put in place 40 mental health and wellbeing hubs to provide health and social care colleagues with rapid access to assessment and local, evidence-based mental health services and support where needed. These have been accessed around 63,000 times

We are keen to strengthen our in house occupational health services too and this is a strategic priority.  On June 20th, we launched our Growing Occupational Health and Wellbeing Together Strategy.

The strategy was developed with guidance from Dr Steve Boorman and with the collaborative input of NHS staff and with the partnership and support of the professional bodies working in this field.

What’s Next?

This is about changing the way whole organisations function and what they prioritize, and how well this is working can be hard to measure.

At the moment, burnout is an issue for many sectors and that includes the NHS. Further to the report by the Health and Social Care committee and the Government response to its recommendations, the 2021 Survey includes, for the first time, a set of questions on burnout called the Copenhagen Burnout Inventory.

This index has been used many times with healthcare samples in different countries, including the UK. As burnout is a new measure for the NHS Staff Survey, we cannot compare figures with previous years, but we will track it from now on, using the results to really understand which groups of staff are at greatest risk and how we can help organisations engage with those groups to understand how improvements can be made.

These questions form part of a wider set of questions through which we will measure the element of the NHS People Promise which is ‘we are safe and healthy’.

The necessity for change is reflected in the operational plans for the NHS and the NHS annual planning guidance for each of the last two years has stated very clearly that we need to keep our focus on the health, wellbeing and safety of our staff.

I see this as an acknowledgement of the importance of what we’re doing and as a sign that this is indeed becoming embedded within the culture and strategic agenda of the NHS in a new way.