To improve NHS staff wellbeing, there is a need to move away from calling for greater individual resilience and towards improved change and support at an organisational level, says Ian Tegerdine.
Concerning stress levels in the NHS workforce have been well documented with increasing workloads being largely to blame for the declining mental wellbeing of our vitally important frontline staff.
The latest NHS annual staff survey results show that 77 per cent of staff feel they have unrealistic time pressures at work and 56 per cent report working additional unpaid hours.
The survey also found that the percentage of staff reporting work-related stress illnesses is now at its highest level of 40.3 per cent (an increase from 36 per cent in 2016). The impact of this is enormous, not only for staff but also patients, service users and the taxpayer.
Stress is believed to account for over 30 per cent of sickness absence in the NHS, costing the service £300-400m per year.
If we are going to reverse this trend then it’s crucial that we make changes on an organisational level to support frontline staff, a position which was endorsed last year by Prerana Issar, the NHS’ chief people officer, who said NHS staff should be prioritised for receiving mental healthcare because of the “stressful” nature of the job.
I recently spoke at the HSJ Workforce Forum about the need for intervention to meet the challenges of NHS workforce stress and introduced a Workforce Stress and the Supportive Organisation framework which has been developed for Health Education England by the National Workforce Skills Development Unit at The Tavistock and Portman Foundation Trust.
The NWSDU was commissioned by HEE and has been established to meet the workforce challenges in healthcare.
Impact of systems on staff wellbeing
The framework has been underpinned by our research and designed to be used alongside NHS England’s Health and Wellbeing framework to challenge NHS employers to evaluate the impact of their systems, processes and cultures on staff health and wellbeing, and consider how they can provide better support.
A clear learning from our research is that the NHS has a substantial role to play in supporting the workforce to undertake what are inherently psychologically demanding roles and that there is a need to move away from focusing on a call for greater individual resilience and towards organisational change and support.
It is not about relying on individuals to improve their own mental wellbeing but encouraging the space to think, reflect and plan change at an organisational level.
The aims of the framework are to move beyond basic health and wellbeing interventions and compliment existing measures which are in place to reduce staff stress. It is underpinned by five pillars of psychological wellbeing: behaviours, attitudes and beliefs, leadership and management, the nature of work, psychological safety, and structures and processes.
As a resource, it is designed to help senior staff take an in-depth look at their organisation and identify its more or less supportive aspects and gives practical advice and resources for creating change to increase workforce wellbeing
As a resource, it is designed to help senior staff take an in-depth look at their organisation and identify its more or less supportive aspects and gives practical advice and resources for creating change to increase workforce wellbeing.
As well as internal processes, it also encourages the consideration of external demands on a specific team or organisation including resource allocation, relationships with commissioners and regulators as well as educational and professional bodies.
The framework has been ‘bench tested’ in NHS organisations and HEE has made it available via its website.
One of the biggest challenges facing the NHS is workforce resilience, capacity and wellbeing and it is important to acknowledge that the nature of the work done by any caring profession can be challenging to psychological wellbeing.
Individual trusts and NHS managers don’t have the standalone power to tackle the issues of increasing NHS staff workloads and the growing recruitment crisis but they can make changes which can have a significant impact on the mental wellbeing of their staff who are, after all, the most important resource in the NHS.