How NHS England and NHS Improvement worked tirelessly to support the wellbeing of NHS staff during the most challenging 18 months the NHS has ever experienced led to the service winning the ‘Best wellbeing initiative’ in the 2020 Occupational Health & Wellbeing Awards, as our latest winner’s profile illustrates.
It barely needs repeating that the NHS has been under probably the most amount of pressure in the past 12-18 months that any nurse, doctor, practitioner, or healthcare employee will be able to remember. This has, of course, had a profound impact on the health and wellbeing of all NHS workers, and especially those on the Covid-19 frontline.
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‘The reputation of the service, the perception of OH, has really changed, and in a positive way’
‘Virtual physiotherapy is cost-effective; people are much more receptive’
Barely a week goes by without another warning around NHS stress and burnout, including the need for wellbeing to be at the heart of any NHS ‘recovery’, and fears over levels of post-traumatic stress disorder among intensive care staff in particular. On top of this there are real fears that we could see a mass exodus of NHS staff post pandemic once the crisis of Covid-19 is finally over.
To that end, how the NHS has supported the health and wellbeing of its workforce has been – and continues to be – a central part of how it manages and navigates the pandemic. We’ve seen in the past few months plans revealed plans for 40 “mental health hubs” for health workers, which will offer staff access to confidential advice from mental health clinicians, therapists, recovery workers and psychologists. Staff wellbeing has also been put at the heart of the NHS People Plan, as outlined by NHS chief people officer Prerana Issar last year.
An unprecedented situation
The initial response of NHS England and NHS Improvement in terms of employees’ physical, emotional and practical needs also won plaudits in 2020’s Occupational Health & Wellbeing Awards, with the team behind the “workforce cell” tackling this area winning in our “Best wellbeing initiative” category.
As things ease, hopefully with the vaccine rollout for the long term, you then have to look at the ‘recovery’ phase and what that will mean, especially in terms of health and wellbeing” – Sonya Wallbank
As Sonya Wallbank, who is now the director of HR and organisational development for the Department of Health and Social Care and a consultant clinical psychologist, explains to Occupational Health & Wellbeing, everyone in those early months of the pandemic was working at pace to respond to what was an immensely fast-moving, unprecedented situation.
“Originally, when we framed the work we were doing, we had no idea what was coming over the hill,” she says. For much of the past year, the NHS has been of course immersed in the reality of fighting the pandemic. But as things ease, hopefully with the vaccine rollout for the long term, you then have to look at the ‘recovery’ phase and what that will mean, especially in terms of health and wellbeing.
“We know there will be a mix picture of what happens to people following the pandemic, with some who won’t be well; we know that this extended period of stress will be more difficult for people. When we submitted the award entry we never knew it was going to go on this long.
“We saw the Thursday clapping in the first lockdown, which really encouraged people to keep going. But then there was a sense of exhaustion. Now, however, I am definitely seeing a real national pride about what we’ve managed to achieve. There is something about the vaccine; the vaccine has brought us hope, it has brought us an ambition. And who has delivered that? The NHS has delivered that; it has been amazing work,” Sonya points out, with NHS OH teams very much again at the forefront of the delivery programme, especially to NHS and frontline staff.
Occupational health making a difference
How can OH make a difference in this context, especially in terms of NHS OH, with all its complexities and challenges?
“It is having that connectivity,” argues Sonya. “We talk very much about the ‘journey’ for the staff member. You see lots of patterns within the occupational health clinic, then if you are very proactive in around wellness, so you are operating in a preventative area, you can often identify if a specific team has a bit of an issue because perhaps you seeing something occurring regularly, whether it is a stress occurrence or there is something else going on.
“From there it is also about teaching and communicating what the wider organisational issues might be here. How can we work together to promote and develop some of that knowledge, skills and learning, rather than treat the person in front of us as a one-off issue? And OH can be critical to that.
“It is about looking at OH as a more systemic, advisory function and then bringing about learning and education as a result of what you are seeing in the clinic. I’m a psychologist by background and so, for me, it is important to be bringing together both that medical and clinical expertise, and occupational health and psychology are not usual bedfellows.
“For example, when we were thinking about the fact you may now have a lot of PTSD coming back into the workplace because of what people were being exposed to, how can psychologists therefore help occupational health understand some of those presentations in more detail and work together with a plan? If, say, a going back to a ward is triggering you, because that is where difficult events have happened, can you be deployed to a different ward? That might mean you may be able to come back to work a bit quicker. That sort of hand-in-hand partnership work has worked really well,” Sonya outlines.
“OH is almost like the person who is the centre, the person who is connecting all these dots together because you’re seeing the result – negative and positive – of what is happening in those systems/places around the hospital and the wider organisation. And what you have ended up with is a really rich seam of data that says, ‘ah, alert here, we need to be able to take action’.
Entering the awards provided us with a real opportunity to both think about the value of our work but also to stand back and evaluate the purpose. It was a real opportunity to show both the value of occupational health as an intervention, but also for you to think about what it is you are doing” – Sonya Wallbank
“With the NHS beginning to look at the recovery phase, I think occupational health has got a massive part to play in terms of the wellbeing support that takes place within teams. It is about recovery across the piece, for people who are going to be really tired – and it is going to take us a bit of time. It is the sort of tiredness that two weeks’ holiday doesn’t get you over,” Sonya adds.
Finally, how did winning an award help or boost the team? “Entering the awards provided us with a real opportunity to both think about the value of our work but also to stand back and evaluate the purpose. OK, you have done this great piece of work but ‘so what?’. It was a real opportunity to show both the value of occupational health as an intervention, as a preventative intervention not just an intervention in itself, but also for you to think about what it is you are doing,” explains Sonya.
“We are all very good at getting really busy every day, doing lots of daily activity, but so what? What point are we making, what is the purpose and outcome of what we’re doing? I would absolutely encourage people to apply for the awards, watch the awards, and use it as an opportunity to celebrate the hard work that your team is doing,” she adds.
The NHS England and NHS Improvement team in a nutshell
The 50-strong NHS England and NHS Improvement team was very much multidisciplinary, and brought together a wide range of skills and subject matter experts, including psychologists, doctors, nursing, occupational health and programme managers.
“Then there was a whole group of people who were professional expert academics and who were used to studying the long-term responses to staff trauma. We’d got military staff as well. It was a really, really strong mix of people,” explains Sonya.
The team also worked with the Faculty of Occupational Medicine and Society of Occupational Medicine. “We had Dr Anne de Bono (president of FOM) and Dr Shriti Pattani (consultant occupational health physician) very much working in step with us, sitting on our advisory taskforce,” says Sonya. “It was really helpful as, at the time, we were working through the People Plan and thinking about what did ‘recovery’ look like? So being able to have occupational health as a voice for ‘these are the changes that we think we need to make’ was incredibly valuable.
“What we were doing was almost like a lived experiment; this is how occupational health can influence the policy in this area, how it can work with us, together, on health and wellbeing, rather than it being just seen as a sort of illness service. We were actually having a really good conversation about wellness; how do we keep people well, how do we prevent them from needing specialist intervention while recognising there will, of course, be a group of people who don’t get through this and don’t retain their wellness. So they did a great job of connecting us back through that really rich vein of occupational health.”
More widely of course, the NHS England and NHS Improvement team was just one part of the jigsaw, feeding in as it was to the myriad NHS OH teams working on the ground in trusts and hospitals across the service. As Sonya says: “It was about seeing occupational health as one of the concentric circles that radiate support and do that early intervention work, especially because those teams are on the ground with the staff in the hospitals.”
How NHS England and NHS Improvement became an OH&W winner
As the Covid-19 pandemic unfolded, a “workforce cell” was set up within NHS England and NHS Improvement to respond to employees’ physical, emotional and practical needs at a time when demand from and risk of Covid-19 exposure was high.
Its approach, which led to the team winning the “Best wellbeing initiative” category in the 2020 Occupational Health & Wellbeing Awards, was informed by how the service handled other traumatic incidents, such as the 2005 London bombings, with eight workstreams tackling different challenges.
Projects undertaken by these groups included setting up a national helpline to listen and signpost staff to sources of support; developing virtual “common rooms” so staff could offer psychological support to one another, as well as one-on-one support from professionals; providing self-guided learning modules around sleep, resilience, wellbeing and anxiety; understanding the needs of black, Asian and minority ethnic colleagues; and working on a resilience project with the Centre for Army Leadership.
There was a focus on breaking down organisational barriers, and representatives from Public Health England and Health Education England joined to provide data capture, evaluation and to support the development of screening tools for the next steps of recovery planning.
As of last October, when the winners were announced, more than 3,000 calls had been made to the helpline, 1,400 text conversations had taken place, and there had been 120,000 downloads of its self-guided learning app and 130,000 visitors to the website. With the third wave of Covid-19 over the winter, these figures will have undoubtedly increased significantly.
Our judges felt the team “showed outstanding work with an in-depth knowledge of the challenges faced”. The initiative was “was expertly prepared for, including removing barriers to delivery and partnering with experts outside of the healthcare arena”, they said, adding that it was “a brilliant wellness initiative, shown by the fact it has utilised hundreds of thousands of times.”