Over the last decade, staff have been working at full pelt in a service that has faced funding challenges, workforce shortages and rising patient demand. Compounding operational pressures including the Covid-19 pandemic, the cost-of-living crisis and the longest period of industrial action in the NHS' history have all led to staff reporting a worrying decline in their morale and wellbeing.
Yet, research shows that a healthy and happy NHS workforce leads to high-quality patient care and services. Working environments that support staff and their wellbeing are therefore essential. Trusts know this, and despite significant challenges, are continually innovating to best support their staff.
NHS Providers has spoken to trusts about how they are successfully embedding staff wellbeing interventions – as well as what stands in their way. Here are the key themes that emerged.
Organisational culture
An organisation's culture is shaped by its leaders. Trusts have repeatedly found that a leadership approach that reinforces the importance of wellbeing and promotes positive values such as support, compassion and empowerment is paramount to fostering a positive workplace culture. This has never been more important as the sector seeks to learn the lessons from high-profile quality failures and strengthen safety culture. Open and inclusive leadership is a key feature at East of England Ambulance Service NHS Trust, where ongoing efforts to build a culture mean staff feel supported and safe to speak up about concerns. This includes holding fortnightly open question and answer sessions with a member from the senior executive team and all staff, to allow an open exchange regarding any issues staff are facing. This has helped embed a culture of transparency within the trust.
Evidence-based approach
Trusts are moving away from the old "tick-box" approach to staff wellbeing that often involves initiatives that do not get to the heart of the issue. Instead, they are developing health and wellbeing strategies that are more in tune with local needs. One way to achieve this is by collecting robust data that measures employee wellbeing – ensuring interventions make the intended impact. Mersey and West Lancashire Teaching Hospitals NHS Trust gathers data from various sources including the NHS Staff Survey and sickness absence data to assess the needs of its workforce. The trust uses this as the basis of its health and wellbeing strategy, which comprises education and awareness programmes, support for developing personal resilience as well as training and support for managers. They also have more than 120 wellbeing champions who feed back to their line manager on the effectiveness of the support in place for staff.
Funding and resource allocation
Wellbeing initiatives require adequate resources, but trusts are constantly up against budget constraints. While trusts can prioritise their own budgets, they are tasked with delivering more activity for less – making it harder to prioritise funding for staff wellbeing initiatives. In September 2022, Royal Berkshire NHS Foundation Trust was able to open a dedicated staff wellbeing centre, The Oasis – the construction of which was financed partly through private and public donations alongside the trust's own capital investment. This has proved hugely successful: since it opened, almost half of the trust's staff has visited the site to use the quiet rooms and therapy rooms for massage and reflexology.
Support for managing stress and high workloads
High patient demand, staff shortages, and excessive workload are some of the most significant blockers to staff wellbeing. Healthcare professionals often work long hours with limited breaks, leading to physical exhaustion, increased stress levels and staff leaving the service altogether. At a time when the NHS faces more than 125,000 staffing gaps, enabling staff to positively manage their mental health is especially vital to aid retention. Lincolnshire Partnership NHS Foundation Trust has invested in its staff wellbeing service for nearly 13 years – and it's paid off. Initiatives include an employment support pathway and a domestic abuse pathway, which not only support staff to return to work after struggling with their mental health, but help staff to remain in work through access to professional support.
Equality and diversity
An organisation that promotes equality, diversity and inclusion is fundamental to staff wellbeing. It also provides value for money: a report from McKinsey found that organisations in the top quartile of racial/ethnic diversity were 35% more likely to have financial returns above their national industry median. Oxleas NHS Foundation Trust recognises this in its "Building a fairer Oxleas five step challenge", which is working to instil a culture where staff feel valued and have a true sense of belonging. Similarly, Cornwall Partnership NHS Foundation Trust is investing in pastoral support to improve staff wellbeing and build a culture that actively promotes treating all staff with dignity and respect. Initiatives such as these are occurring across the country and are seeing demonstrable benefits to staff engagement and retention.
The wellbeing of NHS staff is not just a moral imperative; it directly impacts the effectiveness and sustainability of the healthcare system. Trusts' efforts to create supportive environments and working practices are noted in the NHS People Plan, the NHS Long Term Workforce Plan and equality, diversity and inclusion improvement plan – but these efforts need sustained national support to ensure the required resources.
When NHS staff are physically and mentally healthy, they are better equipped to provide high-quality care to patients. This, in turn, leads to improved patient satisfaction, better health outcomes, and reduced healthcare costs. Prioritising staff wellbeing can also make the NHS a more attractive employer since an organisation that values and supports its workforce is more likely to attract and retain talented individuals – benefiting patients and the NHS overall.
This blog was first published by HSJ.
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