Overview
Since the onset of the pandemic in the UK in 2020, greater focus and commitment has been directed towards the wellbeing of health and social care staff.
While support for staff prior to the pandemic was available, the delivery was guided by the generic Healthy Working Lives programme. The programme, while valuable, relied on staff to deliver these activities, in addition to their contracted responsibilities. In August 2021, the Midlothian Health and Social Care Partnership (HSCP) took the decision to fund a Staff Wellbeing Development Lead post for 12 months. The purpose of the role was to focus on developing innovative solutions to strengthen staff wellbeing, supporting NHS Lothian and Midlothian Council staff within the HSCP.
The challenge
Employers have a fundamental duty of care for the physical and mental health and wellbeing of their employees. Wellbeing is, however, complex and subjective, and can be impacted by many different factors and experiences in our lives.
Wellbeing can be influenced by our health, education, economic circumstances, environment and occupation, and other personal circumstances. Wellbeing can be influenced by the nature and quality of our relationships, our individual capabilities and our sense of purpose. Wellbeing as a concept has universality. No matter what our background and personal circumstances, people instinctively recognise the value of wellbeing.
Since March 2020, staff working in health and social care have faced unprecedented risk to their personal wellbeing. While the concerns related to Covid-19 have been subsiding, staff continue to find themselves under increasing pressure as the population ages, with more people living with long-term conditions and a growing backlog of care requests created by the pandemic. Pressures are continuing to build and resources are limited.
Outline of activity
The staff wellbeing project utilises the eight areas of wellbeing to capture the breadth of work while trying to avoid creating unrealistic expectations. The work is framed around six areas of development aligned to NHS Lothian’s staff wellbeing strategy and the Council’s wellbeing aims:
- Engagement - Create an environment to ensure engaged, informed and empowered staff.
- Communication - Provide clear and informative communication to simplify access and drive engagement.
- Programme of Support - Establish a programme of support to strengthen and where possible extend existing local arrangements for staff wellbeing.
- Leadership - Train managers/ leaders to enable them to facilitate change in staff wellbeing.
- Mental Wellbeing - Increased access to mental health support that enables psychological wellbeing.
- Environment - Utilise and improve local facilities that enhance the working environment.
Results
Engagement
Over the past 18 months, HSCP staff have played a fundamental role in the ongoing development and delivery of the staff wellbeing delivery plan. Involvement includes shaping staff wellbeing spaces, sharing personal experiences through ‘story telling’ and carrying out workplace surveys. Over 200 staff participated in the creation and delivery of the new Midlothian HSCP staff experience and engagement plan, published in February 2023.
Communication
To increase access to wellbeing information, the wellbeing group delivered on the provision of an electronic and hard copy staff wellbeing directory (now in its second edition), a bi-monthly newsletter (‘Support for You’) and regular sharing of information via meetings and email. In addition, the use of recorded question and answer sessions have been trialled to share information about the challenges faced by those experiencing menopause, for example.
Programme of support
Following NHS Lothian’s Work Well strategy, the HSCP has promoted access to a number of wellbeing activities, including the ‘Energise You’ online resource, ‘Take a Break’ resources, wellbeing coaching and peer support.
In February 2023, funding was secured to trial the Changing Gear programme. This programme offers four short sessions focusing on mindfulness, managing worry, simple circuit training and yoga taster sessions.
Leadership
Supportive leaders are central to staff wellbeing work. It ensures active buy-in to supporting compassionate and caring conversations and demonstrates a commitment to practical support.
In September 2022, the HSCP agreed to not only increase the hours of the staff wellbeing lead role, but extended the post until September 2024.
Mental Wellbeing
Creating space for listening has been hugely valuable. It has taken time to develop an understanding of the multiple services within the HSCP and build relationships. This time has been well spent creating opportunities to deliver bespoke wellbeing sessions. Many of these sessions have focused on the emotional demands of work. Support has included worry management, understanding and coping with stress and exploring relational dynamics. Twelve sessions were specifically offered to the care at home team. Forty-five staff attended. These are some of the comments made following the sessions:
'I don’t feel alone’
‘This is something that is missing from our work. It is needed’
‘It has helped with my anxiety’
‘I know that I am stressed, this has helped’
‘I feel these sessions have been great for talking about your feelings, problems, and work issues’
‘You feel better and more able to cope after because you have offloaded things’
‘It has helped me to cope and made me calmer about issues that I have’
Environment
The pandemic created significant changes in the way we work and the places we work in. Many staff moved to working from home or hybrid working while office facilities changed their layouts and reduced access. For many, this created sterile spaces with restricted social interaction.
While offices and community bases adapted, those working across the community had their own challenges as public shops and toilets closed. This made it increasingly difficult to address fundamental needs such as access to food and fluids, toilets and safe places to take a break.
Over the past 18 months extensive work has been undertaken to improve access to safe and comfortable spaces through the creation of staff wellbeing rooms and gardens. We received funding from the Scottish Government Social Work and Social Care fund and from NHS Lothian Charity. Eight areas are in the process of development or have reached completion. In addition, the HSCP has mapped local sites willing to support health and social care staff to access places to rest, refresh and refuel (see the Rest, Refresh, Refuel project case study).
Learning
The pandemic placed additional pressures on staff who were already vulnerable to poorer wellbeing due to the nature of their roles. While staff have felt nurtured by the outpouring of appreciation from the general public, the demands placed on them physically and emotionally continues to grow. Wellbeing can no longer be an afterthought but must be ingrained in structures and systems to ensure we continue to have meaningful conversations, build resilience and nurture recovery.
Employers have a duty of care to their employees. Public services would be deemed liable if moving and handling equipment and training was not provided to staff deemed at risk. However, the way in which we prepare staff for the emotional demands of their role is lacking. We teach staff how to support grief and loss in others but often fail to recognise the cumulative impact that change and bereavement can have on the people offering ongoing compassionate care.
In order to reduce the numbers of competent, caring and skilled professionals leaving the health and social care system, we need to recognise and address the fundamental wellbeing needs associated with engagement, communication, leadership, support and the environment.
Health and social care services must embed a commitment to staff wellbeing from recruitment to retirement, ensuring staff wellbeing is a priority within all the services we provide.
Staff across Midlothian have emphasised how important this role has been, with one stating “The role of Staff Wellbeing Development Lead has been pivotal to the success of so many fantastic projects within Midlothian Community Hospital”. Each project appears to be well received, particularly the staff wellbeing room as this was described as “a safe haven, a space for staff to rest and take the weight off”. The collaboration that went into this project specifically was praised, as “staff were consulted and engaged in choosing the shape of their space, allowing all staff to have a say in their area, making all feel valued in the entire process”.
Additionally, the Staff Wellbeing Development Lead has also been crucial to other projects supporting an organisational focus on staff wellbeing, such as the re-opening of the on-site Café, and it was noted the role “has also been a champion of the Soup Stop, a local kindness and wellbeing initiative for staff from across the Partnership”.
Resources
Wendy Armitage - Staff Wellbeing Development Lead, Midlothian HSPC
Email: Wendy.Armitage@nhslothian.scot.nhs.uk