Ensuring staff wellbeing: lessons from the COVID-19 response

On 4 August we held the second in our “Doing Things Differently” series of virtual learning sessions and we focused on a topic that resonates with all those working in health and care: the wellbeing of staff.

Supporting the wellbeing of staff is not a new idea, but managing the COVID-19 pandemic brought this into sharp focus as the reality of the challenges ahead became clear. As we learned from our Joy in Work event back in November 2018, the NHS has a stress-related sickness rate that is significantly higher than other sectors and many organisations have been doing excellent work to address this. In this session we were interested to learn about how organisations shifted or accelerated their approach to this in response to the COVID-19 crisis.

We had eight speakers for this session, drawn from a range of backgrounds and organisations. Some had been directly involved in setting up and supporting the Nightingale Hospital in London, but we also heard about their experiences in their own organisations and from people working in mental health and primary care.  The breadth of experience was tremendous and as Sandi Drewett, Director of Workforce and Organisational Development, Moorfields Eye Hospital NHS Foundation Trust and Deputy HR Director, NHS Nightingale London and the chair of our session said, while each speaker talked about distinct ideas, the wider themes that emerged were much bigger than the individual contributions that were shared.

I wanted to share some of my own reflections on some of those themes that emerged in the discussion.

“Culture = behaviour”

In our last session, we heard about the Learning System that was put in place at the Nightingale London and this session taught us the crucial role it placed in creating a structure that placed staff wellbeing at the forefront. John Jeans, an anaesthetist at Imperial College Healthcare Trust but also part of the Education and Training team at Nightingale London, talked about how the shallow and flexible structure across disciplines helped to engender high quality behaviours, such as giving and receiving feedback, mutual respect and openness to learning.

Creating a structure that allows all levels and disciplines of staff to be involved through debriefs and in learning and feedback loops helps to embed a culture in which staff are engaged and feel connected to the purpose, which is one of the key factors in ensuring workplace wellbeing.

“It’s all about kindness and supporting each other”

This structure was also instrumental in promoting visible and compassionate leadership, which was highlighted by Jo Cooke, Tracheotomy Advanced Nurse Specialist, Great Ormond Street Hospital NHS Foundation Trust and part of the Nightingale London team. By establishing effective two-way communication, staff felt safe and supported. There was a clear message that “It’s OK not to be OK”, people were actively encouraged to speak up when they were struggling and a buddy system for staff to support each other was set up. These are elements that could be established in any organisation at any time and as Jo summarised, a true measure of leadership is the willingness to confront and support the anxiety of staff.

“Is there a breach in your psychological PPE?”

The final thing I wanted to reflect on was the talk by Krishna Bakhai, GP Registrar, Sutton and Chloe Kitto, Highly Specialised Occupational Therapist, RNOH who were part of the team providing induction training for staff redeployed to NHS Nightingale London during the peak of the pandemic. This team developed the concept of Psychological PPE, an education and training workshop equipping staff with skills of self-care, enabling them to recognise and anticipate stress, and so better preparing them for the environment at Nightingale. Once again, this approach put staff at the centre, with Krishna commenting that solutions that came from the individuals rather than via a didactic approach were much more effective in helping them to develop the skills they needed. As Chloe said in the session chat, we wouldn’t deploy staff into a high viral risk environment without PPE – this approach advocated for supporting deployed staff into a psychologically high-risk environment with psychological PPE as a practiced skill and habit.

Further reflections

Following the session, I asked Rebecca Graham, the Director of HR and OD at UCLPartners and the co-host of this session for her reflections from the webinar, which I also wanted to share here:

• Listening and humility: In normal times people make a lot of assumptions about patient experience, staff experience etc, but there was a lot of listening happening during this crisis – something that we can learn from in all care settings.  The investment in exit interviews from Nightingale London and the engagement with care homes and primary care in the NCL in Mind programme demonstrated examples of how much we didn’t know and how much we were keen to learn from front line staff about how to support them better

• Compassionate Leadership: Wellbeing is important and compassionate leadership and appreciative inquiry are key elements in facilitating this.  People are not an asset you can sweat, there is a lot of care required to get the most from teams and individuals

• Human Factors: Paying attention to systems and teams is vital to our future as integrated care systems and working collaboratively.  Understanding that a change in one part of the system can impact another and how we have established techniques (in human factors) that can mitigate and improve on things we can’t get right the first time.

More information

You can watch the recording of the webinar.

The next webinar in the Doing Things Differently series will be announced shortly – more details will be available via our website.