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Health and wellbeing of NHS workforce is too often seen as 'optional extra'


Trusts are consistently failing to give serious consideration to the health and wellbeing of their staff, despite the increasing pressure that the NHS workforce is under, a report has warned.

Less than two thirds of trusts have a plan in place for NHS staff health and wellbeing, according to the report published today by the Royal College of Physicians.

In addition, only 28% of NHS trusts in England reported that they had a plan or policy in place to help reduce obesity among staff and just 57% had a plan to support the mental health of their staff.

Staff often noted a shortage of basic staff amenities, including adequate working space, rest facilities or somewhere to buy food, the report added.

customer survey

The report – titled Work and Wellbeing in the NHS: why staff health matters to patient care – stated that high quality patient care relied on skilled staff who were not only physically and mentally well enough to do their jobs, but also feel valued, supported and engaged.

“Staff wellbeing should no longer be treated as optional extra for the NHS”

Sian Williams

It highlighted evidence suggesting that good staff health and wellbeing was linked to reduced MRSA infection levels and lower patient mortality rates but better patient satisfaction and experience.      

NHS organisations were often ignoring the “compelling” advantages of having a robust plan in place for their staff, which was putting patient care at risk, the report warned.

The report also highlighted that organisations with higher levels of staff engagement had 13% lower staff turnover and significantly reduced sickness absence rates. 

It said the issue had been “scrutinised and discussed” for the last 20 years with “little meaningful change”, while noting that the health service’s greatest asset was the people who deliver it.

Woman experiencing office stress

NHS staff facing increasing stress

Dr Sian Williams, the RCP’s clinical adviser on NHS workforce health, said: “It is time to move beyond short term, one-off initiatives to help staff improve their health at work.

“It is clear that we need action now,” she said. “We owe it to those who work hard every day for our NHS to help them maintain and improve their health.”

“Staff wellbeing should no longer be treated as optional extra for the NHS – it is critical to patient care,” she added.

The report’s findings back results from the latest Nursing Times annual survey, published in December. Nearly two-thirds, 60%, of the nearly 750 survey respondents said their employer did not attach a high enough priority to staff health and wellbeing.

It is now over five years since the government-commissioned Boorman Review concluded there was a “strong case” for investing in NHS staff health and wellbeing.

“A healthy workforce is essential for an effective health care service”

Peter Carter

Peter Carter, chief executive and general secretary of the Royal College of Nursing, said the RCP’s report “shines a light on one of the most serious issues facing the NHS”.

“The Boorman review demonstrated the importance of staff health and wellbeing programmes for NHS organisations more than five years ago, yet this appears to have been ignored by too many trusts,” he said.

“Nurses are some of the hardest working people in the UK and deserve to feel healthy and motivated in their professional lives,” he added. “NHS organisations need to acknowledge this issue and take action.”

Danny Mortimer, chief executive of NHS Employers, acknowledged that trusts faced an “uphill struggle” on the issue due to increasing pressures on services.

“We support the call for greater national support for this vital area, which builds on the work being done by many employers in the NHS,” he said.



Readers' comments (17)

  • Indeed, and they are very quick to discipline staff for their sickness, but not help them recover, or address the reasons for staff being off sick, especially if it is stress related.

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  • Both trust I've worked in have had gymnasiums on site which staff can join. The only problem is, like a lot of the "benefits" in this job, it's pitched at the 9-5ers, not the shift workers so it would have been pointless and a waste of money for me to join these gyms as they'd never be open when I could use them before or after a shift and there are plenty of gyms nearer to where I live that cost just the same that I'd use in my time off.

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  • working in the NHS over the last few years and being constantly exposed to change after change after change, having listened to colleagues being screamed at down the phone for not meeting targets, after listening to their tears and seeing them leave after lengthy periods of sickness, after seeing my own department lose 80% of it's staff and having to soldier on alone serving a whole county myself has caused me to become more than a little disenchanted with working for the NHS, it's also left me with bouts of depression, time off with work related stress, anxiety and high blood pressure all caused according to my doctor by work, and it's not over yet after yet another move around I find myself in another team that itself is going through the whole thing again, so happy times ahead, again!
    I pray for redundancy daily, but more likely I'll get Tupe'd over to a private provider to see my terms and conditions eroded even more.

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  • The Trust I work for supports staff health and wellbeing in many ways and often allows staff to take a phased return to work following a particularly long or severe illness, whether involving physical or mental health problems. However like the previous writer the gymnasium and relaxing therapies are all available between 9am and 5pm, and especially at 'lunchtimes' which as all nursing staff know is of no use at all. Even if one does get a proper lunch it has to be taken when it is convenient for the ward so cannot be planned in advance unless you are very lucky. However late in the evening, after a long, busy and tiring shift, who wants to go to a gym, or have a massage anyway?

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  • I have a genetic blood condition that has left me with a poor immune system. 18 months ago when I was moved to a new environment by a higher manager who wanted me to be on her team. I was sat down on the first day and told that my sickness was going to be closely monitored for three months because I had a bout on bronchitis and was off for a week just before I had moved. Unfortunatley that had been my third bout in 9 months and I'd also had some weeks off through carer stress and a death ealier in the year. She appreciated the carer stress and death bit, but the bronchitis appeared to be unforgiveable.

    I explained my health condition, but she apparently also had a life threatening health condition and didnt let that stop her from coming in. I said that I do come in if I am able to get out of bed and drive in safely, the I was told that the Health Service could not afford to pay people to be off work even if it was genuine and the sickness policy was in place to ensure that they could get rid of anyone who was off sick, even if with a doctors note. This woman was Head of Operations for the Trust.

    A few months later, she knew I had struggled in really ill and had to be driven in at times and even made a comment that she was glad to see it, but forcing myself made things worse and I ended up being ill for a lot longer and pretty unproductive at work as well. I have my own office so that part is not so noticeable.

    That was 2 years ago, I now have another new manager, she passed me over to a good manager for a year but who has since left because she does not like the Trust ethos. Now I have another, a lower grade but with the same attitude as the head of Operations except whe wears a smile on her face when she says anything.

    First day in position, she came in and said I'd had 4 sicknesses in 6 months, which I hadn't but through working at home after a meniere's episode, my nice old boss had registered I was off, but not altered it when I started work later at home, even though I had worked a full day. Hence here I am once again at the threat of losing my job if i go sick again.

    Recently got so ill with bronchitis but carried on coming in, infection spread to my ears and burst my eardrum, still came in, but as unfit to drive had my husband, who fortunately was not working, driving me around from base to base.

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  • I'm really sorry for being blunt and pointing this out but quite honestly there are a high number of workers in the NHS who are also taking the absolute pi$$ out of the system too!!! Obese or overweight, I'm sorry but you have control over what goes in your mouth, please don't blame your job for that and I'm a shift worker also! Every council run gym which are for the most part, bloody excellent, give all NHS workers a discount!!!!
    And staff being disciplined for sickness, with the exception of a select few, probably bloody deserve to be!!
    As an NHS worker you get 6 months full sick pay before going on to half. I'm sorry, but name any other industry in Britain that offers that!! My husband works in hospitality, pulls 12-15 hour shifts, deals with horrendous management and doesn't work under the greatest of conditions, is on his feet from the minute he goes on the shift until he walks back through our front door and has the added pleasure of dealing with the public making nowhere near what nurses make and this is also after attending university in hotel management for 3 years.
    Trusts perhaps need to investigate higher management level and their attitudes towards staff but on the whole, as a nurse on the frontline, I do my job for my patients, for my team and quite frankly as a band 5 working both days and nights, I'm earning a heck of a lot more than a lot of people my age who are working under worse conditions for substantially less pay!
    The NHS is haemorrhaging money and sick pay is where much of it goes!! People are too quick to blame their job in the NHS for what is wrong with them and quite frankly I'm sick of hearing about it! And I work in acute admissions where beds are tight and nurses are short but honestly people, it's the same in most industries, suck it up and/or do something constructive about it to help change it as opposed to whining and doing nothing!!

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  • Unfortunately the story above is not likely to be a one off.
    It is both sad and heartening to see this headline - sad because it's been said on many occasions and no more clearly than by Steve Boorman. Heartening because it needs to be kept on the agenda and is mission critical for the success of the 5YFV
    The North West Coast Academic Health Science network has commissioned a piece of work to try and get underneath 'why despite all the evidence and of the business case for good staff HWB is the NHS still not achieveing the transformational change in staff health and wellbeing'. The results will be available by mid April. It won't necc tell us anything we don't instinctively know. It isn't necc about resource. It isn't about providing gyms, whether it's a 9-5 opportunity or open 24 hours. The chances are those gyms will be used by people who would use gyms anyway. The biggest health gain is getting people who do nothing to do something. The evidence base for being more physically active stares us in the face, not only to improve staff HWB and performance but to reduce demand on health services and yet we still don't see a systematic approach to supporting staff to be more active. Staff HWB is about culture and leadership. We don't need a new shiny approach - we need authentic leadership, engagement and commitment, we need to make use of the improvement tools the NHS has at its' finger tips and a clear acknowledgment that it is a business critical agenda. Many staff including executive teams are beleaguered, turning up day after day to do the best job they can in the challenging circumstances. We need an approach which acknowledges this and takes it into consideration when planning and developing an organsiational approach to staff HWB. We don't need anymore evidence of importance of staff HWB, toolkits or guidance. There's enough available to wave a big a stick at! They're not used.
    In 2010 we launched a prog in response to Boorman to support staff to become more physically active. More than 220,000 staff participated, following an evaluation the prog demonstrated clear ROI, improved staff morale and engagement. Funding stopped in 2014. It would now cost £1.00 per member of staff per year - less than 10p per month but orgs can't/won't pay it. We need a little less conversation and a little more action.

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  • Anonymous 13th March. 3.18pm

    In the nhs, you only get 6 months full and 6 months half pay when off sick if you've been in for a long time.
    Your husband works 12.5hr shifts; so do I, but he does not have the accountability or responsibility we have as nurses. Neither do a lot of people on less pay that are non nhs. Without shift enhancements, our band 5 pay would be crap for what we do. I say yo people who moan that we are so well off that if they think it's so good they should do their training and join us. You say you're a band 5 nurse so should know the pressure we're under.

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  • I have to agree many health trusts adopt a reactive (and often quite an aggressive approach) not a proactive approach to safeguarding the health of its workforce.
    Pressure is applied sometimes quite subtly to 'encourage' staff to work when they are ill or over stressed, the latter being the root cause of many other illnesses.
    They do not consider the effect outside stress has on mental wellbeing such as financial hardship (due to pay restraints/rising costs) and how that impacts on the individual work performance, this coupled with staffing shortage, dealing with difficult emotional settings, little or no breaks and long hours, management ingratitude/complaints etc all of this eventually leads to individual meltdown and sickness/reduced income and loss of confidence in ones own ability to cope when contemplating a return to work. Mental Health and Wellbeing is to me the most key issue which needs addressing if trusts are to retain/recruit staff.

    However that aside I have to say for physical mechanical ailments my trust does provide some resources to help albeit a limited service with restricted appointment times.
    I am a clinic based nurse and for many years I was sitting long periods in awkward settings with poor equipment (previously never enough in budget to address long term) I now have neck and back problems (spondylosis/arthritis) .
    Our location is better now however we move room locations regularly (depending on clinic) so a work place assessment is futile as room layouts are not identical or even similar in some cases and desks/chairs are not in same positions and quite a few do not have adjustable height computer screens.
    I suppose I am lucky as most of time I can manage on simple analgesia but usually about once a year (sometimes up to 18mths) the neck pain gets worse triggering headaches and I need more than painkillers. I have had physiotherapy incl acupuncture, traction & TENs.
    Luckily my trust has a self referral programme to occupational health which incorporates a physio team but because we are so busy/working on reduced staff that I cannot get time off (around 30 mins/week) to attend in the appropriate opening hours and as I live quite a distance from my work place and don't drive its impractical to travel in by bus (3-4hr round trip) on my day off so the only other option is GP referral to physio service in my own health authority area which is quite time consuming and lengthy waiting lists so I plod on trying to get time to go for treatment and hoping it does not so bad I end up having to take time off sick!

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  • I agree with Carol.
    Lunchbreaks! I once worked on a team where the manager insisted we all took our lunchbreaks, Not in the office, NOT inputting on the computer, NOT answering phone calls, NOT looked down on for going for a short walk in the fresh air, as long as we were back on time. It was wonderful.
    I'm sure my work was better, more efficient, just because I'd had a proper break.
    Sadly that is the exception, not the rule in healthcare. what does lack of proper breaks do to OUR health ?

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