Themes:
- Evidence-based interventions
- Confidentiality
- Funding
Background
Stress, anxiety and depression are the most common reasons for NHS staff sickness absences (NHS Digital, 2023a). Access to support for staff struggling with their mental health when carrying out extremely challenging roles is therefore vital. Providing such support also sends a clear message that the organisation values the mental wellbeing of its workforce.
Lincolnshire Partnership NHS Foundation Trust (LPFT) has been running its in-house staff wellbeing service (SWS) for almost 13 years. The dedicated team consists of cognitive behavioural therapists, occupational therapists, counsellors, a psychological wellbeing practitioner, assistant psychologist, clinical psychologist, psychiatrist, and a physiotherapist. The SWS is separate from the trust’s occupational health service and supports all aspects of staff health and wellbeing.
Access to confidential psychological therapy
Healthcare professionals can face specific barriers to accessing mental health services, including concerns that by using services delivered by their colleagues they could be perceived as vulnerable (Zaman et al, 2022). To improve access, the trust funded a separate psychologically safe space for staff. Nikki Gibson, staff wellbeing service and hub lead, said: "Confidentiality is paramount to the service. It has its own dedicated building and clinical system which ensures all support provided is discreet and completely confidential."
Staff have access to psychological therapy such as one-to-one counselling, in-person and online cognitive behavioural therapy, as well as a consultant psychiatrist who is able to support with medication reviews and contribute to the management and treatment of mental health problems. Support is offered for both work and non-work related reasons.
Employment support and domestic abuse pathway
Run by occupational therapists, the SWS’s employment support pathway targets staff who are currently absent from work, or those who are struggling to maintain work. Upon receipt of a referral (either self-referral or management referral), the SWS aims to offer initial support within five working days, followed by a further assessment from an occupational therapist.
Working in collaboration with the staff member, their manager, human resources, occupational health and other relevant professionals, workplace adjustments are provided to support the individual. Interventions can include a phased return to work or a phased remain at work, by reducing working hours, changing working patterns, redeployment and reviewing job design.
Staff can also contact the SWS if they are experiencing domestic abuse (or they are concerned someone else is) and would like support. The domestic abuse pathway helps staff to identify risks to personal safety and develops an action plan for the individual at risk which can include support from a range of professionals, including external agencies. Staff are empowered to take each step at their own pace, with no pressure or expectation to continue accessing support.
Wellbeing workshops
The SWS offers a range of core and bespoke wellbeing workshops open to all staff. Core workshops focus on improving self-esteem and sleep, reducing burnout and managing moral injury, understanding emotions, becoming more assertive, and managing menopause. The bespoke workshops offer team level support for unique issues.
The workshops increase understanding and awareness of issues related to wellbeing and equip staff with tools to support themselves and their team colleagues.
The trust has received a range of feedback about the SWS and the services it offers, one staff member said: "The SWS and hub do an amazing job. Supportive, proactive and offering lots of options for me to support myself as well as receiving support from them 1:1 or in groups". Another said: "Excellent service. Our staff wellbeing service offer is a motivator to stay within this trust as it’s one of the best services I’ve accessed."
Reflections
99% of all staff who accessed the support offered through the SWS said it's had a positive impact on their wellbeing, it helped them do their job better and supported them to stay in work or get back to work more quickly. One staff member said: "The practical parts I found most helpful were support with planning for the short-term, to recognise the importance of asking for changes in the here-and-now at work and support for communicating boundaries." Further, 70% of staff said they would recommend LPFT as a place to work – almost 10% above the national average (NHS Staff Survey, 2023).
LPFT is convinced that workplaces which actively promote and support colleagues' mental health secure benefits for themselves and their employees. Offering a wellbeing service and standing by staff when they are experiencing a mental health problem is not only about retaining a valuable staff member, but also highlights the level of commitment the organisation has to colleagues.
Access to clinically led support services is vital to anyone experiencing a mental health problem. NHS staff mental health and wellbeing hubs were established during the Covid-19 pandemic to support staff struggling with their mental health, however, funding is due to end in March 2024 and many hubs have had to close as a result. With a third of NHS staff reporting burnout because of their work (NHS Staff Survey, 2023) and over a quarter of doctors reporting a mental health diagnosis at some point in their life (British Medical Association, 2019), it is more pressing than ever to ensure the NHS workforce has access to support services within their trust.