Item 1

Dr Lade Smith CBE

Royal College of Psychiatrists

The NHS is wholly reliant on its workforce. Delivering free, universal and comprehensive healthcare is only possible because 1.4 million people – from porters to psychiatrists – choose to come to work. Without those workers, the NHS ceases to exist.

Despite this dependency, the NHS has sometimes overlooked the fundamental needs of its workforce. The latest NHS data shows approximately one in 20 workers is on sick leave, with many experiencing debilitating anxiety, stress and depression (NHS Digital, 2023a). Workforce shortages are endemic and entrenched, particularly in mental healthcare where one in five nursing and one in six medical posts in England are now vacant (NHS Digital, 2023b).

While the NHS Long Term Workforce Plan (NHS England, 2023a) provides a framework for recruiting skilled workers over the long term, more action is needed to address retention in the short term.

Improving wellbeing is key to ensuring colleagues continue to come to work. For that reason, addressing wellbeing can no longer be considered a 'nice to have'. The future of the NHS depends on it.

Equally, responsibility for wellbeing is not something that can be outsourced to others to worry about. We each have a role in ensuring colleagues are always treated with "respect, dignity, compassion and care" (Department of Health and Social Care, 2023, p3) as envisaged by the NHS Constitution. As the NHS Constitution reminds us, "patient safety, experience and outcomes are all improved when staff are valued, empowered and supported" (Department of Health and Social Care, 2023, p3) and it’s also the right thing to do.

As part of our efforts to improve the wellbeing of NHS workers, the Royal College of Psychiatrists (2023) recently published guidance to support healthcare employers to tackle covert and overt racism in the workplace. We know workplace inequity and racism in particular drive colleagues out of the NHS.

Our guidance was developed over two years in consultation with medical directors, doctors with lived experience of racism, patients and others. While the guidance focuses on tackling racism, the principles can be applied to improving workplace culture generally as well as staff wellbeing.

The College guidance identifies 15 actions to implement meaningful change at a strategic and systemic level across six domains: leadership and strategy, accountability, addressing concerns, equity of opportunity, organisational culture, specific sections of the workforce.

Our guidance highlights the importance of developing a robust strategy underpinned by measurable targets, creating an environment where staff feel safe to speak up and accountability for delivery assigned to a senior leader.

It provides clear and pragmatic actions for employers and a step-by-step guide to implement change. It shows employers how to recognise and respond to instances of discrimination on racial and ethnic grounds and signposts them to sources of support within and outside their own organisation. These are all themes that will resonate after reading this report.

This report provides practical examples of how some employers are actively improving staff wellbeing. It highlights the importance of targeted and informed interventions rather than tokenistic approaches. The emphasis on compassionate leadership, accountability and transparency echoes the findings of our work. It is vital that colleagues of every background feel psychologically safe at work and trust that their concerns will be listened to and acted on.

Improving the wellbeing of NHS workers requires a collective effort to ensure every colleague is treated with respect, dignity, compassion and care. This report shows how this can be achieved. It is a timely and welcome reminder of the importance of supporting staff to improve their wellbeing, so they feel valued, empowered and supported so patients can experience the best care and achieve the best outcomes.