There is no doubt that the past year has had a massive impact on the NHS workforce. The pandemic has shed a light on its vulnerability in terms of capacity. Frontline workers have faced extended hours, separation from families to protect loved ones, inadequate protection, as well as grief. The pandemic has accelerated technological and structural changes that were already afoot within the NHS and staff may have been forced to make moral decisions that no one should ever contend with. So how can we rebuild the NHS workforce post-COVID to make it more resilient and able to respond to future adversity?
Many staff have been exposed to traumatic events and moral dilemmas, whether they be decisions around allocation of ventilators or choosing between their own health and wellbeing and that of their colleagues and patients. Professor of Defence Mental Health, Neil Greenberg, says “these situations place healthcare workers at risk of suffering ‘moral injuries’. This term describes the distress experienced when circumstances clash with one’s moral or ethical code. Staff who suffer with moral injuries are at risk of developing a range of mental health issues including anxiety, depression, PTSD and even addiction.” And the pressure does not stop there. Some estimates show that more people may actually die because of COVID rather than of it i.e. the burden of untreated new and long term health conditions together with the post-pandemic mental health fall out could be catastrophic.
Professor Dame Carol Black DBE believes that “HR and managers will need to understand the fluidity of the present time and communicate and listen more in order to get to grips with the topmost problems – creating purpose, clarity and autonomy and supporting mental and physical wellbeing.” Employers will need to adopt a more personalised and intuitive approach when it comes to identifying those most at risk of psychological trauma and to ensure that access to early interventions and support is provided. An open culture that reduces stigma and fosters honest conversations between managers as well as colleagues should be at the very core of healthcare organisations.
Prevention will play a key role, ensuring staff are fully protected in terms of exposure, adequate safety equipment, sustainable shift patterns and flexibility. We are already seeing an acceleration of self-care initiatives but these need to resonate more within the NHS. iOH President Neil Loach believes that “adopting the self-care approach not only improves resilience but benefits patient outcomes.” Nic Malcomson who has been running the doctors’ resilience programme at Chelsea and Westminster hospital for the past five years agrees. He has been working on dispelling negative emotions, anxiety and fear of failure using an integrated model of psychotherapy and coaching alongside elements of positive psychology to build resilience, support wellbeing and enabling doctors to flourish.
Despite the massive out pour of support for NHS workers and a dramatic turn in public perception, NHS workers still need to feel valued by their task masters. The impending downturn in the economy will no doubt impact on the ability to offer financial rewards for those who have put their lives at risk, so employers will need to look at additional ways of rebuilding employee trust post-COVID. Values at the heart of organisations will need to be re-examined and clear messages of support amplified. Compassion and kindness towards workers are as important as compassion and kindness towards patients. The two are completely intertwined. We need to ensure there is a balance between protecting the health and wellbeing of NHS staff with providing seamless and cost-effective care for patients. BACP’s Nicola Neath advocates that “if workplaces remain driven by economics without the appropriate value put on human beings, it will be very hard to focus on physical and mental health.”
Managing the health and wellbeing of NHS staff is a major theme at this year’s Health and Wellbeing at Work Week. Sessions include Professor Neil Greenberg discussing moral injury; Nic Malcomson and Dr Mike Blaber on improving doctors’ wellbeing; Dr Jo Billings on preventing PTSD in healthcare workers; Neil Loach on self-care for healthcare workers; Dr Robyn Vesey on rebuilding workforce resilience; and Philippa Foster Back CBE on rebuilding employee trust. If you work within a hospital, GP surgery or ambulance service and are responsible for managing the health and wellbeing of NHS workers, then you are eligible for a 20% discounted NHS rate, valid until 28th February.