NHS Reset is a new NHS Confederation campaign to contribute to the public debate on what the health and care system should look like in the aftermath of the COVID-19 pandemic.
In this blog, part of a series of comment pieces from NHS Confederation leaders, members and partners, service user and activist Marsha McAdam calls executive teams to remember to look after themselves, while introducing Neil Thwaite, who reflects on the steps his organisation has taken to protect the wellbeing of the workforce.
Back in March I was in London at the pre-conference dinner for the Mental Health Network Annual Conference and Exhibition. I got to meet some warm, passionate and approachable mental health leaders from across England. The next day was the conference at the King’s Fund and I had arranged to meet with Neil Thwaite for a catch up. We then sat together for the morning session and I took the opportunity to give him a copy of the Greater Manchester Personality Disorder Strategy which he subsequently followed up with me after reading it on the train back to Manchester!
I had been asked to be on the panel for the session on the NHS People Plan chaired by Peter Molyneux. We were discussing how the mental wellbeing of all staff was of paramount importance and I remember giving a plea to them to make sure that they not only take care of their staff but also of themselves and their executive staff, which I am hoping was one of the things that they took away from the day!
Lo and behold the country was floored and immobilised by COVID-19 and I now think of the CEOs, chairs and executive team members being deer caught in the headlights, trying to maintain the infrastructure of their organisations and taking into account the health and wellbeing of their staff and those in need of their services. How are you able to take time for your own wellbeing while working more than 12+ plus hours per day, seven days a week. What about you and your family? As there is much talk about supporting staff for the aftermath and the trauma that COVID-19 has left in its wake, will you make sure that you too acknowledge that the trauma of it all will have easily reached your door and that it is not perceived as weak to been seen having help. Remember to take care of you too!!
As Marsha has pointed out, supporting the mental health and wellbeing of all of our staff has been a paramount concern for our trust during this difficult time. Working in mental health has meant that many of our staff have had a raised awareness and first-hand experience of the psychological impacts of crises. We have been overwhelmed by their fantastic response to the crisis. All staff have gone the extra mile, continuing to place their primary focus on the welfare of our service users while also supporting colleagues inside and outside our organisation. We have been careful to ensure that staff know when they are not needed and have had opportunity to take time back or take planned rest to maintain their resilience. This is a marathon not a sprint!
At the beginning of the outbreak, we were all exposed to huge amounts of rapidly changing information from a range of different sources. In this context, we had to ask our staff to make changes and problem solve at a relentless pace and also take decisions that might previously have seemed inconceivable. I am proud of the way they have responded, demonstrating their ability to adapt and stay strong. Continued access to supervision and peer networks has proved a key source of support throughout, in addition to formal and informal support from our clinical psychology staff.
Supporting our staff to embrace new ways of working has been a key strand of our COVID-19 response.
We have redeployed staff to assist with the continued provision of essential services and support the establishment of new services such as mental health urgent care centres and our 24/7 helpline for all our service users and carers. We have also been heartened by voluntary offers of support from staff across the trust to assist in those service areas hardest hit by COVID-19. This includes our later life wards, where sadly we experienced some deaths of services users on end-of-life care pathways. We recognise the significant impact these losses have had and have provided enhanced support to staff working in those areas. Myself and executive directors have also visited these wards to show support in person and enable action on any additional needs.
We have also enabled approximately 1,200 staff (over 20 per cent of our workforce) to work from home during this period. We have recently completed a detailed survey with our homeworking staff to understand more about their experience and the challenges faced during COVID-19. Having achieved an 85 per cent response rate to the survey, we are now using this rich data to inform much of our thinking on future ways of working.
Prior to COVID-19, we had begun to make progress in the implementation of our new digital strategy. This laid the grounds for the rapid digitisation of our IAPT and other community services early in the pandemic, enabling staff to support their clients online rather than in person. We have also introduced an online system of training and induction for staff working in health and justice settings despite most prisons being on lockdown.
Our wellbeing offer
We have continued to engage with our staff via our existing communication channels and networks, asking for their feedback and views at all times. Our wellbeing offer responds directly to what our staff are telling us they need.
We have established a number of trust-wide initiatives to support staff mental health and wellbeing, including staff and family testing for COVID-19. As our services are geographically spread and provided over 150 sites, many of these initiatives have been picked up and tailored to local need. For example, ‘NoVid’ rooms have been set up for relaxation in some of our service areas, where any topics other than COVID-19 can be discussed.
Centrally we have created a hub of wellbeing resources that all staff can access via our intranet. This is updated on a regular basis and includes information on mental and physical wellbeing, guidance on working from home, guidance on financial support and information on national offers, including access to free support apps such as Headspace and Sleepio. We have also produced daily COVID-19 briefings to keep all staff informed and motivated. We have heard some reports of loneliness and feelings of isolation from our homeworking staff and have used these briefings to re-enforce the message that everyone is ‘doing their bit’ as part of a wider team approach.
We also already had a wealth of mental health and wellbeing support for staff in place pre COVID-19, including our mental health first aiders, our specialist post-incident debrief support and our programme of Schwarz Rounds. We have ensured that staff are reminded of this pre-existing support in our regular communications. We hope that staff will remember our wellbeing offer beyond COVID-19 and those in need of support at any time will know instantly how and where they can go.
Making sure our support remains inclusive
Maintaining close contact with our various staff networks and trade unions has been key to ensuring our support remains inclusive. They represent the employee voice and guide us in the right direction to ensure what we do makes a difference to all of our staff.
We have continued to support our BAME Network to meet, albeit virtually, during this crisis. These meetings have been well attended, including by myself and my executive director colleagues. They provide an invaluable opportunity for staff to tell us first-hand how they are feeling and the impact COVID-19 is having, and have helped us shape our approach to risk assessments and other policies. In addition, our LGBT+ Network is considering the recently published LGBT Foundation Hidden Figures report to examine how we can tackle health inequalities for these communities.
Our support package on our internet and intranet has included numerous resources for parents who are working while also supporting children at home. We know how challenging this is and will continue to offer tailored support as we transition through the next phases of this crisis.
We are now planning our restoration and recovery from COVID-19, including giving thought to what ‘new normal’ working conditions might look like for our staff. Based on the inspirational response of our staff to date, and their enthusiastic engagement in our recovery planning work, we are confident of our ability to rise to any future challenges presented by COVID-19.
Marsha McAdam is a mental health ambassador and peer consultant. Follow her on Twitter @Marsha_MHAdvMcr.
Neil Thwaite is chief executive of Greater Manchester Mental Health NHS Foundation Trust. Follow him and the trust on Twitter @NeilThwaite and @GMMH_NHS
Mental health is one of the key themes of the NHS Reset campaign.
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