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Physician heal thyself (Luke 4:23)

  • Jamie Hacker Hughes (a1), Amra Saleem Rao (a2), Neelam Dosanjh (a3), Esther Cohen-Tovée (a4), Jeremy Clarke (a5) and Gita Bhutani (a6)...

Summary

The performance culture of the health service means that the psychological well-being of staff is becoming paramount in maintaining the workforce and in sustaining psychological health and morale. A Charter for Psychological Staff Wellbeing and Resilience is introduced that puts the onus on us and on employers to make the necessary adjustments to their workplace cultures and encourage professionals – us – to break through the barrier of stigma.

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Copyright

Corresponding author

Professor Jamie Hacker Hughes, Veterans and Families Institute, Anglia Ruskin University, Bishop Hall, Chelmsford CM1 1SQ, UK. Email: jamie.hackerhughes@anglia.ac.uk

Footnotes

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Declaration of interest

All authors are members of the British Psychological Society's Psychological Wellbeing Steering Group.

Footnotes

References

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1 Felstead, A, Gallie, D, Green, F, Inanc, H. Work Intensification in Britain: First Findings from the Skills and Employment Survey 2012. Centre for Learning and Life Chances in Knowledge Economies and Societies, Institute of Education, 2013.
2 HSCIC. Annual NHS National Sickness Absence Rate Declines to Lowest Level in Five Years. Health and Social Care Information Centre, 2015.
3 Quality Watch. Closer to Critical? The Health Foundation, Nuffield Trust, 2015.
4 NHS England. Simon Stevens announces major drive to improve health in NHS workplace. NHS England, 2015 (https://www.england.nhs.uk/2015/09/nhs-workplace/).
5 Chew-Graham, CA, Rogers, A, Yassin, N. I wouldn't want it on my CV or their records: medical students' experiences of help-seeking for mental health problems. Med Educ 2003; 37: 873–80.
6 Hillis, J, Morrison, S, Alberici, F, Reinholz, F, Shun, M, Jenkins, K. ‘Care factor’: engaging medical students with their wellbeing. Med Educ 2012; 46: 509–10.
7 Boorman, S. NHS Health and Wellbeing Review. Department of Health, 2009.
8 Appleby, L. Putting mental health safety at the heart of the fitness to practise process (GMC blog post at https://gmcuk.wordpress.com/2016/04/07/putting-mental-health-safety-at-the-heart-of-the-fitness-to-practise-process/). GMC, 2016.
9 Black, C. Working for a Healthier Tomorrow: Dame Carol Black's Review of the Health of Britain's Working Age Population. TSO (The Stationery Office), 2008.
10 Price Waterhouse Coopers, Health Work and Wellbeing. Building the Case for Wellness. Price Waterhouse Coopers, 2008.
11 Rao, A, Bhutani, G, Dosanjh, N, Clarke, J, Hacker Hughes, J, Easton, S, et al. Psychological wellbeing and resilience: Resetting the balance (unpublished report available at http://www.bps.org.uk/system/files/Public%20files/ar_v10_resetting_the_balance_160516.docx.pdf).
12 British Association for Behavioural and Cognitive Psychotherapies. Bullying culture in NHS mental health services putting vulnerable patients at risk. Cogn Behav Therap 2014; 5 September.
13 West, M, Dawson, JF. Employee Engagement and NHS Performance. King's Fund, 2015.
14 Commission on Wellbeing. Wellbeing and Policy. Legatum, 2014.
15 British Psychological Society. Charter for Psychological Staff Wellbeing and Resilience. BPS, 2016 (http://www.healthcareconferencesuk.co.uk/news/newsfiles/charter-2016_1314.pdf).
16 New Savoy Partnership. NSP/BPS Staff Wellbeing Charter. New Savoy Partnership, 2016 (http://www.newsavoypartnership.org/nsp-bps-staff-wellbeing-charter.htm).
17 Mental Health Today. Stress and depression increasingly common among NHS psychological therapies staff, survey finds. Mental Health Today 2016; 5 February (https://www.mentalhealthtoday.co.uk/stress-and-depression-increasingly-common-among-nhs-psychological-therapies-staff-surveyfinds.aspx).

Physician heal thyself (Luke 4:23)

  • Jamie Hacker Hughes (a1), Amra Saleem Rao (a2), Neelam Dosanjh (a3), Esther Cohen-Tovée (a4), Jeremy Clarke (a5) and Gita Bhutani (a6)...

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Physician heal thyself (Luke 4:23)

  • Jamie Hacker Hughes (a1), Amra Saleem Rao (a2), Neelam Dosanjh (a3), Esther Cohen-Tovée (a4), Jeremy Clarke (a5) and Gita Bhutani (a6)...
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eLetters

Increasing wellbeing amongst NHS staff: Solution at our finger tips?

Ranjita Howard, Psychiatry Registrar CT3, Tees, Esk and Wear Valleys NHS Foundation Trust
31 May 2017

I have to agree that wellbeing amongst NHS staff is becoming an increasing problem but this has been the case for the past two decades1,2. Indeed, as far back as 1996, the Nuffield Provincial Hospital Trust called for more to be done to deal with the increasing amount of stress that NHS doctors were facing and that a more adequate means of support should be more readily available1. However, despite such calls for action, it would still seem that very little attention is being given to the wellbeing of NHS staff and the implications that this is having on patient safety3, NHS finances4, staff morale5, and dwindling staffing levels6. And with the new uncertainties over Brexit7, the advent of a new government, and the imposition of the new junior doctors contract, it would seem that wellbeing and its consequences are still far from being a top priority.

Although I certainly applaud the intentions of the new Charter for Psychological Staff Wellbeing and Resilience and the Wellbeing Collaborative Learning Network, I do think we have to be careful that these initiatives don’t fall by the wayside by being too generic or rhetorical in their message or because they simply didn’t have enough punch to have any sustained impact on the frontline. A call for more specific and immediate initiatives from within our own community may go someway towards a sustained solution. Indeed, the clinical entrepreneur programme that was launched last year drew attention to the vast untapped resources that are available in the form of ourselves as doctors and that given that we are all on the frontline day-in day-out we are in the best place to devise innovative solutions to the problems we regularly face. As a clinical entrepreneur myself, for example, to deal with this wellbeing issue I would propose some kind of coaching app based upon the process of salutogenesis8,9 which, during times of great difficulty, encourages staff to focus on those things that are ‘healthy’ or ‘working well’ as opposed to the mere negatives within the NHS workplace, and utilise General Resistance Resources (GRRs), which are those resources that help one cope and even flourish during these difficult times if necessary. Research has indeed shown that a coaching intervention which encourages the emergence of this salutogenic mindset results in the increase in wellbeing and resilience of NHS staff via the use of ‘wellbeing frames’10, and I think that if such could be executed via a mobile application that this could serve as one potential solution towards offsetting the downward spiral of wellbeing amongst the NHS workforce.

But, of course, this is just one potential solution. I suggest that as a field we continue to do our best to encourage as many of our NHS staff as possible to engage in such entrepreneurial thinking to tap into the resources that we already have available at our finger tips. This, in conjunction with the broader initiatives as laid down by the likes of the new Charter for Psychological Staff Wellbeing and Resilience and the Wellbeing Collaborative Learning Network, will go a long way towards ebbing away at the many challenges that we currently face as frontline staff.

References

1. Nuffield Provincial Hospitals Trust. Taking care of doctors’ health: reducing avoidable stress and improving services for doctors who fall ill. London: Nuffield Provincial Hospitals Trust, 1996.

2. Williams S, Michie S, Pattani S. Improving the health of the NHS workforce: Report of the partnership on the health of the NHS workforce. London: The Nuffield Trust, 1998.

3. Royal College of Physicians. Underfunded, underdoctored, overstretched: the NHS in 2016. Royal College of Physicians, London, 2016.

4. Boorman, S. NHS Health and Wellbeing: Final Report. DoH. London, 2009

5. O'dowd, Adrian. Staff morale is dropping as NHS money pressures grow, says King's Fund report. BMJ: British Medical Journal (Online) 349, 2014

6. http://careers.bmj.com/careers/advice/Half_of_foundation_trainees_now_choose_not_to_progress_straight_to_specialty_training

7. Simpkin, Victoria L, Mossialos, Elias et al. Brexit and the NHS: Challenges, uncertainties and opportunities. Health Policy, Volume 121 , Issue 5 , 477 - 480, 2017

8. Antonovsky, A. Health, stress and coping: New perspective on mental and physical well- being. San Francisco: Jossey Bass, 1979

9. Antonovsky, A. Unravelling the mystery of health – How people manage stress and stay well. San Francisco: Jossey Bass, 1987

10. Gray, D. Developing resilience and wellbeing for healthcare staff during organisational transition: The salutogenic approach. International Journal of Evidence Based Coaching and Mentoring, Vol. 14, No. 2, 2016
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Conflict of interest: None Declared

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