STAFF WELFARE
Staff health and wellbeing inthe NHS
Prioritising staff health and wellbeing is crucial to the performance of NHS Trusts and it is now being incentivised. So have lessons been learned from high profile reviews or are staff now becoming the ‘shock absorbers’ of a system under pressure? The Clinical Services Journal reports.
In 2009, an influential review of the health and wellbeing of NHS staff, known as ‘the Boorman report’,1
found that organisations
that prioritised staff health and wellbeing performed better, with improved patient satisfaction, higher quality scores, better outcomes, greater levels of staff retention, and lower rates of sickness absence. However, feedback showed that many staff were “not convinced that their employer viewed their health and wellbeing as important” and the review called on NHS Trusts to “put staff health and wellbeing at the heart of their work.” Recommendations included an identified board-level champion, senior managerial support, and training in health and wellbeing for healthcare leaders. The NHS Constitution, which followed, in January 2010, subsequently included a commitment to “provide support and opportunities for staff to maintain their health, wellbeing and safety”. Despite the increased awareness around this issue, some Trusts unfortunately failed to deliver on this commitment. The Mid Staffordshire NHS Foundation Trust scandal provides a high-profile example of how care quality can be impacted when healthcare leaders do not have sufficient regard for staff welfare.
When staff are disengaged and feel
undervalued, care quality suffers and a series of reviews and reports since the Boorman report have succeeded in re-emphasising this link. A review, chaired by Chris Ham, chief executive of The King’s Fund and
commissioned by the Minister for Care and Support, Norman Lamb MP, concluded that organisations with low levels of staff engagement are more likely to provide poor-quality care.2
The report added that
NHS organisations with high levels of staff engagement report: l Lower mortality rates. l Better patient experience. l Lower rates of sickness absence and staff turnover.2
Following a request from NHS England, NHS Employers also commissioned a report from Dr Jeremy Dawson of Sheffield University to look at the international research evidence on the links between staff and patient experience.3
Staff experience and patient
outcomes: what do we know?, concluded: “There are clear links between improved staff experience and better care for patients. Good HR practice and, in particular staff engagement, should therefore be seen as integral to overall objectives for the NHS, not a separate HR initiative.”3
Cost impact
There are significant costs to the NHS when Trusts fail to ‘put staff health and wellbeing at the heart of their work’. NHS Employers estimate that 30% of NHS sick leave is caused by stress, costing up to £400 million a year in lost productivity. Additionally ‘presenteeism’ – described as the act of attending work while sick – doubles the costs of absenteeism. Related to this are the
Staff retention and recruitment are also being impacted by workplace morale, issues around working conditions and increased pressures, as well as dissatisfaction around pay and funding for training.
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hidden costs of mental illness in staff. The total cost to the NHS of mental health related staff illness stands at £1.3bn (£1,000 per employee).4
Five Year Forward View
The Five Year Forward View set out the ambition for NHS England to become a national exemplar in the support it offers its 1.3 million staff to stay healthy and noted that only one in three NHS Trusts offer their staff support in keeping to a healthy weight. Three quarters of hospitals also fail to offer healthy food to staff working night shifts. NHS England subsequently announced a £5m national initiative to improve and support the health and wellbeing of its staff. The funding has been committed to a range of initiatives, including serving healthier food, promoting physical activity, reducing stress, and providing health checks. Last year, the Department of Health (DH) also introduced a £450m incentive to address some of these issues with the launch of its NHS staff health and wellbeing CQUIN. The CQUIN guidance points out that, even small reductions in sickness absence can have a large impact across the NHS. If sickness absence was reduced by one day per person per year then the NHS would save around £150m, equivalent to around 6,000 full time staff.5
Performance
So how is the NHS performing in relation to NHS health and wellbeing, and should health leaders be concerned? There have been some improvements reported – NHS Digital latest figures show that NHS staff sickness absence has consistently reduced since 2015, from 4.44% to 4.29% in 2017.6 In addition, NHS England’s staff survey (which is mandatory for all Trusts) showed that NHS staff engagement scores are “at their highest level in five years.”7 The survey, which was carried out between September and December 2016 across
SEPTEMBER 2017
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