As an Independent Academic Partner to the Commission, we are pleased to see the release of this important Report. It addresses a broad population: from secondary school-aged young people likely to work in the NHS, to those currently working in the NHS, including nurses, doctors, paramedics, and any other members of NHS staff. The difficulties unique to NHS staff and learners are outlined, and case studies of solutions are given.
The new recommendations from the commission are summarised and divided into the stakeholders expected to implement them below:
Recommendations for NHS organisations:
- Introduce a Wellbeing Guardian, a board level executive, who operates within 9 principles set out by the Commission and provides information to the Board, so it can benchmark, set organisational expectations and monitor performance.
- Introduce a Wellbeing Leader who would actively listen to staff at their level and report to the Wellbeing Guardian.
- Introduce Wellbeing Tutors: people at a similar level within placements, with sufficient, dedicated protected time in their job-plan, who provide personal wellbeing support that is not linked to educational progression.
- Introduce a wellbeing check-in 2 weeks into any new placement for postgraduate trainees.
- Offer a schools’ work experience bureau service.
- Provide evidence that estate development plans will also enhance, or create, dedicated space for staff and learners.
- Provide trainees working on an on-call service with ‘designed for purpose’ on-call rooms that enable rest and sleep during, before or after on-call shifts.
- Ensure all staff have suitable, accessible, psychologically safe and confidential spaces in which to socialise, share and discuss experiences and to rest.
- Ensure Service Managers develop incident protocols for instances when staff, or learners, are placed in situations that would disproportionately impact on their wellbeing, including timely provision of post-incident support and post-trauma counselling.
- Provide dedicated time for all NHS staff to periodically access a reflective learning space, such as clinical supervision.
- Examine the death by suicide of any NHS staff or learners and report the findings, through the Workforce Wellbeing Guardian, to the board.
- Create organisational protocols to respond to staff and learner deaths by suicide. This should include targeted psychological support for colleagues.
- Provide access to a proactive occupational health service that promotes staff wellbeing.
- Fully implement the recommendations given by the Thriving at Work
- Adopt the ‘Promoting a Positive Culture to Tackling Bullying’ work done by NHS Social Partnership Forum and NHS Employers.
Recommendations for NHS provider organisations of undergraduate and postgraduate healthcare programmes:
- Train relevant staff and give clear guidance on support procedures for students/trainees with mental distress.
- Recognise and proactively provide support for the transition stresses that students/trainees may face.
- Fully implement the changes described in Enhancing Junior Doctors’ Working Lives, and apply these to all postgraduate students.
Recommendations for the Department of Health and Social Care and the NHS:
- Develop a NHS ‘Samaritans-style’ service with the aim of providing a complete emotional support service to NHS staff and learners.
- Ensure all NHS staff and learners have self-referral access and rapid access referral pathways, through priority requests from primary care or occupational health clinicians, to a practitioner psychological treatment service locally, or nationally.
Recommendations for Regulators and Representative Bodies:
- Undertake a ‘root and branch’ examination of how complaint handling can be sped up without compromising the rights of patients and staff members.
Recommendations for UK Foundation Programme, Royal Colleges and Health Education England:
- Work with Medical Students and Doctors in Training to agree an allocation system that is both just and more humane.
Recommendations for Universities:
- Ensure healthcare undergraduate curriculums include training in self-awareness, self-support, suicide awareness and prevention, and signpost to support.
- Introduce Wellbeing Tutors: people at a similar level within the placement, or organisation with sufficient, dedicated protected time in their job-plan, who provide personal wellbeing support that is not linked to educational progression.
- Introduce a wellbeing check-in 2 weeks into new placements.
- Recognise and proactively provide support for the transition stresses that students may face.
- Consider the financial and wellbeing impact of placement locations for their students.
Recommendations for UCAS:
- Ensure the information for young people with Learning Difficulties is reviewed.
Recommendations for the NHS Careers Service:
- Ensure the information available to young people is revisited and regularly updated with flexible education options, different training entry routes, and career journeys.
Read the full report:
NHS Staff and Learners Mental Wellbeing Commission. Health Education England.