Senior level ‘Wellbeing Guardian’ for every NHS workplace

Author: Caroline White

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Every NHS workplace should have a senior level ‘Wellbeing Guardian’ to drive organisational expectations, monitor performance, and provide reassurance that their organisation is one in which NHS staff and learners can thrive, finds a review* published today by the NHS Staff and Learners’ Mental Wellbeing Commission for Health Education England (HEE).

The mental health of NHS clinical staff and learners has worsened in recent years, amid fears about complaints, investigation, and blame, says the report, which follows up an interim report published last summer, with a review of the published evidence, in a bid to support the ambitions set out in the NHS Long-Term Plan.

The physical and emotional health of NHS staff is key to patient welfare, with stress and burnout putting patient safety at risk, says the report.

Mental ill health issues are one of the biggest causes of long-term sick leave among NHS workers. And poor mental health in the NHS workforce costs between £1,794 - £2,174 per employee every year.

But staff don’t feel able to talk about their issues, says the report, citing a survey of 3,500 doctors which showed that nearly three quarters would choose to disclose mental ill health to family or friends rather than to another healthcare professional.

One in three of the NHS workforce have felt unwell because of work-related stress, and one in two have come to work despite feeling unwell because they felt pressure from their manager, colleagues, or themselves.

And suicide rates are higher in some professional groups, particularly nurses.

“We need to change cultures, remove the stigma that is attached to talking about mental health and encourage open discussion. That is why the work of the Commission is so vital: it sets out how we can tackle some of the many issues faced by staff and learners alike,” comments Professor Simon Gregory, Health Education England primary care lead and the Commission’s clinical director.

“The mental wellbeing of staff contributes positively to patient care so we must get it right,” he adds.

Among the raft of recommendations for improving the mental wellbeing of NHS staff and learners, it says that ‘Wellbeing Guardians’ should become the norm in every practice, trust and healthcare facility in the country.

A board level role, ‘Guardians’ would be responsible for the mental wellbeing of their staff, by setting organisational expectations, monitoring performance, and providing reassurance that their organisation is a healthy workplace.

All NHS organisations should appoint a ‘Workplace Wellbeing Leader’ as a first point of call, to work alongside the ‘Workforce Wellbeing Guardian’.

The report also recommends that every student and postgraduate trainee has access to personal wellbeing support that is quite separate from their education and assessment.

A wellbeing ‘check-in’ should be provided to all postgraduate trainees (within two weeks) of starting the placement and on each placement. The personal wellbeing tutor must have enough dedicated, protected time in their job plan, which is audited and reported, it says.

The report also recommends that HEE’s Enhancing Junior Doctors Working Lives programme should be fully implemented and applied to all postgraduate trainees, not just doctors.

In response, the government has today pledged to provide better mental health and wellbeing support to NHS staff, based on the review’s recommendations.

British Medical Association mental health policy lead, Dr Andrew Molodynski, said: “Given the current pressures that the NHS workforce is under, the secretary of state for health and social care’s commitment to improving mental health and wellbeing support for staff is both timely and necessary.

“While these measures will go a long way to providing much-needed support for NHS workers who are struggling with their mental health and overall wellbeing, more must be done to address the wider pressures on the system, such as underfunding, workforce shortages and rising patient demand, so we can reduce the number needing to seek help in the first place.”

Paul Jenkins, chair of the Mental Health Network, commented: “The NHS is founded on care and compassion and that has to extend to our staff. This report presents a clear case for change which will require a significant shift in behaviour and culture across the whole of the NHS and social care. But this is essential if the NHS is to achieve the Long-Term Plan’s goal of being the best place to work.”

Sue Covill, director of development and employment at NHS Employers, said: “NHS trusts are working extremely hard to improve and support the wellbeing of their staff. Where this works well, organisations have strong leadership from their board to drive improvements, influence the culture of the organisation and engage with staff to provide the preventions, support and interventions needed.”


*NHS Staff and Learners’ Mental Wellbeing Commission. NHS Health Education England, February 2019.

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