Evidence Bites: Staffing Pressure

An evidence summary inspired by safety discussions held at the Wirral University Teaching Hospital NHS Foundation Trust’s Safety Summit

Why is staffing pressure a patient safety concern? Ensuring NHS providers are staffed with the appropriate number and mix of clinical professionals is vital to the delivery of quality care and in keeping patients safe from avoidable harm. Pressure on staffing may have implications for patient safety incidents relating to human factors and interruptions / distractions in the clinical environment.

New publication: The risks to care quality and staff wellbeing of an NHS system under pressure
A report commissioned by The King’s Fund in Jan 2018 summarises the research evidence on the direct and indirect impact of staff health, wellbeing and engagement on patient care.

Date of publication: Feb 2018

Thriving at Work: a review of mental health and employers

A Policy Briefing aimed at healthcare professionals is available for LKS staff to share in their own organisations. This has been produced and shared by the JET Library, Mid Cheshire Hospitals NHS Foundation Trust. Please feel free to reproduce it (with acknowledgement to JET Library) for your own purposes.

Impact on library policy/practice: 

Whilst this driver is something that needs to be implemented at a higher level, there are still some things libraries can do to support it and the document demonstrates that investment in mental-health initiatives show a positive return.

Firstly, all NHS libraries contribute to the provision of information to patients and the public, and there are a number of suggestions in the PPI Ideas Bank that support mental wellbeing, including:

• Offering work placements in the library team for service users recovering from mental illness.
• Service user reading groups or book clubs
• Provide materials for Recovery Colleges
• Provide access to self-help collections such as the Reading Agency’s Books on Prescription titles, or Mood Boosting books

Libraries also support the wellbeing of staff (as recommended in the Boorman review), and this might be through self-help book collections, craft or reading groups, stress relief initiatives such as jigsaws and colouring books, organising mindfulness training, writing competitions, organising ‘pets as therapy’ sessions, or in many other ways. As well as staff, the needs of students need to be considered, and many universities are running programmes to support their students especially during exam time and NHS libraries might be involved in these, run their own, or signpost to them.

Libraries can also support managers to support their staff, and could look at what resources they have on managing staff wellbeing or engagement.

Whilst these are no substitute for formal mental health support, they are things that could help promote mental wellbeing and reduce the burden of mental ill-health on the individual and the organisation.

Source: Department for Work and Pensions and Department of Health

Link to main document

Publication format: PDF

Date of publication: October 2017

Summary of driver: Thriving at Work sets out what employers can do to better support all employees, including those with mental health problems to remain in and thrive through work.

Key features of driver:

• 300,000 people with long-term mental-health problems lose their jobs every year
• Around 15% of people in work have symptoms of an existing mental-health condition
• The cost to employers of mental ill-health is estimated at between £33bn and £42bn
• The cost to the Government is estimated at between £24bn and £27bn
• The cost to the economy as a whole is estimated at between £74bn and £99bn
• Case studies consistently show a positive return on investment for mental-health initiatives
• Employers should:
  • Produce, implement and communicate a mental-health-at-work plan
  • Develop mental-health awareness among employees
  • Encourage open conversations about mental health and the support available
  • Provide employees with good working conditions
  • Promote effective people management
  • Routinely monitor employees’ mental health and wellbeing
• Larger employers should increase transparency through internal and external reporting and provide tailored in-house mental-health support
• In the public sector:
  • Regulatory bodies should include employers’ handling of mental health in assessments
  • Senior leaders should have a performance objective of supporting mental health
  • NHS England should continue developing its Healthy Workforce programme
  • Employers should identify people at higher risk of stress or trauma and produce a national framework to support them
• The Government should:
  • Form a mental-health online information portal to promote best practice
  • The Access to Work, Fit for Work and other NHS services should be aligned to create an integrated in-work support service
  • The Government should protect and promote the current tax reliefs for mental-health schemes
  • Legislate to enhance protections for employees with mental-health problems
  • Statutory sick pay should be more flexible to make a phased return to work easier
  • NHS bodies should provide clear ratings for apps and other digital platforms which provide mental-health support
  • Government and the NHS should improve patients’ access to their medical records so patients can share their data with employers should they wish to

Primary audience: Employers and managers, both public and private sector

Date last updated: November 2017

Due for review: November 2018

Group member responsible: JC

NHS Health and Well-Being (Boorman Review)

Title of driver: NHS Health and Well-being Final Report (Boorman Review)

Source: Independent review commissioned by the Department of Health and led by Dr Steve Boorman

Link to main document: http://www.nhshealthandwellbeing.org

Publication format: Web site, with interim and final reports available as PDFs

Date of publication: November 2009

Summary of driver:

The report is an analysis of impacts on staff health and well-being within the NHS. The final report states that NHS organisations which prioritise staff health and well being:

• Achieve enhanced performance
• Improve patient care
• Are better at retaining staff
• Have lower rates of sickness absence

Suggestions include focusing on prevention and health improvement, providing efficient support for staff who present with ill-health, being proactive in tackling the causes of ill-health and providing early intervention services, where appropriate.

Reducing staff absence by a third could save the NHS working days equivalent to 14,900 whole-time equivalent staff.

Key features of driver: There is a separate Appendix with 50 case studies of NHS trusts sharing examples of best practice.

Primary audience: Department of Health, SHAs, NHS Trusts.

Impact on library policy/practice: Libraries could support the health and wellbeing of staff in a number of ways. These might include:

• Leisure reading collections
• Book clubs
• Displays related to health awareness weeks
• Poetry competitions
• Involvement in Health and Wellbeing events for staff, such as a stall at roadshows
• Development of collections of books or leaflets to support healthy living

One specific example is South Devon Healthcare NHS Foundation Trust, whose library service ran Mood Boosting events to support Trust’s staff health and wellbeing.

Date last updated: November 2013

Due for review: November 2014

Group member responsible: JC

Supporting health and well-being at work (University Hospital of South Manchester NHS Foundation Trust)

Title of project : Library Services supporting health and wellbeing at work Project

Team Project Lead: Library Manager (1wte)
Project team: Library Team (2.71wte)

Resources Required : Staff time for e.g. selection, acquisition, and processing of resources, trust meetings, marketing, and promotion. (estimate one day per month) Funding via external and/or internal bidding processes Occupational Health Department – recommendations resources, fitness DVDs etc

Timeframe : April 2011 – March 2012 initially but expect it to be ongoing

Description of product/service:

• Build a collection of books and DVDs to support the wellbeing of hospital staff and students
• Broaden collection e.g. Wii Fitness loan (through trust Health & Wellbeing Group)
• Refurbish a section of the library to be a relaxed environment for people to sit in away
• from their workplace e.g. “comfort zone” or “library breakout” etc.

Alignment to local, regional and national drivers:

• Trust Health & Wellbeing strategy
• Healthy lives, healthy people: our strategy for public health in England – provision of reading for leisure supports the health of staff
• Investors in People – health and well-being is a large component of the IiP gold standard for which this trust is required to provide evidence by March 2012
• London Olympics – the trust is involved in bringing the Olympics to the Wythenshawe community – fitness DVDs and books and the trust “Fit for Life” initiative support this
• Working for a healthier tomorrow – Dame Carol Black’s Review of the health of Britain’s working age population

Intended outcome for customer / organisation / library :

• increase library usage
• improve the health of workers through reading for leisure
• improve the health of workers through loan of health books aimed at non-clinicians create an environment conducive to relaxation away from the work place
• library service to be an essential player within the trust health and wellbeing strategy

Next steps :

• Utilise bid opportunities and investigate trust lottery funding – ongoing
• Continue to engage with the designers regarding refurbishment of the “breakout” room
• Organise additional library space for the collections
• Add to marketing plan
• Train staff on new policies and procedures relating to the collection
• Measure library usage increase, reflect on loan of Wii Fitness and DVDs

Aim is to implemented above by March 2012