Making the case for staff wellbeing in the NHS

In 2015, NHS England announced a plan to invest £5 million in improving staff health and wellbeing, an initiative that was warmly welcomed as an important step towards understanding employee wellbeing and recognising people as their most important organisational asset.

The NHS is the UK’s largest employer with 1.38 million employees. Whilst people who work in health care are valued highly by the general public, health service workers are more stressed and unhappy than the general workforce. The reasons for this are not entirely clear, but are usually attributed to the complexity of the working environment, combined with the fact that many work processes in health care have not been purposefully designed, but have evolved over time.

The nature of the work itself – which involves dealing with physically and emotionally challenging tasks, and providing care in increasingly financially stretched environments to people at their most vulnerable – also takes a significant emotional toll. Dealing with patients and their loved ones, witnessing suffering, pain, grief and dying, is part of the daily routine for many people working in the NHS.

The need to take a better approach to the wellbeing of NHS staff was evident in the 2015 staff survey in England, where only 50% of staff were happy with flexible working opportunities and 37% of staff reported feeling unwell due to work related stress and pressure. Additionally 63% of staff reported coming to work despite feeling unable to carry out their duties or the requirements of their role.

Unsurprisingly, the relationship between the wellbeing of staff and patients’ wellbeing is strong, with people reporting that how they feel affects patient care. The Boorman review found that 80% of people working in the NHS in England felt that their health and wellbeing had an impact on patient care, but only 40% of staff felt their employer was proactively trying to improve their health and wellbeing. In the 2015 staff survey only 29% of NHS employees felt there were enough staff enabling them to conduct their role properly, with unplanned work steadily increasing.

There are financial consequences too. Sickness absence is estimated by Public Health England to cost the NHS in England a total of £2.4bn a year, equating to £1 in every £40 of total budget, and when agency worker costs are added the actual figures will be significantly higher.

Recognising the importance of NHS workforce wellbeing, the Health Foundation has commissioned The Work Foundation, The Point of Care Foundation and RAND Europe to explore the links between staff wellbeing, care quality and productivity. This will be a collaborative piece of work that aims to build the business case for the issues of staff engagement and wellbeing.

In the light of a changing external environment, we will revisit the analytic models used in the Boorman review, updating it and getting closer to understanding the current problems with how engaged people are. The work aligns with the intention of the NHS Five Year Forward View, to support the NHS in England to become a better employer, nurturing staff and developing employee engagement to move towards improved patient outcomes.

We will explore the mechanisms linking staff wellbeing with improved outcomes (economic, physical health, mental health and social) and will assess the strength of the business case for investing time, money and other resources into staff wellbeing and engagement initiatives. We will also consider the current level of employee engagement and wellbeing across the NHS, drawing comparisons and learning from other sectors and will draw on working examples of good practice. We want to create practical advice, supported by evidence, demonstrating what the NHS can do to improve staff wellbeing and present a business case to underline the beneficial outcomes of these strategies.

For further information, please contact Project Manager Karen Steadman at The Work Foundation.

Rhiannon Barker (@barkingMc) is Head of Business Development at the Point of Care Foundation