The mental health of our health service (NHS) staff is at breaking point and it is time that leaders, decision makers, policy writers, and those tasked with strategy implementation started to pay attention to that.
The latest statistics from NHS Digital reveal a worrying trend of staff citing poor mental health as a reason for taking sick leave, with managers most likely to mention stress, anxiety, and depression as their reason for absence.
If the NHS, which is the third largest Healthcare employer in the world, is losing 348,028 working days due to anxiety, stress and depression in just one month, it’s clear that something isn’t working. These numbers are much higher than for employees in other sectors and yet we all rely on NHS staff being well enough to come to work to care for us, our families and friends in a service provision that spans 24/7, 365 days a year.
Unfortunately this data highlights that while the NHS maybe taking the right steps, and making great strides in some areas, it is not quite making good on its commitment to embedding the core and enhanced mental health standards outlined in the 2017 government-commissioned “Thriving at Work” report. There was widespread support at the time of publication, but perhaps for all the vocal enthusiasm that has been displayed, very little progress has been made by way of implementation of actions being made to improving the NHS staff wellbeing.
As we continue without such changes, staff mental health continues to suffer. This is a large and complex workforce, so we do need to understand that such important change and improvements will not occur over night, and embrace the fact that there are efforts towards broad improvement being made, through the development of the NHS Workforce Health and Wellbeing Framework, but what needs to happen is a swift and clear understanding of what progress is being made.
The NHS is attempting to demonstrate its commitment to the mental wellbeing of its staff in 2019 through the Pearson Report but who is tasked with embedding the recommended changes, how are staff being engaged and open dialogue being encouraged, to ensure that the right level of changes with desired impact actually occur? Where is the approach of leaders and managers demonstrating that workforce wellbeing is a priority?
The mental health of the NHS staff, is of paramount important, and needs to be as high a priority as the delivery of care for patients who have mental health, because it can be the difference between a patient receiving good care or poor care, it can impact decisions being made, clinical judgement, diagnosis, and onwards pathways of care, which in essence what I describe is medio-legal risks. Which may highlight to us that more staff are suffering from mental health, than what we have come to know, perhaps many staff ignore this, work in denial of this, perhaps they fear for their job, their career, their loss of funds, their loss of registration, their loss of standing in society.
The role of managers is crucial, because we know there are often extra barriers for healthcare staff when disclosing mental health problems, such as fears about being deemed unfit to practice or feeling like they must be immune to ill health. Do we know whether our NHS managers and leaders are mentally well enough themselves to create the right environment?
Having observed a manager for years who has a history of depression, this really impacted the managers ability to manage people day to day, and perhaps it didn’t help that this manager is what one can only define as an “accidental manager” placed into that position by an NHS Employer (clinician) because of loyalty and being a good administrator, not necessarily because they possessed the desired skills required of a manager.
I reflect with great sympathy for this manager, in that no consideration was made to the fact that the manager did not have the level of emotional intelligence to manage people, the level of maturity required to lead and take responsibility, or accept upwards critique, this was a manager who would take everything very personal, and in response hold grudges with people who had to report to this manager directly, and over time presented as very unstable and unhappy in the workplace.
The NHS employer (clinician) who placed this vulnerable person into a role beyond capacity or capability, always responded with “let’s go for a drink” have a social, have a jolly, this was probably the last thing this manager needed, was to become intoxicated.
Perhaps a clinician of all people would know that alcohol is not a good medicine for someone with mental health problems. The realisation was this manager was not offered the right level of support by the NHS employer, by way of counselling, or coaching, and continued to have stress and anxiety at work, and was medicating for this.
While other parts of the health service might be able to use technological developments and advanced equipment to complement staff efforts, mental health services are entirely reliant on employees who are motivated and well-trained enough to meet people’s needs, sometime community mental health nursing teams, are working in volatile, isolated environments, which require a different level of skills to working within the safety net of a primary care setting.
The time to pay attention to this is now, when it is evidenced and we understand there is increasing pressure on the health service and the provisions and people within, particularly in the area of mental health where demand continues to grow, and the age of those being effected is getting younger.
In order to get these figures down, all NHS employers must put in place preventative measures to keep staff well at work, not just support them when they need to take time off. Having the right workforce, with the right skills, in the right place is central to achieving the NHS long-term plan’s ambition to improve services and take a more joined up approach to healthcare. To do this, staff need to feel supported by their employer, and need to feel that their own health needs are as equally as important as that of the patients they serve.
This means promoting staff wellbeing, tackling the work-related causes of mental health problems and offering support to employees who are struggling with their mental health. All NHS staff are vital and can make a real difference to the experiences of people accessing the service, and can make a long and lasting impact on someone’s life and their lifestyle choices, thus helping them to manage their long term conditions, reduce the occurrences of short term conditions, and to live a more healthier longer life, all of which can not be done so at the detriment of the health of those delivering the care.
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