Last reviewed 28 October 2021

In this feature, Healthcare Consultant, Thoreya Swage, prompts the conversation of health and wellbeing in primary care and how to prioritise it.

Looking after the health and wellbeing of NHS staff has always been a challenge when set against balancing the needs of patients and primary care services. This was brought to the forefront due to the Covid-19 pandemic, with staff now reporting that they are exhausted due to the heavy demand from patients expecting normal service to have resumed.

So, what can be done to provide some resilience to staff from the constant demand that we know will continue throughout this winter and possibly beyond?

In response to the pandemic, numerous national health and wellbeing (HWB) initiatives have been developed for NHS staff from national bodies, regionally and within individual organisations. Many tools, apps, articles and short videos have been produced from sources. However, a closer examination reveals that what staff actually need are the basics and recognition that they are valued in the work that they do.

The factors that make people vulnerable to stress include:

  • over working

  • unclear or conflicting expectations

  • threat or change to job role

  • challenging working environments, including remote working

  • being isolated socially

  • lack of personal control

  • working in a hostile, unethical environment or one with a defensive atmosphere

  • lack of communication

  • TV and social media where there are mixed or conflicting messages

  • societal concerns and anxieties.

A key element to understanding health and wellbeing is the “stress arc”.

It is recognised that a certain amount of challenge is required to enhance an individual’s performance until the peak is achieved. However, when the pressure starts to cause stress in individuals, performance deteriorates eventually, leading to burnout.

Having wellbeing conversations can benefit in managing this. An essential part is to identify some time out with the team or one-to-one and start a discussion asking the following.

Your health and wellbeing — where are you?

  • Where in the stress arc are you at the moment?

  • What could you do to reduce this stress? Consider time out for a break, drink, eat and take part in some physical activity.

  • What does the team culture feel like? It is important to be honest and share this with others.

  • What could you and the team do to keep going to avoid getting into the “red zone”? Consider small steps, eg find somewhere for “downtime” where there will be no disturbance and respect when people are taking a break.

Your role — how is work going?

  • Is there anything you have done that you are proud of recently?

  • Is there anything that the team has achieved?

  • Is there anything that you have learned or improved on?

  • Is there anything that you have found challenging?

  • Is there any support from your colleagues or manager? For example, returning to work after remote working.

The final part of the process is to listen and take on board the issues raised, and for the team to work together to come up with workable solutions. Successive NHS staff surveys have shown that teams that have common objectives and work collaboratively to deliver those, and reflect regularly on how they can have lower levels of error, stress and injury, demonstrate better resilience. Each member has a part to play in identifying the issues and suggesting solutions.

The main outcome from this approach is to reassure individuals that they are not alone and working with the team builds up confidence and improves the work environment.

To complete the health and wellbeing support, information about other resources should be made available to staff, such as a welfare leaflet or poster with information on wellbeing apps, access to counselling and other online support from, for example NHS People.