In its third interim report in the investigation of issues around patient handover to emergency care, the HSIB (Healthcare Safety Investigation Branch) has found strong links between patient safety and staff wellbeing.
The investigation heard that whilst staff are doing their best to ensure safe care, harm is happening, which is affecting patient outcomes and staff wellbeing.
The HSIB investigation team spoke to staff working across the urgent and emergency care system, including emergency departments, NHS 111 call handling centres and ambulance services. They recorded “significant distress” from staff who had been unable to help the sickest of people and the impact that had on their personal health and wellbeing. Often, the issues staff have experienced in their working environment extend into their private lives as well.
The investigation also examined the support that is offered by NHS organisations to their staff, finding that often such support is only prioritised when there is time, and that the approach to staff wellbeing is reactive, relying on staff seeking help.
Currently, the NHS England People Plan focuses on staff wellbeing whilst the Patient Safety Strategy focuses on patient safety and the two are not interlinked. HSIB recommends that NHS England should include staff health and wellbeing as a critical part of patient safety in the NHS Patient Safety Strategy. It also suggests that it may be beneficial for NHS organisations to provide time and safe spaces for staff to engage in reflective practice, to talk about the emotional impact of their work with support from specialists with expertise in staff wellbeing.
NHS Providers Chief Executive, Sir Julian Hartley comments on the findings, saying: “At the heart of this problem lie systemic issues including high demand, low capacity, delayed discharges and vast workforce shortages. This feeds into a deeply challenging work environment right across the system, which leaves staff feeling they can't provide the care they want to – leading to a sense of moral injury, further exacerbating a difficult situation.
"Trust leaders are working extremely hard to recover urgent and emergency care services, but this can't be done overnight and not without action on a national level. Growing capacity and investing in mental health support for staff is a key short-term solution.
"On top of that, the NHS' long-term workforce plan, which needs to be funded by the government, should go a long way to shore up vital resources. We also hope the decision to withdraw national funding for NHS staff wellbeing hubs is reversed, as they provide invaluable mental health support."
