Burnout is a state of physical and emotional exhaustion. It can occur when you experience long-term stress in your job, or when you have worked in a physically or emotionally draining role for a long time.
The NHS Staff Survey 2021 results indicate that NHS staff are experiencing high levels of burnout. Research by The King's Fund shows that NHS staff are 50 per cent more likely to experience chronic stress, a known contributor to burnout. Factors such as staff shortages, high workload, and pressures to maintain high quality patient care all contribute to burnout in NHS staff. According to the British Medical Journal (BMJ), burnout significantly impacts the retention of our highly valued NHS workforce, with more staff thinking about leaving the NHS.
Although burnout is a long-standing issue, the pandemic has placed further burden on NHS staff and exacerbated the problem. Whilst there may be factors beyond control, such as increasing demands on the service, employers must act quickly and effectively to tackle burnout by facilitating a supportive, compassionate, and positive experience that prioritises the experience and wellbeing of our staff.
This guidance intends to support leaders in the NHS, including health and wellbeing leads and managers, who all play an important role in beating staff burnout.
What is the impact of burnout?
- Employee wellbeing - Burnout can negatively impact both mental and physical health, and often results in presenteeism and absenteeism. Organisations have a moral and legal obligation to look after the wellbeing of their staff.
- Financial cost to the organisation - The cost of absenteeism and presenteeism can be detrimental to organisations. Although we are slowly moving out of the height of the pandemic, the long-term negative effects of issues such as long COVID and patient waiting-list backlogs are likely to remain.
- Patient care - How staff are feeling can impact on the quality of care provided to patients. Staff who have constant exposure to traumatic events associated with caring responsibilities, can often experience compassion fatigue.
Top tips for NHS organisations
We have outlined several practical tips that can help you support your staff:
- Ensure optimum staffing levels where possible.
- Shift towards a culture of prevention and early intervention.
- Overcome the stigma of mental health conversations at work.
- Recognise pressures of maintaining a ‘hero identity’.
- Upskill staff to understand burnout symptoms.
- Upskill managers to support staff effectively.
- Encourage compassionate leadership.
- Build organisational resilience.
Beating burnout in practice
Optimum staffing levels
Rising sickness absence levels, poor retention, and unsuccessful recruitment campaigns have been major contributors to staff shortages. Whilst there are often financial and practical barriers to achieving optimum staffing levels, employers can work to boost retention, strengthen recruitment efforts, and support those staff off work to return to the workplace. See some resources below to help you:
- The improving staff retention guide for line managers and employers in the NHS.
- Our sickness absence toolkit details how you can support your staff and help them return to work.
- The NHS Staff Council’s guidance on the management of long COVID sickness absences.
- The inspire, recruit and attract toolkit provides resources and guidance to support your workforce supply.
- Our case study on how Wye Valley NHS Trust filled some of their ‘hard to fill’ vacancies through upscaling and improving their international recruitment campaign
A supportive organisational culture
Mental Health UK outlines the strong relationship between burnout and poor mental health. It is therefore crucial to create a healthy and supportive working environment, where mental health conversations are encouraged and not stigmatised. Read more about how you can raise awareness of mental ill health, upskill your managers and put supportive initiatives in place on our mental health in the workplace web page. In addition, organisations can:
- ensure your managers hold regular and ongoing wellbeing conversations with their staff, and staff are enabled to seek support when needed. Read our guidance on embedding effective health and wellbeing conversations
- encourage senior leaders to share honest personal experiences to inspire others to do the same and get help. This can reinforce that NHS staff should not feel under pressure to constantly maintain a ‘hero-identity’. Listen to our podcast with Deborah Lee on mental health: leading the way and tackling the stigma
- create safe spaces for discussion, where staff can openly share views and experiences. Use these conversations to better understand the problems staff are facing, and to shape local health and wellbeing initiatives
- ensure your initiatives are inclusive. Provide alternative routes for staff to share thoughts if they are not comfortable with open discussions.
In this five-minute case study watch how Well_Lab worked with the Barts Health NHS Trust’s non-emergency patient transport team which demonstrates how you can quickly experiment solutions in your workplace. You can also use Well_Lab’s burnout calculator to see how much it's costing your organisation.
Well_Lab also presented at our staff experience conference on Tuesday 6 December and shared their latest research and evidence-based recommendations, they also who provided insights into how trusts can practically address the impact of workplace burnout in the NHS. Read their slides for more information.
Focus on prevention
Most members of staff will have some element of mental health needs. They will therefore require some form of mental health interventions regularly to help prevent burnout. Ensure you:
- challenge perceptions of ‘wellbeing hubs’ so it is no longer a place to go only when struggling with mental health, but a space to help maintain good mental health
- embed preventative wellbeing initiatives into all aspects of the employee lifecycle. You could start as early as your induction programme and continue to hold regular mandatory mental health maintenance sessions
- prioritise meeting basic staff needs. This includes ensuring staff can get adequate rest and good quality food when on shift. Read how Sherwood Forest Hospital Foundation Trust effectively coordinated and agreed staff break times at the start of their shifts to ensure they were taken.
- download our NHS staff wellbeing needs poster and read the supporting the wellbeing needs of NHS staff article to see how you can make great health and wellbeing a lived reality
- promote wellbeing and the importance of self-care through highly visible senior role models. This will help a culture of wellbeing filter down to the rest of the organisation
- make your health and wellbeing offer and useful resources relevant, accessible and that they are regularly promoted through various channels. Read how you can implement health and wellbeing champions into your organisation to support you with this.
Ensure early recognition and intervention
Recognising burnout symptoms and providing the right support early on can help prevent problems from escalating, and reduce the chances of staff absences. Research by Maslach & Leiter identified energy depletion, reduced efficiency and depersonalisation or cynicism as key symptoms. Organisations should:
- train managers and staff to spot symptoms of burnout, and signpost to appropriate interventions. Embed burnout into wellbeing conversations, encouraging a compassionate and personalised approach as there is no one-size-fits-all solution
- consider a rapid access service for staff to access therapies and counselling to address symptoms of burnout early
- ensure your interventions target a range of symptoms, as staff may be affected from burnout in different ways. For example, initiatives that moderate workload demands can help address energy depletion. However, interventions that target workplace civility through ensuring staff are treated with dignity and respect are more effective in decreasing cynicism.
Encourage a supportive and compassionate culture
Embedding compassion and support into organisational culture enables staff to seek help when they need it. Organisations should:
- ensure leaders and managers seek to understand the challenges that staff face through continuous dialogue and ensure that staff wellbeing is a priority in all aspects of organisational strategy. Read our guidance on how wellbeing guardians can help influence your leaders at board level to implement a culture of wellbeing.
- ensure staff have access to the right equipment, training and development to ensure they feel able to do their jobs to the best of their abilities. Listen to Michael West’s blog on recovery and renewal and how to implement compassionate and inclusive leadership.
- support your teams by working closely with them to harmonise working relationships. Identify and resolve barriers to effective communication and collaboration. Follow up with team building exercises to strengthen relationships, this helps optimise ways of working and builds psychological safety amongst team members.
Effective leadership and management
Encourage compassionate leadership
Compassionate leadership helps staff feel supported, understood, and able to perform their job effectively. Encourage leaders to model positive behaviours and promote their visibility and accessibility to staff so everyone’s voices can be heard.
Upskill managers to offer the right support
Workplace and external pressures can both contribute to burnout. Upskill your managers to have effective wellbeing conversations with their teams and provide the right support for any pressures staff may experience. These can include:
- the rise in of cost of living. Read how you can support the financial health of your staff on our in-work poverty hub
- caring responsibilities outside the workplace. They could be caring for disabled, elderly, and children. Flexible working opportunities can ease this pressure and allow staff the time to care for loved ones, increase productivity and reduce the chances of compassion fatigue. Read more about how you can implement flexible and agile working practices into your organisation in our flexible working - enablers for change web page
- physical or mental ill health. Signposting staff to the right support in a timely fashion can help prevent these issues from getting worse or hindering recovery.
- Burnout in healthcare: the case for organisational change
Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis.