Lack of access to basic wellbeing needs such as hydration and sleep have been identified as a major concern for NHS staff wellbeing and patient safety. In the 2022 NHS Staff Survey, over 21 per cent of respondents indicated that they often or always felt that every working hour is tiring for them. It is therefore vital we address basic staff needs, such as sufficient breaks, as priority.
Inspired by Maslow’s hierarchy of needs, this NHS staff wellbeing needs poster demonstrates that basic needs are critical and the foundation for fulfilling the overall health and wellbeing agenda. Together with our poster, this guidance is for NHS health and wellbeing leads, staff experience leads and line managers to support them in ensuring that our staff are safe and healthy at work and can deliver safe and high-quality patient care as part of the ‘looking after our people’ theme in the NHS People Promise.
As we know, there is no one size fits all approach when it comes to supporting the wellbeing of your staff and NHS organisations may be at different points of their health and wellbeing journey. We also appreciate there are often a number of barriers to fulfilling your staff needs, this guidance highlights some ways to overcome them.
As well as the organisation, individuals have a personal responsibility towards looking after their own wellbeing. Collectively, organisations should work closely with their people to ensure the workplace environment fulfils all needs.
Top tips for health and wellbeing / staff experience leads
Identify how your current wellbeing offer meets your staff needs
- Use our NHS staff wellbeing needs poster to help you identify the wellbeing needs you do well or need to improve. Collaborate with your wider multidisciplinary team to make improvements, this could include engagement with infection prevention control, HR, occupational health, estates and facilities. Certain wellbeing needs are dependent on others, so building a holistic picture of your current wellbeing measures can help you identify gaps in meeting staff needs. For example, ensuring toilet facilities are functional and hygienic should ideally be coupled with ensuring staff get enough breaks to use them.
- Assess whether you have safe and secure on-call facilities to allow staff to sleep, change and store their belongings such as the sleep pods that Lancashire Teaching Hospitals NHS Foundation Trust installed. Sleep expert Michael Farquhar welcomes the investment and offers recommendations in his blog. You can also read more on this topic on our sleep, fatigue and the workplace web page.
- Involve your staff. Listen to employee feedback on what they feel their most important needs are. A consultative approach can positively impact on engagement and help overall staff experience. Ensure that if you ask for feedback, you follow up on outcomes and show you have implemented suggestions where possible. You should use the data from your local and national annual NHS Staff Survey and People Pulse to gain insight into how staff are feeling and identify key issues for them.
Formulate a plan to bridge gaps in staff needs
- Use your evidence/data to formulate an action plan to meet basic needs as a priority. Our eight elements of workplace wellbeing resource outlines important considerations and can help you shape your strategy.
- Think about how your might address resistance to culture change. The Do OD TEAM toolkit includes information on how you can influence team cultures and leadership styles in your organisation.
- Where possible create a sustainable plan. Consider how staff needs may change in the future and how you would approach this. Circumstances are often unpredictable but forecasting and planning can often help you to be proactive when supporting staff.
Get your board on board
- Get your board on board with a wellbeing agenda that prioritises basic staff needs using our guide. Demonstrate to your board how gaps in meeting the basic wellbeing needs are barriers to achieving the overall organisational strategic goals, and impact negatively on patient care. You could use statistics from our back to basics infographic to support you.
- You may also influence your senior leaders through your wellbeing guardian, who sits on the board to ensure that the health and wellbeing of your staff is considered in all decisions that board members make. You could approach your HR director to ensure your agenda is promoted on the board if you do not have a health and wellbeing guardian.
Implement your plan and engage your staff
- Provide dedicated spaces separate from patients to enable staff to properly rest and recharge throughout their working day. This is vital for physical and mental wellbeing as well as preventing errors and mistakes. Read how Shrewsbury and Telford Hospital NHS Foundation Trust revamped its staff room to be a space for NHS staff to relax and re-energise.
- Develop infrastructure and facilities to promote active lifestyles and help staff improve their fitness and physical wellbeing, for example, exercise facilities, secure spaces for showering and changing, and cycle parking.
- Take a holistic view to staff experience of the working environment by linking in with colleagues from the safety team.
- Ensure staff have access to safe and secure parking. Milton Keynes University Hospital NHS Foundation Trust set up working groups to determine how it could offer this as a benefit to staff.
- Upskill your managers. They play an important part in enabling staff to engage in initiatives and focus on their personal wellbeing. Read Michael West’s blog on recovery and renewal to learn how compassionate and inclusive leadership can be used to support staff wellbeing and your organisation's recovery from the impact of the pandemic.
- Engage senior leaders in your wellbeing initiatives for top-down influence and encourage a positive culture change. Read our top tips on staff engagement for inspiration.
- Work with your learning and development team to roll out an effective educational programme for managers and employees based on the training needs identified. Read our health and wellbeing top tips for supporting managers web page.
Evaluate the impact
- To understand what is working well and areas where you may need to change your approach, it is important to evaluate the impact of your interventions where you can. It can help you allocate budget towards interventions that are resonating well with your staff and having the most significant positive impact. Use our evaluation guidance to help you.
Top tips for line managers
- Encourage and allow your staff to access and implement their basic needs, such as taking sufficient breaks and staying hydrated. Build this in as part of someone’s shift, so staff are more likely to take their break instead of trying to squeeze this in.
- Empower staff to speak openly about their needs through a transformational leadership approach, which aims to embed honest conversations into organisational culture. Read the Leadership Framework and Team Development toolkit by the NHS Leadership Academy for more information on implementing effective leadership styles.
- Encourage your staff to use our poster and health and wellbeing conversations.
- Personalise your approach to individual staff circumstances.
How organisations can fulfil higher level needs
- Gain buy-in from your board and senior leaders to support fulfilling higher level staff needs.
- Ensure you are meeting all basic staff needs first and these are sustainable within your team/department and organisation.
- Encourage a compassionate and inclusive leadership culture where contributions are appreciated. Read more about the importance of this leadership style and how you can achieve it in our blog by Michael West, senior fellow at The King’s Fund.
- Actively support the personal development of your staff so they are able to work towards achieving their full potential.
- Ensure a sense of belonging to a particular team/organisation through minimizing the number of staff transfers to different wards where possible.
Sherwood Forest Hospitals NHS Foundation Trust introduced a rest, rehydrate, refuel project to understand any barriers to employees accessing sufficient hydration, breaks and refreshment facilities and how they could resolve them. After evaluating a staff survey, interventions such as setting break times as a team at the start of shifts, increasing restaurant food choices and opening hours, and increasing the number of ‘rest areas’ were implemented and well received by staff.
Read how Gloucestershire NHS Health and Care NHS Foundation Trust use a locally designed survey to get a more regular snapshot of their staff’s views.
Birmingham Women’s and Children’s Foundation Trust encouraged their people to put their needs first by giving nurses the confidence to ask for flexible working opportunities for any reason.
North Cumbria Integrated Care NHS Foundation Trust has replaced its annual appraisal with quarterly discussions between managers and staff, covering a range of topics including wellbeing, learning and development and performance. For each quarterly discussion, managers are given prompts to discuss elements of wellbeing with their staff members. For example, a discussion about factors which have a positive or negative impact on their wellbeing and identify things that would improve their wellbeing.
North Bristol NHS Trust made a bold statement to their colleagues that ‘your health is as important as our patients.’ The organisation created a comprehensive wellbeing programme and ensured they listened to their staff when formulating this. They adapted their approach to influence ‘hard to reach’ groups such as junior doctors to engage in self-care and interact with newly introduced wellbeing champions. Within a year, they saw a reduction in staff sickness by 3,923 days saving the organisation £301,015 a year in sickness costs.
South Central Ambulance Service (SCAS) Since implementing a wellbeing guardian, SCAS has said that the visibility of health and wellbeing has increased on the agenda at board level, they have found that there has been more opportunity to share good practice and greater discussions about of health and wellbeing within the trust have taken place, for example, showing leadership on webinars such as 'What's Normal Anyway?' and 'Time to Talk Day'. Read more about how you can use wellbeing guardians.
When the pandemic began, Hertfordshire Partnership NHS Foundation Trust acted quickly to ensure basic needs relating to working remotely were put in place. The trust:
- provided staff with appropriate equipment to fulfil their job roles
- ensured IT support and guidance were available
- enabled managers to lead their teams remotely
- supported staff with cultural changes and challenges.
Read about how The Isle of Wight NHS Trust became one of the NHS Staff Survey’s most improved trusts, and how the NHS England and NHS Improvement Culture and Leadership Programme supported putting compassionate leadership at the heart of change. You can also listen to our Dear Matilda: how great leadership turned around a trust podcast on how great leadership at the Isle of Wight NHS Trust transformed the organisation.
Learn how Sheffield Teaching Hospitals engaged with and supported carers in the workplace which resulted in their staff reporting they felt better supported by the organisation and feel less isolated.
West London NHS Trust reviewed its exit interview data in collaboration with Great with Talent and developed a new initiative they called ‘promotion, praise and promise’ which won a Healthcare People Management Award.
Blackpool Teaching Hospitals increased its staff communications during the initial phases of COVID-19 to include floor walks by senior clinical leaders, weekly engagement activity updates, and launched a new app with a dedicated wellbeing section and facility for staff to book their annual leave. They also installed a gratitude rainbow with messages from patients and staff. These initiatives lifted staff morale and engagement.
Wrightington, Wigan and Leigh NHS Foundation Trust introduced wellbeing champions into their organisation in 2019 as a part of their quality improvement project. The trust now has around 150 wellbeing champions in post as well as six wellbeing leads.
The trust follows the following procedure to recruit for wellbeing champions:
- they are sent an application form (manager approval is required) and role descriptor
- once that is returned, they are then asked to complete E-learning packages on: three step process in having supportive conversations and mental health responder, each one takes around 40 minutes
- on completion of the training, they then schedule an induction with the wellbeing lead, this is an opportunity to give clarity and expectations, and share what other champions within the network are doing.
The trust also offers a six-hour diffuser training they can access if they wish. This was put together by the company who trained the staff in crisis management.
Read about how Northumbria Healthcare NHS Foundation Trust were awarded the Freedom to Speak Up Organisation of the Year Award at the 2021 HSJ Awards for its demonstration of an integrated approach to speaking up.
The links and information below provide further information to help you support the wellbeing needs for yourself and your colleagues:
- The COVID-19 Clinician Cohort (CoCCo) study: Empirically Grounded Recommendations for Forward-Facing Psychological Care of Frontline Doctors. Aimed to develop empirically grounded recommendations and a model of psychological care taken from the experiences and psychological care needs of COVID-19 frontline doctors.
- CoCCo study - towards a model of psychological care in frontline doctors. The study above is supported by this animation that highlights the key programme of research into mental health of frontline doctors and a model of psychological care, both in response to the pandemic and beyond.
- Welfare facilities for healthcare staff: Read the guidance from the NHS Staff Council’s Health, Safety and Wellbeing Partnership Group (HSWPG). It was developed to support NHS organisations to improve their provision of staff welfare facilities.
- NHS England's national standards for healthcare food and drink: These standards describe the methods by which organisations must ensure the quality and sustainability of their food and drink provision for patients, staff and visitors, and how they should be applied and monitored, as well as recommending future improvement aspirations and actions.
- NHS England - Better hospital food on the menu blog.