I spend a lot of my time talking to clinicians, managers, commissioners, those outside of healthcare and leaders about the importance of promoting and supporting Staff wellbeing within the #NHS workplace. Some are already on board with the reality that excellence in healthcare simply cannot happen in the absence of a workforce that is cared for and nurtured to thrive. Others feel discomfort at the thought of caring for staff when the ‘patient comes first’ and some simply don’t know what to do for the best. In any case, nobody seems to want to destroy the NHS workforce (correct me if I am wrong)!… and everyone seems to want to learn more.
A good staff experience where staff feel ‘engaged’ is critical to achieving excellence in healthcare…What do we mean by ‘Staff Engagement’?
‘Institute for Employment Studies (IES), defined staff engagement as a positive attitude held by the employee towards the organisation and its values. An engaged employee is aware of business context and works with colleagues to improve performance within the job for the benefit of the organisation. The organisation must work to develop and nurture engagement which requires a two-way relationship between employer and employee (Robinson et al 2004, p 4).’
Recently, I was asked to provide some evidence as to why the wellbeing of NHS staff matters by someone else who was keen to make a difference in this area. They needed to make the case to others in order to make change happen. I imagine that lots of other change makers will be needing to provide evidence too, and so I have set out some arguments for the case below. I hope many of you will find it useful to have some of the arguments in one place.
Please feel free to share this evidence widely with others…. If you have other evidence to add to this, please feel free to comment below…
(There can never be too much to share)!
Financial reasons to care for NHS staff:
Over 2014/2015, the NHS Litigation authority (NHSLA) paid over £1.1 billion to patients who suffered harm and their legal representatives, this coming year it will be c £1.4 billion and with accumulated provisions in our balance sheet of over £28 billion further significant increases are already in the pipeline. When staff are unwell, in psychological distress, communication is hampered by poor working cultures and there is a lack of staff engagement, NHS staff are more likely to make medical errors (Hall et al, 2016).
Good staff health, wellbeing & engagement = reduced medical errors = reduced litigation costs
Estimates suggest that recruiting a nurse from overseas costs between £2,000 and £12,000 and return-to-practice costs some £2,000 per nurse, while training a new nurse costs around £79,000. Additionally, recruitment costs to replace staff who leave owing to work-related stress and/or poor job satisfaction is estimated to be £4500 (More for senior posts). As such, in order to get best value for money, the NHS will need to work hard to retain and recruit a high quality workforce.
Good staff health, wellbeing & engagement
= Increased recruitment and retention = Best value for money
Staff sickness absence rates cost an estimated £3.3million annually per NHS organisation. When staff are absent, there is the added cost of agency staff to fill in gaps (The NHS Improvement team now expect the NHS to spend a total of £3.7 billion on agency staff by the end of the 2015/16 financial year).The Francis inquiry into Mid Staffordshire also exposed the consequences for patients and staff of not addressing this issue of staff morale and sickness. Typically, if an NHS organisation reduced staff sickness rates by a third,it would provide an additional 3.4 million working days a year for NHS staff, equivalent to 14,900 full-time staff, saving an estimated £555 million.
Good staff health, wellbeing & engagement = Decrease in sickness absence = reduced agency/sickness spend & therefore, improved patient care
(Image source :http://www.slicedbread.co.uk/solutions/employee-engagement/)
Practical reasons to care for NHS staff:
Ultimately and practically, the NHS exists to provide high quality and safe care to patients. Evidence so far shows that better staff health and wellbeing is associated with improved patient outcomes.
Some of the many benefits to improved NHS wellbeing is that better staff health results in lower infection rates and lower standardised mortality figures. The Keogh review of 14 hospital trusts with high patient mortality rates found all these trusts also had higher levels of staff sickness, compared to national average.
Good staff health, wellbeing & engagement = Safer and higher quality patient care
When an NHS organisation invests in staff health, wellbeing and engagement, they improve their ‘Brand’. Branding is one of the most important aspects of any business, large or small, and its impact shouldn’t be underestimated when it comes to engaging staff with health and wellbeing initiatives.
Good staff health, wellbeing & engagement = Your NHS organisation looks good & therefore attracts more staff
A report from the Kingsfund suggests that job satisfaction, organisational commitment, turnover intentions, and physical and mental wellbeing of employees are predictors of key organisational outcomes such as effectiveness, productivity and innovation. Everyone wants more of these things..right? They all have the potential to save money and improve the safety and quality of care.
Good staff health, wellbeing & engagement = Higher productivity, staff effectiveness and innovation = Cash savings and better services
Moral reasons to care for NHS staff:
Staff are entitled to a psychologically and physically safe professional journey. Caring for them is not an optional issue, it is an ethical one.
When staff are well cared for, they experience greater job satisfaction, improved morale and general wellbeing. Few aspire to be ill, and many feel great shame in letting others down or asking for help.
Where the emotionality of distressing work remains unrecognised and void of support, distorted thinking, emotional distress, reduced productivity, increased sickness rates, poor decision making, and maladaptive patterns of behaviour may present. Physical symptoms can also result, where severe job stress evokes irregular menstrual bleeding patterns for female healthcare workers, poor sleep quality and bodily exhaustion.
The NHS workforce is one of the largest work forces in the world. They are patients, they are the public, as are their friends and families. As such, by caring for this group, we are also caring for a large part of society. Moreover, there is also a strong statistical link between the wellbeing of staff and patient satisfaction. This means that if we are failing to care for staff, we are also missing an opportunity to improve patient satisfaction.
Good staff health, wellbeing & engagement = A nice and decent thing to do for all.
There are many more reasons for NHS organisations to care about the the health, wellbeing & engagement of their staff..Financially, practically & morally speaking… Please feel free to add these below.
I hope that these few facts and figures can be shared and used to convince everyone throughout the NHS of these facts. Many will say that it is the patient that must come first. However, I argue that excellence in health and social care may only be achieved if both the staff and patients are cared for equally, as they work in partnership to achieve the best outcomes.
Looking for ways to turn this vision into practice? See my blog on 20 ways to create a thriving NHS workforce here
Until next time, look after yourselves and each other .
