We are delighted to host a takeover of the Evolve Workplace Wellbeing Podcast by the IPPO (The International Public Policy Observatory) to mark the publication of the IPPO's rapid evidence review on NHS staff wellbeing.
Professor Kevin Daniels from our UEA team offers an overview of the report's findings first, then Sarah O'Meara of the IPPO asks questions of report authors Professor Sara Connolly (UEA), Dr Christian van Stolk (RAND Europe) and Professor Kevin Fong (UCL).
A summary can be found here: New report highlights the need for investment in NHS staff wellbeing - evolveworkplacewellbeing.org
The full report can be downloaded here: IPPO NHS Staff Wellbeing report_LO160622-1849.pdf (ioe.ac.uk)
We are delighted to host a takeover of the Evolve Workplace Wellbeing Podcast by the IPPO (The International Public Policy Observatory) to mark the publication of the IPPO's rapid evidence review on NHS staff wellbeing.
Professor Kevin Daniels from our UEA team offers an overview of the report's findings first, then Sarah O'Meara of the IPPO asks questions of report authors Professor Sara Connolly (UEA), Dr Christian van Stolk (RAND Europe) and Professor Kevin Fong (UCL).
A summary can be found here: New report highlights the need for investment in NHS staff wellbeing - evolveworkplacewellbeing.org
The full report can be downloaded here: IPPO NHS Staff Wellbeing report_LO160622-1849.pdf (ioe.ac.uk)
00:00:00:00 - 00:00:34:17
Helen Fitzhugh
Welcome to the Evolve Workplace Wellbeing Podcast. This podcast is part of a toolkit of free, evidence-informed workplace wellbeing resources provided by the Workplace Wellbeing Research Team based at the University of East Anglia in the UK. You can find the resources on wwww.evolveworkplacewellbeing.org The contents of the toolkit draw upon cutting edge multi-disciplinary research on workplace wellbeing, including insider insights and case studies.
00:00:34:19 - 00:01:06:14
Helen Fitzhugh
This month we're delighted to host a takeover of the Evolve Workplace Wellbeing Podcast by the International Public Policy Observatory, or IPPO. Sara O'Meara from the IPPO asks questions of researchers involved in the NHS staff wellbeing review and economic analysis. Before we get to the questions, the recording starts with Professor Kevin Daniels giving an overview of the talking points from the report.
00:01:06:16 - 00:01:40:07
Kevin Daniels
This report is focused on organizational and management practices in the NHS, their influence on staff wellbeing and how this can be improved. The focus on organizational and management practices is because this is what people experience every day and therefore have a significant influence on their health and wellbeing in the workplace and therefore are a fundamental area for improvement as recommended in multiple guidance published by different bodies such as NICE.
00:01:40:09 - 00:02:24:13
Kevin Daniels
We took an approach focused on rapid evidence review, which is a systematic approach to reviewing the relevant literature in a short time frame and then subjected that to economic analysis. Our estimates are that the cost of poor mental health and wellbeing to the NHS is over £12 billion per year. This comes from the influence of mental health on things like absence, having to cover staff costs with agency staff and presenteeism, which is turning up to work when ill and therefore not being at maximum productivity.
00:02:24:15 - 00:03:00:11
Kevin Daniels
So what works? How can we reduce this burden on an array of stuff? What we found was things like flexible working practices can have a positive effect on staff, we think improvements to the physical work environment can actually have psychological effects as well. These are things like rest spaces or ergonomically adjustable desks. But administrative staff change is focused on the culture of a workplace which is more systemic and includes leadership, development and many other activities to improve
00:03:00:11 - 00:03:46:11
Kevin Daniels
working practices seem to have a positive effect on wellbeing and for some people at least improving access to supportive relationships. Automating some of the more boring processes and virtual working can have positive effects on wellbeing, although the effects are not necessarily uniform, but they can have positive effects. What is missing from the literature is anything on higher level interventions, and we think this is important because if we take our finding, the systemic changes work in specific locations and we can extrapolate from these findings and findings from other sectors
00:03:46:16 - 00:04:22:11
Kevin Daniels
that systemic wide scale changes are important in managing programs of multiple activities. So to do that, we recommend a much more strategic approach in the NHS, a much more comprehensive approach which clearly embeds wellbeing into the functioning of the NHS. And within that measurement and monitoring at a close level on what is working and what isn't working and what can be improved to embed a continuous learning process.
00:04:22:13 - 00:04:51:15
Kevin Daniels
So we could say spend money to save money, spend money in the short term to save money. Certainly in the longer term. But the evidence is these kind of interventions that we've looked at and the evidence from other sectors can have quite significant short term effects as well.
Sarah O’Meara
Thank you so much, Kevin Daniels, for that fantastic description of the review and the interventions and outcomes that the review team recommend.
00:04:51:15 - 00:05:24:15
Sarah O’Meara
And from what this research can tell us, what I'd like to do now is talk about some of the questions that people might have based on the findings that this large piece of evidence has brought up. So I'll first go to Sara Connolly, who is a professor in personal and personal economics at the University of East Anglia. And sadly, the report says that the cost to the NHS of absenteeism, presenteeism and agency cover, in part caused by poor staff mental health and wellbeing, could estimate to be at least £12 billion.
00:05:24:17 - 00:05:54:10
Sarah O’Meara
How have you come to this conclusion?
Sara Connolly
Thank you, Sarah. The NHS publishes monthly figures on days lost through illness and the reasons for those days lost. And so we use these along with salary costs, to estimate the costs of absenteeism. And as I have mentioned, in addition to people not going into work because they are ill, many people work through illness and there are losses in productivity as a consequence of that.
00:05:54:12 - 00:06:24:03
Sara Connolly
They're less effective in in the workplace. And this is really important in health care, where you need to be mentally there, physically and emotionally. That and the costs of presenteeism research has found, is at least double the cost of absenteeism. And this is included in all calculations. And finally, we're looking at the kinds of costs that are incurred due to poor mental health and due to voluntary quits from the service.
00:06:24:09 - 00:06:57:16
Sara Connolly
And these give us the estimates of the agency expenditure due to poor health and wellbeing in the NHS. And these together come to just over £12 billion a year.
Sarah O’Meara
So in your recommendation you've suggested how much could be spent on staffing if the NHS saved 1 billion. But what about the other 11 billion?
Sara Connolly
Yes, well saving 1 billion is a really significant amount of money that would be equivalent to the profits that large supermarkets like Tesco's make in one year in the UK.
00:06:57:18 - 00:07:23:20
Sara Connolly
But what we wanted to do in this report was to focus on what was feasible, what was manageable, and what research tells us the sorts of improvements that might be made in the short to medium term.
Sarah O’Meara
Yeah, yeah. So do these cost savings only apply to clinical staff or to other personnel, such as admin staff? The interventions we looked at looked at improvements in wellbeing for staff across the NHS.
00:07:23:22 - 00:07:57:21
Sara Connolly
So that includes administrative staff and and also clinical staff. We know that there are probably common drivers of poor health and wellbeing within the NHS, but also there may be some, some pressures that are staff category specific, as be mentioned, automated processes may work in pharmacies, standing desks for administrative staff, but clinical support like the Schwartz Rounds would, would, would, would be more appropriate for medical and clinical staff.
00:07:57:23 - 00:08:27:21
Sarah O’Meara
And the figures you've costed, they may relate to England and the cost benefits be the same in other parts of the United Kingdom?
Sara Connolly
Although the NHS is organized and managed differently in Scotland, Wales and Northern Ireland. The same underlying pressures exist across the United Kingdom. There's a concern about absenteeism, but crucially a concern about UPS days lost through to poor mental health across the United Kingdom.
00:08:27:23 - 00:08:50:08
Sarah O’Meara
And I guess, I mean, the most important question is such a large amount of money could be saved. Why? Why isn't it being done? Like in reality, how much does it cost to actually state this amount of money?
Sara Connolly
Well, as Kevin said, it's a question of investing in staff, spend more to save more. And so there will be upfront investments that are needed.
00:08:50:10 - 00:09:11:01
Sara Connolly
What we do in the report is to look exactly at how much needs to be invested and how much can be saved. And in the short run, our estimates suggest that for each pound spent, savings of at least £2 could be could be made in the short run and possibly more in the longer run.
Sarah O’Meara
Thank you. I appreciate that.
00:09:11:03 - 00:09:34:09
Sarah O’Meara
So now let's move on to talk about the kinds of interventions that are needed and what it would take to make them happen. Kevin Daniels is a professor of organizational behavior at the University of East Anglia, and he's going to talk to us about what it would take for these kinds of interventions to make change. Kevin If we invest money now, when we would be, for example, see staffing shortages decrease?
00:09:34:11 - 00:10:01:19
Kevin Daniels
Well, I think staffing shortages are a slightly different kettle of fish because of course you have to train staff both in terms of improving quality of care, improving wellbeing and reducing absence. Many of the studies we looked at actually have quite a short time frame in terms of a matter of months before they see their first effects. So you can see small improvements very, very, very quickly.
00:10:01:21 - 00:10:34:14
Kevin Daniels
And the idea is that these improvements will accumulate over time as you build more, more activities and initiatives around improving organization and management practices over time. And I think Chris might want to add a little bit in there. He's worked a lot with the NHS. I mean, he has insights. I don't.
Chris van Stolk
Yes, thank you, Kevin. And I think we should also keep in mind that there's a specific context here across the piece in the NHS because of COVID, but also in terms of the catch up that is associated with the COVID crisis.
00:10:34:16 - 00:11:02:02
Chris van Stolk
Health and wellbeing has been worsening across health staff, so this review is not only about improving the health and wellbeing of staff, but also arresting the decline. So there is a a crisis happening within the NHS and that we should acknowledge as parts of this crisis existed before the pandemic. But of course the pandemic and the subsequent catch up have sort of have sort of made this crisis worse.
00:11:02:04 - 00:11:21:07
Chris van Stolk
So the changes can be made in a relatively short time frame, but they're also very necessary to make. And so that's the point I wanted to emphasize.
Sarah O’Meara
Yeah. And in the review, it says that the interventions you've looked at haven't been tested at scale. So what exactly do we do? How do we know these these interventions would work?
00:11:21:09 - 00:11:51:17
Kevin Daniels
Well, that's a it's a really interesting point. I think we have to look at other factors and also look at the guidance that you get from the International Organization for Standardization from NICE and so forth. Is that you're looking at systemic, large scale changes. And if you look at other sectors and best practice, what you find is that the leading organizations do a lot around prevention as well as rehab integrated programs of activity.
00:11:51:17 - 00:12:14:11
Kevin Daniels
So they actually look at their organizational cultures, I mean, look at their management practices and they look at how to improve those in often using continuous improvement processes so they don't stand still. And the reason for not standing still is technology doesn't stand still, society doesn't stand still. So you have to have an evolving, evolving program of activities because things change.
00:12:14:13 - 00:12:44:01
Sarah O’Meara
Yeah. And so what exactly are you proposing?
Kevin Daniels
Large scale, systemic and cultural change. And there are small steps you take to do that. You can't suddenly wave a magic wand and make everything better overnight with a different culture. Culture change involves small steps. You improve management practices, you improve how things are done. You embed wellbeing in the strategy, you also embed
00:12:44:03 - 00:13:08:20
Kevin Daniels
continued performance improvement in the strategy, wellbeing and performance are not mutually exclusive. And indeed, one of the studies we looked at where there were tangible wellbeing benefits, the focus was on improving quality of care and safety. That was one of our systemic culture change ones. So it's very, very important to bear in mind wellbeing and performance / quality of care are not mutually exclusive.
00:13:08:20 - 00:13:34:24
Kevin Daniels
They are actually the same thing because one thing you can say about most people is they don't go to work to do a bad job. They go to work to do a good job.
Sarah O’Meara
Yeah. Chris Did you want to add anything to that?
Chris van Stolk
No, other than to say I agree with Kevin. And we know that there's a really strong association between good health and well-being in the NHS and the range of outcomes, be it financial performance, but also quality of care, patient satisfaction and so on.
00:13:35:01 - 00:14:00:06
Chris van Stolk
We also know that really embedding the practice of improving health and wellbeing in the NHS has been really difficult and we haven't really succeeded in doing this over a decade or more. So this really is another call to try to do this. And ultimately what we're talking about is organizational change, culture change, as Kevin outlined in terms of properly embedding this within NHS employers.
00:14:00:08 - 00:14:21:11
Chris van Stolk
So that's that's what we're talking about today.
Sarah O’Meara
So we're talking about culture change and there's no one better to speak to this than someone that works deeply within the culture. And we've got Kevin phone with us. He's a professor of public engagement and innovation and University College London and also a consultant anaesthetist within the University College London Hospital.
00:14:21:13 - 00:14:46:07
Sarah O’Meara
Kevin, can I talk to you about the recommendations of this review from the perspective of a clinician? And a lot of people might just think that COVID had a huge impact on the capacity of the NHS, and is there a case for saying we just need to wait for staff to recover and kind of move on?
Kevin Fong
This is, you know, one of these things that we think about that COVID is, is the cause of all of this.
00:14:46:07 - 00:15:20:22
Kevin Fong
But it's very clear from the evidence that these problems long pre-dated COVID, and indeed successive reviews over the years show that there has been a problem that has gone largely unaddressed. Now, one of the great things about this review, I think, has been its engagement with us as frontline professionals, and its relevance to that problem. Very often this type of review can seem quite abstract, but COVID has illuminated a problem that has been longstanding and creates an urgency in finding a resolution.
00:15:21:01 - 00:15:52:21
Kevin Fong
Everything you've heard today is what we know have failed so far to act on. The recommendations show that the needs of our patients and the needs of our staff are truly aligned and that to actually improve the quality and safety of care by improving the staffing numbers, we need to be ready to fundamentally adjust the culture, putting our staff at the centre of of and their wellbeing at the centre of the operational culture of the NHS.
00:15:52:23 - 00:16:21:06
Kevin Fong
But to do that by investment at scale and it's not enough, it's not enough to have words, it's not enough to, to, to have slogans that this needs investment and scaled. Now it's affordable because the evidence also shows that we save vast amounts of money by doing that. So for me, this is a welcome report and a welcome both in its engagement with us as frontline teams, but also in terms of its wide ranging recommendations.
00:16:21:06 - 00:16:48:10
Unknown
The recognition that action is needed at scale and urgently, and the understanding that it is affordable because it will lead to savings that in the not themselves can improve the situation, but in the short, medium and the long term.
Sarah O’Meara
So let's talk a little bit about recruitment. The NHS is ostensibly recruiting more nurses. I think maybe in the minds of the public, this is this is the sort of fix that the NHS needs just more people coming in.
00:16:48:12 - 00:17:16:12
Sarah O’Meara
So why won't less fix the problem? And why do we talk about culture and more substantial change?
Kevin Fong
We need more staff. I mean, that's one of the fundamental problems and the number, the adequacy of staffing is directly connected with the wellbeing of our teams. And indeed you lead to a vicious negative cycle. If, if wellbeing is poor, more people leave, more gaps appear in the rotas and more staff and the staff there remain feel more stressed.
00:17:16:14 - 00:17:37:11
Kevin Fong
So there's this sort of negative spiral down if you leave this problem unaddressed. We are doing very well in recruiting nurses but actually it takes a long time to recruit and train new staff. The best thing you can do is to not lose the staff you've got because it hurts to lose the staff you've got because you're not just
00:17:37:13 - 00:18:02:10
Kevin Fong
Losing quantity, using quality, losing experience, you're losing organizational memory. And so the quickest early fix here is to not lose the people that you've got and improve the health and mental health and wellbeing of the people who are on the shop floor and that will relatively consistently improve the situation. And so it's not about recruitment alone. We're doing well with that.
00:18:02:13 - 00:18:28:16
Kevin Fong
But actually the unaddressed inefficiency in the health service is this inefficiency over its use of human resource. If you could keep and maintain and protect the wellbeing and mental health of the staff that you found, then actually that would ameliorate some at least some of the of the staffing gap.
Sarah O’Meara
Yeah, yeah. Thank you. That the review does recommend that staff need better monitoring at their wellbeing.
00:18:28:16 - 00:19:04:14
Sarah O’Meara
And this is a key recommendation, you know, based on a very, very extensive look at the evidence. But I mean that's a huge recommendation. What should we be doing better?
Kevin Fong
So we already have the NHS staff survey, which we've seen in the press recently shows deteriorating figures and that's a useful strategic overview. I think what is much needed is a shorter, more frequent validated formal tools for us to measure the mental health and the wellbeing of our operational teams on a perhaps quarterly basis.
00:19:04:14 - 00:19:31:04
Kevin Fong
Now that should be something that we are very prepared to do. It requires cultural change because we we don't tend to check ourselves. And yet certainly as clinicians, nurses and doctors and allied health care professionals on the front line, we're used to checking our equipment and our working spaces on a daily basis to make sure they're in good functioning order when so that they're there and they will work properly when we need them.
00:19:31:06 - 00:20:07:12
Kevin Fong
We being much more reluctant and less used to turning that sort of check upon ourselves to check that we are functioning in the same way. So I think there's a little bit of cultural change there, but I think also that type of longitudinal monitoring which is performed, that there's good evidence of this working in other organizations, notably the British military, longitudinal monitoring of of the wellbeing and mental health of frontline teams allows operational managers closer to the shop floor to understand how a successful or not their interventions are.
00:20:07:14 - 00:20:30:23
Kevin Fong
And and you know, as as you have heard earlier from other speakers, this is an iterative process. And for us to improve, we're going to have to find ways of making small changes, monitoring the impact of those changes and improving and continue improving into the future.
Sarah O’Meara
Thank you. And one technical question. The review mentions the problem of presentism.
00:20:30:23 - 00:20:55:00
Sarah O’Meara
Now, this is something that I haven't come across before, so what makes this an issue in the NHS and how does it make productivity less good and how does it sort of affect mental health and wellbeing among staff?
Kevin Fong
Presenteeism is the phenomenon in which people are physically, mentally unwell to the point where they shouldn't really be at work, but they turn up anyway.
00:20:55:02 - 00:21:31:04
Kevin Fong
And this is one of those hidden problems because the numbers present look okay, but actually it impacts the productivity, both the site, the productivity as well as the quality of the care that you deliver. So actually it's very erosive presenteeism harder to see hugely erosive. And this is where some of the massive gains are really we talk about trying to improve the productivity of the organization, but actually this by addressing the wellbeing of the workforce, we can address the presenteeism and thereby impact productivity.
00:21:31:05 - 00:22:08:13
Kevin Fong
So some of the work that this evidence reviews looked at actually came from groups that I've worked with and we specifically monitored the the wellbeing of frontline teams. We looked at their work and social adjustment scale, which is a measure of how able they outperformed their day to day tasks. And certainly in the wake of COVID, even with a past recovery going on, we were seeing one in three staff who were on the operational frontline reporting that they weren't really fit to perform their duties.
00:22:08:13 - 00:22:37:02
Kevin Fong
That's an enormous fraction, and I suspect that's probably reflected across of a large fraction of the workforce. So presenteeism is a big problem. And and on the flipside, addressing that is a more rapid fix than trying to recruit new people.
Sara O’Meara
Thank you. And finally, the review's recommendations. It doesn't actually have that many considering the scale of the problem.
00:22:37:02 - 00:23:00:24
Sara O’Meara
And let's be frank, there aren't that many clear things we could do this right now. And why do you think it's so hard to to get that kind of clear evidence and interventions? And where's where's that? Where's the gap in evidence?
Kevin Fong
So I think this review's part of the evidence is is extraordinarily powerful. I think the evidence is there.
00:23:00:24 - 00:23:33:12
Kevin Fong
And it's not just there, but it's been there for a long time, I think is a difficult problem. I think it's easy to articulate the solutions, but it's difficult to solve because it requires some fundamental alterations. And I think it's also sleep borne out of a false choice that we've created in a resource constrained environment where we believe that where there's a requirement for investment, you need to choose between whether or not you improve the lot of the staff or the care of your patients and all of us civilians.
00:23:33:12 - 00:23:55:08
Kevin Fong
The trap of believing that you must always, always pursue the care of the patients first. But that's a false choice and it's a false economy. The needs of the patients and the needs of the staff are truly aligned. And by investing in improving the health of the workforce, we are improving the care, quality and safety of all of our patients.
00:23:55:10 - 00:24:26:12
Kevin Fong
And so I think that this is perhaps the sticking point. It's the lack of recognition that this is a closed system and and how closely aligned the needs of our staff and the needs of our patients truly are. And so it requires vision. This is opportunity and not threats, and it needs to be recognized as such. And if there's one good thing that can come from COVID is that it illuminates this problem for the first time properly and gives proper impetus to the rate and scale at which we need to approach the solution.
00:24:26:14 - 00:24:53:20
Sarah O’Meara
Thank you. And finally, I'm going to turn to Christian van Stolk, who's the executive vice president of RAND Europe, and he's worked extensively on health and well-being in the world, in the workplace. So you've been working in this field for many decades and many recommendations from similar reports haven't been implemented, such as the Boorman report of 2009. How do you think they can be afforded and implemented now and where is the money coming from?
00:24:53:20 - 00:25:24:07
Chris van Stolk
Yeah, thank you, Sarah. I mean, we spent a quite a significant amount on our on our health system, of course, £75 billion a year or the like. A large part of that funding actually goes towards staff. So it seems rather odd that we in fact invest relatively little in the health and wellbeing of staff in terms of supporting that staff when they're in the workplace.
00:25:24:09 - 00:25:53:23
Chris van Stolk
It would make sense, I guess, from an economic point of view and also as as other speakers have alluded to from a quality of care point of view, patient satisfaction, point of view to actually support the health and wellbeing of staff better. So in terms of the spending, overall spending on the NHS and you could argue that that needs to be more over time, but the amount of investment that's required to support staff health and wellbeing is actually relatively small.
00:25:54:00 - 00:26:18:00
Chris van Stolk
I can't give you an exact number across the whole system, but it will be a lot smaller than a small proportion of that overall expenditure. And of course also what this review shows is when you make these investments in terms of staff health and wellbeing, there will also be some returns in terms of savings that you will have in terms of productivity gains, also reduced staff absence and so on.
00:26:18:04 - 00:26:53:11
Chris van Stolk
And then of course wider system outcomes such as improvements in quality of care. So over time, as you're making these investments, there's also an expectation that you're investing to save in the longer term. And some of those savings, as Kevin Daniels mentioned, also occur in the short term. So in a sense, the business case is there. It is relatively affordable given the overall expenditure within the NHS and probably the small levels of expenditure relative to the overall expenditure that it requires us to to start making these investments.
00:26:53:13 - 00:27:18:09
Chris van Stolk
The key question to some extent is, is how can we get the NHS to start embedding, you know, better improvements in staff, health and wellbeing within the system and of course supporting that in the longer term. That's the real question at hand here.
Sarah O’Meara
Yeah. Should we be focusing on reform rather than higher funding levels?
Chris van Stolk
I think this is a bit of a false choice.
00:27:18:09 - 00:27:41:22
Chris van Stolk
I mean, we sometimes hear the NHS needs more reform, not necessarily more funding or some arguments saying, well, you know, we don't need to talk about reform, just need to talk about increased funding. I think this is an area where obviously, as we have established in this review, there needs to be an investment up front and there might be savings down the road, but you need you need that investment.
00:27:41:22 - 00:28:12:02
Chris van Stolk
So this is really not a choice between reforming and higher funding. I mean, the reform we're talking about is really embedding health and wellbeing firmly within the NHS, promoting that culture change and so on, and that will require some funding as well. So this is both a call for that investment as well as a call for reform in terms of changing the culture in the NHS to make sure that's improving.
00:28:12:02 - 00:28:46:09
Chris van Stolk
Staff health and wellbeing is front and centre of NHS operational plans, strategy and, and, and, and guidance going forward.
Sarah O’Meara
Kevin Fong, so if I could just ask you, did you want to comment on that?
Kevin Fong
Because from the, from the clinical side and so the Messenger review, which was an impressive review of the leadership culture within the NHS, was striking actually in its own executive summary at, at the difficult environment of the NHS within and in fact the parlous state of the wellbeing of its staff.
00:28:46:09 - 00:29:23:13
Kevin Fong
And so while it made recommendations within its scope about leadership, it actually was advocating also that there needs to be support at that core level. You talk about reform, but what we need really is we want change. And this the IPPO review that's published here recommends change. So in that sense it does recommend reform. But but it also recognizes that that cannot come without resource, that actually we need to change our attitude to the way we treat our human resource.
00:29:23:13 - 00:29:48:02
Kevin Fong
We need to see our human resource as an asset in which we invest if we are to reap its full potential. These are our carers, these are the people who deliver our health service. The NHS is not a building, it's not an organization, it is the people who work for it. And if we fail to care for those carers, then we will fail in our core operational goals.
00:29:48:04 - 00:30:11:11
Sarah O’Meara
Thank you. And Chris, I'm going to go back to you for the final question. Really, how do we promote this culture change that you've been describing? In fact, everyone here has been describing this, saying it's not low level interventions, it's not minor changes. It is a deep step change. What does it take to to start this?
Chris van Stolk
In terms of how we promote a culture change in the NHS?
00:30:11:17 - 00:30:40:07
Chris van Stolk
It's really we need to firmly embed health and wellbeing at the front and center of how the NHS operates. And that's of course easier said than done. But we really need to look at all levels and that includes leadership. As the Messenger review covered relatively recently. It also includes accountability. The NHS is is not a uniform system. It consists of many different employers.
00:30:40:07 - 00:31:13:00
Chris van Stolk
So you need to make those different employers, those different parts of the system accountable for staff health and wellbeing in their workplaces. And of course it also relies on incentives. I mean, the way that the system, the NHS England's and other bodies incentivize those those employers within the NHS. So it's at all these different levels. You need to think about how we can improve the health and wellbeing of staff, how we can put staff at the centre of the service.
00:31:13:02 - 00:31:39:12
Chris van Stolk
And I think if we can make significant progress on that, then you can start seeing some some some changes at some points. You also need to acknowledge the fact that there is a saying that you should never waste a good crisis and that is that it's maybe, you know, a way of saying is that, you know, we need to really sort of think about what we want in terms of supporting NHS staff coming out of this crisis.
00:31:39:18 - 00:32:05:19
Chris van Stolk
And I would really second what Kevin Fong said ultimately by looking after the health and wellbeing of carers of people within the NHS, we will also will get much quality of care. So there's a real shared value proposition for us to get this right as a society.
Sarah O’Meara
Thank you.
Helen Fitzhugh
So that's a big thank you to Sarah O'Meara from the IPO for her takeover of the Evolve Workplace Wellbeing podcast this month.
00:32:05:21 - 00:32:46:12
Helen Fitzhugh
If you'd like to find out more about the review and read the report, please either visit the IPPO's website or evolveworkplacewellbeing.org where there are also links to the report. Please join us in our ongoing exploration of workplace wellbeing, research and lived experience in our podcast as we go forward. This podcast with produced by the University of East Anglia with the support of Norwich Business School, RAND Europe and all the members of the Workplace Wellbeing Research Team, you can find out more about our team as a whole, our research and use, our practical business focused resources at www.evolveworkplacewellbeing.org
00:32:46:14 - 00:32:59:19
Helen Fitzhugh
Thank you.