The following information is based on guidance from the KingsFund organisation and the British Psychological Society. This guidance is not an exhaustive list of recommendations, but is intended to inform managers of processes which are likely to be helpful or unhelpful. Each area and team are unique and will face different challenges so there is no one size fits all answer to well-being. It is therefore important that you speak to your teams on a regular basis and consider the issues that are affecting them when considering what steps to take.
- Be visible, be available and be supportive, you are best placed to create a protective environment
- Have a communication strategy in place. Ensure that good quality communication and accurate information updates are provided to all staff. Communicate regularly and frequently in simple clear ways using a variety of methods, verbal, virtual, written. Brief staff in an open, honest and frank way so they are best prepared for what they are going to face and what they might be asked to do.
- Be flexible in supporting needs and respond to staff feedback on what is, and is not, helpful. Set up regular feedback mechanisms so messages can reach management quickly. Make sure to act on feedback and where this is not possible, communicate why this can’t be done.
- If possible, rotate workers from higher-stress to lower-stress functions. Partner inexperienced workers with their more experienced colleagues. Such ‘buddy’ systems help to provide support, monitor stress and reinforce safety procedures. Implement flexible schedules for workers who are directly impacted or have a family member affected by a stressful event
- Ensure that the basic physical needs of staff are being met including safety (including appropriate access to personal protective equipment), food & hydration, rest and sleep. Support staff to take breaks, annual leave and attend to self-care. Role modelling of these behaviours by senior staff will be important.
- Provide access to training on the potentially traumatic situations that staff might be exposed to including honest communication of the facts, developing skills to cope with these and awareness of potential mental health issues. This is particularly important for new staff, staff who have been temporarily redeployed into a new area as well as any students who have come into practice early. Some availabile training:
- Pay attention to staff who may be particularly vulnerable. This may be because of pre-existing experiences or mental health issues, previous traumas or bereavements, or concurrent pressures and loss. Think about how to best monitor these staff and put extra support mechanisms in place for them.
- Encourage staff to use social and peer support. It’s not enough just to have good support systems in place, staff need to actively use them. Staff may feel guilty or not want to burden or distress others, particularly their family, so think about how peer and management support can be maximised at work. Evidence suggest that when a person has the informal support of their peers following traumatic exposure, they are less likely to need formal intervention. The efficacy of peer interventions does not come from having a single trauma-informed or trained staff member, but rather comes from the camaraderie and sense of common fate that emerges from a shared experience of trauma.
- Establish explicit peer support mechanisms e.g. daily buddying. This is especially important when staff have been moved away from their established peer support and are working in new areas with different teams.
- Allow staff time and space to be with and support each other and encourage activities and discussions also unrelated to COVID where possible.
- Consider holding regular drop-in CAVaCoffee and TALK events. It may take a few of these sessions to get staff to engage so don’t give up after one
- Facilitate team cohesion and try to foster strong supportive links between team members and managers. It will be important for managers and team leaders to role model a caring and cohesive team approach – “we’re all in this together”. Evidence shows that cohesion between individuals is highly correlated with mental health, and that the resilience of a team may be more related to the bonds between team members than the coping style of any individual.
- Provide an opportunity for staff to talk about their experience, in order to enhance support and social cohesion. This can occur at the end of shifts or at significant points in time. This may take place individually between a staff member and manager or supervisor, or in teams of people who work together. These sessions should not involve anyone being mandated to talk about their thoughts or feelings. It is important for organisations to provide these opportunities, but for staff to be free to decide whether to attend or not. If offered, these sessions should be provided during a staff member’s shift (not afterwards) so as not to encroach on rest and recovery time.
- Continue to actively monitor and support staff after the crisis begins to recede. Where necessary, refer on for evidence-based psychological treatment.
- Take time to become familiar with the well-being resources available for staff, so that you know what they can access and so you can signpost if needed. Share this with line managers.
- Consider developing well-being champions in your teams – training and support for this role is available via the Employee Well-being Service.
- Attend an Employee Well-being Service Well-being Q&A session for managers and encourage your line managers to attend as well.
- Remember to focus on your own well-being and apply all of the above to yourself and senior colleagues.
- Don’t offer Psychological Debriefing, Critical Incident Stress Debriefing or any other single session intervention which involves mandating staff to talk about their thoughts or feelings. There is evidence that these interventions may be ineffective or even increase the likelihood of developing PTSD.
- Don’t offer non-specific training programmes such as ‘mental strength’ training as these do not have a beneficial impact on reducing mental health problems or PTSD and are likely to have high dropout rates. Offer general support and chat.
- Don’t rush to offer formal psychological interventions too soon without careful assessment, including active monitoring. Although well intentioned, intervening in people’s natural coping mechanisms too early can be detrimental.
- Don’t offer any unproven approaches to psychological treatment. Any psychological intervention should be provided by an appropriately qualified and supervised clinician, at the appropriate time.
- Don’t be afraid to ask someone how they are, this situation is unprecedented; it is okay to not be okay.
Detailed guidance available on the traumagroup.org website.
British Psychological Society Covid19 Staff Wellbeing Group how to support healthcare staff:
The King’s Fund COVID Trauma Response Group – guidance for planning early interventions: