Case Study

Buckinghamshire Healthcare NHS Trust: Targeted Wellbeing Conversations in the time of COVID-19

Buckinghamshire Healthcare NHS Trust is a major provider of integrated and community services for half a million people living in Buckinghamshire and surrounding counties. The Trust is well known for the internationally renowned National Spinal Injuries Centre and recognised nationally for its’ Urology, Stroke, Skin and Cancer services.

During the pandemic, the Health and Wellbeing team encountered a number of challenges

  • Wellbeing Walkabouts by the team had ceased due to COVID-19 Infection Prevention and Control guidelines to restrict footfall in the clinical areas of the organisation
  • There was a mismatch between the unprecedented challenges facing staff and the modest numbers accessing psychological support services.
  • The Intensive Care senior nursing team highlighted a need for help in their service specifically.

The Trust decided to deploy a programme of wellbeing telephone conversations to find out how are staff were feeling, ensure the organisation was offering all the support that it could and, most importantly, enable easy access to services.  This initiative followed campaigns already implemented earlier in the year:

  • ‘Time to Change’ is an initiative from the Mental Health Charity, MIND. As a Trust we committed to start talking about mental health more openly with the intention of reducing mental health-related stigma and discrimination.
  • ‘Just Ask’ is a campaign where we encouraged staff to take a moment daily to check in with themselves to see how they are feeling and to carry out acts of self-kindness e.g. self-care: eating well, getting enough sleep, exercising and planning to do something that they enjoy
  • ‘#HAY’ was guidance that came from the NHS South East Region: A guide to looking out for one another for NHS leaders, managers and staff

A decision was made to pilot the approach with the ITU team.

The conversations were led by the Health and Wellbeing team – a group of experienced healthcare professionals able to have open and empathic conversations. The object was to give an explicit message that senior staff appreciated their hard work, were aware of the challenges they were facing, and genuinely care about their welfare. All calls were confidential.

The calls covered the following points:

  • Are you working from home or still on-site?
  • If working for home how are you finding it? Is there any extra support you need?
  • Are you managing to take breaks – hydrating/eating?
  • Are hours of work manageable?
  • Do you have a supportive manager and team?
  • Are you taking days off work to rest and recover?
  • Do you have the support you need at home?
  • Would you like any other support?
  • Have you seen the Wellbeing COVID-19 Staff support booklet?
  •  Have you done your risk assessment with your manager yet?  Do you feel safe at work?
  • Are you from a BAME background?
    • This question is aimed at addressing any heightened anxieties around being in a vulnerable group in relation to COVID-19. The intention is to ensure staff were satisfied with their Risk Assessment and also to raise the profile of the BAME network in the Trust as an additional source of support.

The team found it helpful to use prompts to ensure consistency in the phone calls whilst still offering scope for the calls to be tailored and person centred.

For those the team were unable to reach by phone, a voicemail was left with the service contact details. A follow up e-mail was sent to all ITU staff, with resources attached, including a COVID-19 Staff Resource booklet and advice on grounding techniques.  On reflection having a copy of the off duty would have increased the likelihood of the calls being received.

Themes were fed back to the Intensive Care unit managers and Divisional Chief Nurse, particularly the importance of managing the expectations of staff redeployed to work in ITU.

The calls resulted in signposting individuals for 1:1 psychological support which included counselling, resilience, coaching, clinical supervision and weight loss advice. Staff feedback suggested that the calls made them feel valued and appreciated.  The Health and Wellbeing Team gained valuable insights into staff perspectives to inform their work. It was also felt to foster a trusting relationship between the Wellbeing team and staff.

Due to the success of the pilot, the initiative was subsequently rolled out to Emergency Department staff.