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Mental wellbeing review

The draft Health and Care Workforce Strategy for England to 2027 - Facing the Facts, Shaping the Future - announced a new Commission on the mental wellbeing of NHS staff and learners.

The Commission has been led by Sir Keith Pearson, Chair of Health Education England, and Professor Simon Gregory, Director and Dean of Education and Quality, Midlands and East, as Programme Clinical Director. Four Health Education England clinical fellows have undertaken an extensive literature review and provided invaluable clinical influence with support from colleagues in and outside the organisation. We have already met leading experts, clinicians and academics to scope and understand the issues and find out more about the very good work that many are doing. Where we find organisations demonstrating that they value those learning to work and working in the NHS we want to learn from them and apply this. We are grateful to everyone who has given up their time and provided these valuable contributions.

Our aims

In this first stage, we have reflected on all the learning gained and insights generated which will be explored in the second stage by a Commission panel of subject experts and advisors. The Commission will sit from July until November, to develop recommendations which will be published in the final report and delivered to the Secretary of State for Health and Social Care in December 2018.

To inform these recommendations it will be crucial that the Commission hears the voice of those whose wellbeing has been adversely affected by workplace experiences in the NHS, as well as further engagement with a wide range of stakeholders to ensure that recommendations for change are focused on the day-to-day experiences of our staff and learners. Learners include school pupils, undergraduate students and apprentices, and postgraduate trainees. The Commission will further engage with these learners and staff, employers, professional representative organisations, educators, academic experts, mental health leaders and regulators.

A focus of this second stage of the Commission will be to seek out and review evidence of good practice and successful interventions from around the country, to identify what has worked well and what could be adopted widely.

Ultimately this Commission is about ensuring that the NHS staff and learners are happy and feel fulfilled in their work, that they look forward to going to work and are proud of the care they provide to their patient. There is good evidence that happy staff are more compassionate and provide safer care. HEE recognises its central role in supporting the current and future workforce to deliver high quality safe care and therefore, is rising to this challenge to support the mental health and wellbeing of staff and learners in the NHS.

Our areas of concern

This Commission has examined the culture of learning for individuals, from schooldays, through university and onto advancing their professional careers in the health and care workplace. We have considered various societal factors, pressure points and specific challenges at all stages of their educational and career progression. Throughout this journey, we have identified five key lines of enquiry which have influenced our approach. Our key cross-cutting questions are:

NHS and higher education culture, climate, context and myths

  • What aspects of the NHS or university culture might have an impact upon mental wellbeing? 
  • What elements of the organisational climate might impact upon the mental wellbeing of learners? 
  • Are individuals reluctant to ask for help when feeling under stress? 
  • Are they also reluctant to make their mental health problems known? 
  • Do individuals fear that it might have a detrimental impact upon their success or career? 
  • What might help dispel the myths and misconceptions about mental health problems? 
  • What can be done to support good mental health of all in the NHS and ensure that we do not only focus on interventions and support for those most in need?

Isolation and lack of support

  • What are the challenges for learners who move away from their home area to access education and training, working at a distance from family and friends? 
  • What support is in place for learners clinically and pastorally? 
  • Could this support be improved or delivered differently? 

High expectations on learners

  • Many of our learners will be high academic achievers. On entering clinical training they may find the continued high expectations challenging. What could better prepare learners for this? 
  • What should be put in place to help learners cope with the high demands of their future clinical career roles? 

Societal changes

  • How do changes affecting the role of healthcare professionals over recent decades impact upon learners? 
  • What changes in societal expectations and behaviours are having an impact upon the experiences of our learners? 
  • What should we be putting in place to prepare and support learners with such societal changes? 
  • What could we do differently to manage these pressures? 

Generational changes

  • What are the challenges that learners face in relation to changing perceptions and expectations on lifestyle, careers and working life? 
  • What do we need to do differently to take account of these changes? 
  • How do we best manage the situation that those teaching and supervising these learners may be from a different generation with differing views? 
  • What impact on our learners’ experience will the exponential rise in technology and social media have? 
  • How can we make best use of technology and social media to improve the learner experience and support wellbeing?

Contact the Commission team directly at wellbeingcommission@hee.nhs.uk.