Be well, care well

Overview

Be Well Midlands is a collaboration between health and care organisations across the Midlands, working to improve wellbeing services from a health inequalities perspective. The programme works across 11 integrated care systems (ICSs) that include NHS, social care and the voluntary sector.

The programme aimed to understand how: 

• staff experience and reward are impacting the workforce across the system 
• workforce inequalities and morale impact population health 
• creating a positive culture that prioritises staff wellbeing can generate a thriving workforce. 

Staff wellbeing is crucial for population health, and without a workforce that is well, we cannot meet the needs of our communities through providing good health and care. 

Key benefits and outcomes

• Be Well Midlands enabled the design, implementation and learning for other ICSs and working collaboratively increased the opportunity to improve health and wellbeing provision at pace. 
• Ensuring a strong focus on ethnic minority wellbeing support being accessible to BME staff, recognising that BME staff are less likely to access support.
• It brought together the 11 ICSs to share learning, good practice and resources that staff can access to support them to stay well at work.
• Established stronger relationships across ICSs as well as across individual systems.
• Highlighted workforce inequalities and how it is so much more than jobs and careers, it is about flexibility and creating a working environment where people feel supported and healthy.

What the programme faced

Health and wellbeing programmes were introduced by Midlands ICSs in response to the COVID-19 pandemic. The healthcare workforce is still recovering from the pandemic which led to work-related stress, burnout, staff shortages and service pressures. However, wellbeing support for staff is still not accessible and many staff members feel unsupported, as indicated by the NHS staff survey, and the state of adult social care reports.

Although many ICSs have health and wellbeing services in place, there is little evidence to show their accessibility and effectiveness. Population health data for the Midlands reveals that many authorities experience a high level of deprivation, and there is an increased representation of BME colleagues. A needs assessment conducted in 2022/23 indicates that these factors result in additional barriers to work, including caring responsibilities that may impact somebody's ability to work and their health and wellbeing.

However, the health and wellbeing programmes lack an evidence-based approach to ensure their services are effective in meeting the needs of the workforce and population. An evidence-based approach was essential in the Midlands due to the diverse demographics and challenges across the workforce of over 200,000 healthcare employees. 

What the programme did

The Be Well Midlands programme brought the 11 ICSs together to explore ways to make their health and wellbeing services more accessible. One of the key outcomes of the programme was a needs assessment, which involved gathering evidence related to health and wellbeing. The programme also conducted a ‘big conversation’ with all staff across the Midlands to understand how to support them effectively. 

During the ‘big conversation’ the programme engaged more than 1300 colleagues, visited 10 sites and asked over 300 colleagues for their feedback. All diverse colleagues and systems were represented, making it a unique assessment relevant to the workforce. Based on feedback, an analysis of the themes was conducted and mapped against the NHS health and wellbeing framework. This exercise identified several areas that needed attention, including creating a permission culture that enables staff to take time off for their health and wellbeing, role modelling positive wellbeing by leaders and prioritising people before policy by creating a more supportive environment where individual circumstances are heard and understood.

The programme also identified an overarching theme that health and wellbeing must be positioned as a strategic enabler. Therefore, wellness culture, flexibility and adapting a health and wellbeing offer to support local deprivation must be prioritised. The ‘big conversations’ had several impacts, including:

• developing a regional approach to delivering together
• applying health and wellbeing provision that meets population inequalities
• raising health and wellbeing as a strategic enabler
• focusing on multi-facets of wellbeing (e.g. flexible working)
• influencing the wider staff experience agenda.

The Be Well Midlands programme fostered collaboration across health, care and voluntary sectors. Through developing the infrastructure that built trust, support and a collective approach, partners were committed to working together and delivering as a team, across organisational boundaries. As a result, health and wellbeing is now weaved into the wider staff experience agenda, recognising the multifaceted layers of health and wellbeing and how they impact each other.

Results and benefits of the programme

• Be Well Midlands established strong relationships across the system. 
• Facilitated sharing learning and good practice to adapt at system and local levels and sharing that benefits the wider community. 
• Brought wellbeing to the forefront of conversations at system and board meetings.
• Created a space where there is trust and positive relationships.
• Developed a platform of health and wellbeing from a more strategic level and the recommendations from the needs assessment are part of a cultural transformation that places health and wellbeing as a strategic enabler to operational delivery. 
• It supported leadership development programmes such as the Active Bystander programme led by Leicester, Leicestershire and Rutland ICS to challenge behaviours and create a psychological safe culture. 

Overcoming obstacles

Be Well Midlands was fortunate to have engaged and collaborated with leaders who believed in the prorgammes purpose and saw its value. However, time was a challenge, as the benefit of the programme would be seen year on year, and a cultural shift was necessary for a healthy wellbeing environment. Working on a one year financial cycle was a challenge, but the prorgamme continued to strive for success. 

Takeaway tips

• Work together across systems to address common challenges brings greater benefit in sharing learning and resources. Be Well Midlands programme fostered a culture of collaboration rather than competition. 
• It is crucial to prioritise the cultivation of a healthy and engaged workforce. Despite the operational challenged that healthcare faces, neglecting wellbeing of the workforce jeopardises the achievement of your healthcare ambitions.  
• Place health and wellbeing as a strategic enabler to foster a culture of wellbeing. Rather than being reactive, focus on promoting wellness in all actions and initiatives. This will help you create a more holistic approach to health and wellbeing provision. 
• Wellbeing is not an overnight process, but a long-term effort. To establish a culture of wellbeing, take time, step by step and action by action you can work towards a culture where all colleagues are supported to be well to care well.

Explainer webinar

Watch Shajeda Ahmed, chief people officer for the Black Country Integrated Care Board talk about the Be Well Midlands programme as an innovative approach to addressing health and wellbeing for staff. 

Chapters

06:08 - Priorities for supporting staff wellbeing

07:32 - Positioning health and wellbeing as a strategic enabler

10:48 - Impact and collaboration of the programme