Get your board onboard to improve staff experience

• Integrate staff experience into wider trust strategies so it is considered, supported, and championed at a strategic level. 
• Review how your local workforce strategy aligns with national priorities from the NHS Long Term Workforce Plan and the NHS England Our NHS People Promise. 
• Identify specific areas where local initiatives can support national goals.
• Highlight successful local programs that exemplify national priorities.
• Ensure continuous alignment by regularly updating your strategy to reflect changes in national policies and priorities.

• Identify key interests of various senior leaders.
• Tailor your approach to highlight how your initiative aligns with the priorities of each specific senior leader. 
• Align staff experience initiatives with their priorities.
• Collaborate with divisions and directorates to ensure that both corporate and local strategic objectives are supported, promoting a whole system and holistic approach.
• Workforce leaders are generally receptive, but others may need a stronger case presented in different ways.

• Show how improved health and wellbeing support can reduce absence levels, resonating with the chief people officer and HR director.
• Show the finance director how your strategy can lower agency costs.
• Use your organisation's data to evidence lived staff experience. 
• Build a strong evidence base by maintaining regular, ongoing evaluation. 
• Use national and local staff survey data, statistics and facts to support your case for health and wellbeing in improving staff experience and patient-related outcomes. 

• Ensure messages to senior leaders are clear and impactful. 
• Be clear about what you want to achieve in your strategy. 

• Celebrate good work by ensuring wins are communicated to senior leaders with plans on how to maximise them in the future.  
• Share evaluation outcomes and feedback from staff on how the initiative has improved staff experience and helped staff deliver their work. 
• Show how your strategy or initiative has tackled and overcome previously outlined areas of concern. 

Key responsibilities

• Provides independent oversight and accountability of board-level decision-making and how the organisation is run.
• Has expert experience (financial, legal, clinical, etc) in healthcare and other sectors.
• A senior non-executive director ensures the board meets its obligations and has significant accountability in several key areas, including health and wellbeing and the Freedom to Speak Up Guardians.

Topics, facts and stats to engage this leader

Poor staff health and wellbeing poses a risk to our NHS workforce and patients.

• In the 2023 NHS Staff Survey a significant portion of NHS staff continue to believe that their health and wellbeing impact patient care. 
• A study from NHS Providers said 92 per cent of NHS trusts are concerned about staff wellbeing, stress and burnout following the pandemic.
• In the 2023 NHS Staff Survey 30 per cent of staff reported feeling burned out because of their work and 34 per cent found it emotionally exhausting.
• The Francis Inquiry into Mid Staffordshire NHS Foundation Trust revealed the fatal impact of disconnected and detached staff with poor mental wellbeing and a lack of empathy and emotion.

Leaders play a key role in improving the health and wellbeing of our NHS staff.

• This CIPD report shows less than a third of respondents in the public sector agree that senior leaders encourage a focus on mental health through their actions and behaviour.
• In the 2023 Staff Survey 25.8 per cent of NHS staff reported experiencing bullying over 12 months, with 10.7 per cent of staff experiencing bullying and/or harassment at work from managers and 18 per cent from other colleagues - 2023 NHS staff survey). 
• In the 2023 Staff Survey 55 per cent of NHS staff said they looked forward to going to work.
   

Managers face barriers to prioritising the health and wellbeing of their staff.

The report ‘Mental Health at Work 2019: Time to Take Ownership by Business in the Community (BITC)'  highlights several key findings:

• 62 per cent of managers have had to put the interests of their organisation above staff wellbeing either sometimes, regularly or every day. 
• 70 per cent of managers say there are barriers to providing mental health support.
• The guidance published by Keeping Well highlights that 41 per cent of employees experiencing a mental health problem reported that no changes or actions were taken in the workplace.

What this leader wants to know

Key points from the NHS People Plan including:

• Current priorities: alignment with workforce and long-term sustainability, considering that most NHS organisations are not starting from a place of zero and already have strategies, plans, and governance in place.
• Gain opportunities to build relationships with key stakeholders, such as heads of service and divisional leads, to foster collaboration, align with strategic objectives, and enhance initiatives for staff experience and patient care.
• Mitigation of risk and threats to workforce and patients.
• Alignment of organisational values: do they prioritise staff experience?
• Is the organisation meeting legal standards and compliance?
• Is the current health and wellbeing strategy effective in achieving its goals?

Key responsibilities

• Sets the strategic vision and direction for the organisation in the short, medium and long term.
• Responsible for performance and quality of service provision, as well as financial and corporate viability. Leads by example to inspire the workforce to deliver and perform.

Topics, facts and stats to engage this leader

Poor mental health affects a significant proportion of the workforce.

• As many as one in four UK workers with poor mental health struggle in silence.
• The CIPD report on employee health and wellbeing reveals that only two-thirds (69% of respondents indicated that senior leaders have employee wellbeing on their agenda.
• Like burnout, compassion fatigue has serious implications for the wellbeing of practitioners and patients.

Positive staff health and wellbeing improves organisational outcomes.

• Research from the Social Science Research Network (SSRN) highlights the relationship between employee wellbeing, employee productivity and profitability. 
• The research article “Five-year workplace wellness intervention in the NHS” published in Perspectives in Public Health presents the findings of a five-year workplace wellness intervention within the NHS, focusing on long-term workplace wellness interventions in trusts resulted in improvements in staff health behaviours, job satisfaction, organisational commitment, and reductions in sickness absence.
• The study conducted by The Work Foundation explores how investing in prevention and self-management can help organisations lower the likelihood of absence due to injury, both in and out of work.  This approach not only improves employee wellbeing but also contributes to better patient care and enhanced productivity.

Poor staff health and wellbeing relates to poorer outcomes for patients.

• This article published on PLOS.One highlights the significant association between staff burnout and patient safety.
• The article published on PubMed Central (PMC) emphasises the association between staff and patient experience. Exploring the experiences of staff may provide insights into factors that negatively impact patient experience. 
• The Francis Inquiry into Mid Staffordshire NHS Foundation Trust revealed the fatal impact of disconnected and detached staff with poor mental wellbeing and a lack of empathy and emotion.
• The article in the  Journal of Compassionate Health Care examines how stress among NHS staff leads to defensive inward-focusing and a loss of connection with colleagues.  Schwartz Rounds, which are structured meetings to discuss the emotional and social aspects of work, can mitigate this by increasing interconnectivity and compassion, ultimately improving patient experience.
• The NHS patient safety strategy published by NHS England describes how organisation-led staff health and wellbeing schemes improve safety, efficiency and patient experience. 

What this leader wants to know

• The connection between staff experience and patient outcomes.
• How staff experience affects organisational performance.
• The role of health and wellbeing in long-term workforce supply and staff retention.
• How staff experience contributes to the trust’s long-term viability.
• The return on investment from staff health and wellbeing initiatives.
• Alignment with national priorities such as making the NHS the best place to work.

Key responsibilities

• Act as a critical health and wellbeing friend to the board.
• Challenge the board to place wellbeing at the heart of all that they do.
• Prompts and holds the board to account for undertaking improvement work as required to improve the wellbeing of employees and therefore achieve better patient care outcomes.

Topics, facts and stats to engage this leader

Staff wellbeing and mental health

• Data on staff wellbeing, including stress levels, mental health issues, and overall job satisfaction.

Impact on patient care

• Staff wellbeing directly impacts patient care outcomes; healthier staff are more likely to deliver higher quality care, leading to improved patient satisfaction and safety.

Workplace culture and environment

• The need for a supportive and inclusive workplace culture, including sharing insights on how a positive environment can enhance staff morale and reduce turnover.

National health priorities and policies

• Wellbeing initiatives with national health priorities, such as those outlined in the NHS People Plan.

Benchmarking and performance metrics

• Data from NHS Staff Surveys and other benchmarking tools to identify areas for improvement and track progress.

What this leader wants to know

• Current wellbeing data - statistics on staff wellbeing (stress levels, mental health issues, absenteeism, turnover rates).
• Feedback from staff - Insights from staff surveys and feedback mechanisms.
• Impact on patient care - evidence of correlation between staff wellbeing and patient care outcomes.
• Existing wellbeing programmes - information on current wellbeing initiatives and their effectiveness.
• Financial implications - analysis of the financial impact of staff wellbeing.
• Case studies and examples of successful wellbeing initiatives from the NHS or other organisations.

The NHS People Plan by NHS England mandates that every NHS employer appoints a health and wellbeing guardian. NHS Employers, on behalf of NHS England, has two resources to support these guardians in their roles.

• Wellbeing guardian on the board: explains how your board members can work with and support the wellbeing guardian to create a culture of wellbeing guidance.

• Wellbeing guardian poster: outlines the role of wellbeing guardian and how it can link to wider roles of NHS boards.

  * Please note that when these documents were first published in 2022, the role was referred to as “wellbeing guardian.”. As of October 2023, the role has been renamed to “health and wellbeing guardian”.

Key responsibilities

• Responsible for strategic financial, economic, and fiscal leadership, as well as providing advice to the trust board on matters of financial governance.

Topics, facts and stats to engage this leader

Poor staff health and wellbeing costs the NHS a significant amount of money.

• The report published by Health Education England details cost of poor mental health in the NHS equates to £1,794- £2,174 per employee per year.
• The guidance report published by NHS England highlights the overall cost of sickness absence is estimated at £2.4 billion. Reducing sickness absence by one day per person per year could result in a financial saving of £150 million, equivalent to 6,000 full time staff.
• The report published by Monitor Deloitte explores the cost of mental health issues to employers, the return on investment from mental health interventions and various studies suggesting the presenteeism is increasing year on year, with costs ranging from £17bn to £26 billion.
• The study published in the BMJ indicates that female doctors have a significantly higher risk of suicide than the female general population.

Investing in effective staff health and wellbeing interventions offers a return on investment.

• The report published by Health Education England details that the return on investment in workplace mental health interventions is £4.20 for every pound spent.

Positive staff health and wellbeing improves productivity

• Research conducted by the University of Oxford and the London School of Economics on employee wellbeing and productivity indicates that health and happy staff significantly improve employee productivity and profitability.

What this leader wants to know

• What are the long-term financial gains of investing in staff health and wellbeing?
• What is the cost-benefit analysis of investing in health and wellbeing interventions?
• How can we maximise the return on investment of health and wellbeing interventions? 
• Why should the financial wellbeing of our staff be prioritised? 
• What impact does poor staff health and wellbeing have on our financial position?

Key responsibilities

• Provides medical leadership and management of the services delivered by doctors and medical workforce-related issues.
• Responsible for leading management of medical staff, ensuring they deliver safe, effective, and high-quality care to patients.
• Responsible for ensuring the trust delivers its clinical targets.

Topics, facts and stats to engage this leader

Doctors and doctors in training are at-risk groups susceptible to burnout, suicide and mental ill health.

• The study published in the BMJ Open indicates doctors are at considerable risk of work-related stress and mental health problems such as depression and anxiety compared to the general population.
• The report published by Health Education England indicates the rates of depression among training graduate doctors are estimated at about 30 per cent.
• The report published by the British Journal of General Practice  indicates that the risk of suicide is particularly high among general practitioners, psychiatrists, and trainees compared to the general population. Female doctors, in particular, have suicide rates estimated to be 2.5 to 4 times higher than the general population.
• The 2023 Staff Survey revealed that staff in clinical roles were more likely to report burnout with particularly high rates observed among those in ambulance roles.

Doctors are unlikely to disclose poor mental wellbeing at work.

• The report published by Health Education England indicates that a survey 3,500 doctors showed that 73 per cent would prefer to disclose mental ill health to family or friends rather than a healthcare professional.
• The report from the General Medical Council indicates that18 per cent of doctors considered leaving the profession in 2021, up from 12 per cent in 2019.

What this leader wants to know

• How does the health and wellbeing of doctors affect our patients’ clinical outcomes: patient safety, experience, and care? 
• How can positive health and wellbeing improve the quality of medical services being delivered? 
• How does health and wellbeing improve the productivity of doctors and medical staff? 
• Why should we focus on the health and wellbeing of doctors in particular?

Key responsibilities

• Provides nursing leadership and management of nursing workforce-related issues and the services delivered by nurses.
• Responsible for ensuring the organisation delivers its clinical targets. 
• Responsible for leading effective management of nursing staff, ensuring they deliver safe, effective, and high-quality care to patients.

Topics, facts and stats to engage this leader

Nurses are an at-risk group for unhealthy lifestyle behaviours.

• In the article published on Europe PMC it was highlighted that through a cross sectional questionnaire survey, more than half of the nurses surveyed did not meet public health recommendations for physical activity, indicating a need for intervention to establish healthy lifestyle behaviours early on in their career.
• The article in Nurse Education Today emphasises that promoting physical activity among student nurses significantly enhances their wellbeing, boosting self-esteem and life satisfaction while also reducing the risk of anxiety and depression.

Impact of shift working on nurse health and wellbeing.

• The article published on NurseJournal.org highlights that nurses who work twelve hour shifts are two and half times more likely to experience symptoms of nurse burnout than those working shorter shifts.
• According to a study published by the Journal of Sleep Research being awake for 16–18 hours can impair reaction times as much as having one alcoholic drink.
• In the 2023 Staff Survey, 34 per cent of nurses and midwives reported that they often or always felt burned out from their work. 

Poor health and wellbeing affect patient care.

• This article published on PLOS.One highlights a clear association between staff burnout and patient safety.
• The article published in BMJ Open that fatigue and sleep deprivation affect error rates, quality of care and personal safety.
• The report titled NHS Health and Wellbeing Framework: strategic overview, published by NHS England, indicates that patient satisfaction in acute trusts is higher in those where staff health and wellbeing(measured by injury rates, stress levels, job satisfaction and turnover intentions) is better.
• The article published by The Conversation highlights a culture of self-sacrifice in nursing where self-sacrifice has been seen as a sign of the ‘ideal nurse’ and burnout is viewed as an inevitable consequence of caring.

What this leader wants to know

• How does positive health and wellbeing enable retention in nurses? 
• Why should we focus on the health and wellbeing of nurses in particular? 
• How can health and wellbeing make our organisation a more attractive employer for nurses?

Key responsibilities

• Responsible for the development and strategic planning of a workforce that has the capacity and capability to meet the trust’s vision, values, and objectives to deliver high-quality services now and in the future.
• Responsible for ensuring a well-motivated, highly, and appropriately skilled, high-performing workforce, as well as making sure capabilities of the workforce are aligned to strategic direction and needs of the organisation.

Topics, facts and stats to engage this leader

Poor staff health and wellbeing contributes to staff turnover and presenteeism.

• The article published by Social Science Research Network (SSRN) highlights that poor staff health and wellbeing decrease employee satisfaction and increases staff turnover.
• The report published by Health Education England indicates that employees may leave their employer if they feel unable to work due to the impact of poor mental health, with the cost of staff turnover estimated at eight billion. Additionally, the report reveals that one in two staff members have attended work despite feeling unwell due to pressure from their manager, colleagues, or themselves.
• In a survey conducted by NHS Charities Together Over two in three (69 per cent) NHS staff say morale is the lowest they have ever experienced

Work-related stress impacts significantly on staff health and wellbeing.

• The report published by Health Education England indicates that one in three of NHS workforces have felt unwell due to work-related stress.
• The survey report from CIPD highlights the top three causes of stress-related absence are high workload (62 per cent), management style (43 per cent) and relationships at work (30 per cent).
• In the 2023 Staff Survey, 48 per cent of NHS staff reported that relationships at work are strained.
• In the 2023 Staff Survey, 42 per cent of NHS staff indicated they have felt unwell due to work-related stress in the last twelve months.
• In a survey conducted by NHS Charities Together three in four (76 per cent) NHS staff have experienced a mental health condition in the last year and two in five (42 per cent) NHS staff said they have experienced exhaustion.

Line managers feel uncomfortable or ill-equipped to address mental health at work.

The report Mental Health at Work 2019: Time to Take Ownership by Business in the Community (BITC) highlights several key findings:

• 51 per cent of line managers feel comfortable talking about mental health issues in the workplace.
• 11 per cent of managers in the UK have received training on understanding workplace stressors.
• In the 2023 Staff Survey, 71 per cent of NHS staff felt their manager takes a positive interest in their health and wellbeing.

What this leader wants to know

• How does health and wellbeing enable a motivated, productive, resilient, and high-performing workforce?
• Why is it important to embed a workplace culture that prioritises staff health and wellbeing?
• How can health and wellbeing make our organisation an attractive employer and boost recruitment?
• How can health and wellbeing initiatives improve staff experience and retention?

Key responsibilities

• Responsible for leading the operational delivery to ensure the trust delivers high-quality and patient-centred services. Plays a central role in improving services, developing, and maintaining effective relationships with key stakeholders.
• Ensures high-quality, cost-effective services that are innovative and responsive to the needs of patients.

Topics, facts and stats to engage this leader

Staff health and wellbeing affects patient safety and increases the risk of a never event.

• This article published on PLOS.One highlights that poor staff wellbeing correlates to worse patient safety.
• The NHS England publication titled “Looking after your team’s health and wellbeing guide” emphasises that organisation-led staff health and wellbeing schemes improve safety, efficiency and patient experience.

Staff health and wellbeing affects patient experience and quality of care.

• The report by the Royal College of Physicians (RCP) highlights that good staff health, wellbeing and engagement can lead to improvements in patient experience of care, increased productivity and reduced use of agency staff.
• The Francis Inquiry into Mid Staffordshire NHS Foundation Trust, where patients died because of neglect, revealed the fatal impact of disconnected and detached staff with poor mental wellbeing and a lack of empathy and emotion.
• The article in the  Journal of Compassionate Health Care highlights how Schwartz Rounds significantly increased feelings of interconnectivity and compassion among NHS staff, fostering a supportive environment leading to improvements in patient experience.

Staff health and wellbeing affects sickness absence and staffing levels.

• The independent review Thriving at Work: the Stevenson/Farmer review on mental health and employers emphasise how staff experience is associated with sickness absence rates, spending on agency staff and staffing levels.
• The report published by the Enterprise Research Centre (ERC) examines the rise of presenteeism, with studies suggesting that it is increasing year on year. The cost of presenteeism is estimated between £17 billion to £26 billion.

What this leader wants to know

• How does staff health and wellbeing relate to patient experience, safety, and care?
• How can health and wellbeing enable a high-performing and productive workforce that delivers a high-quality service?
• How does the experience of our staff impact the long-term viability of the services we provide?
• How does health and wellbeing of the workforce enable us to meet our targets?