Nick Bennett, Founder of Fika, discusses how the NHS workforce crisis could be tackled through providing staff with access to appropriate training and development opportunities and how their mental fitness platform, Fika, could help resolve this issue.
There is no escaping the reality of the crisis that continues to face the NHS. Considering both the King’s Fund and the Sir Gordon Messenger’s Leadership report, we know that staff are burnt out or have left, vacancies are increasing, patient waiting time for appointments and ambulances are far beyond safety standards, and leadership training is lacking.
The challenges to delivering a safe, fully staffed service are great, but not insurmountable. Recommendations are forthcoming (e.g. targeted interventions on collaborative leadership) but the practicality of their implementation is not always considered. If we consider those challenges that are deliverable and could have implementable processes, we have the opportunity to immediately support NHS Trusts by:
- Improving staff retention
- Accessing appropriate training and development.
Understanding Staff Retention
It comes as no surprise that, while the NHS views its workforce as a central priority, the King’s Report found stress levels have rapidly increased, with nearly half of staff reporting feeling unwell as a result of work-related stress in the past 12 months. This is to be expected when close to 40 percent of health service workers do not feel there are enough staff within their organisation for them to do their job properly.
This mental health decline in the NHS workforce is causing critical risks in staff performance, absence and retention. Workforce shortages continue to have a direct impact on patient care (including waiting times) and staff experience (performance and burnout). Mental health has overtaken back injuries as the principal cause of sickness absence, costing the NHS £371.2 million annually.
Add to this a below inflation pay raise and pension cuts, and NHS trusts are now faced with the challenge of recruiting staff where known supply issues exist, retaining staff where close to 20% have already said they plan to leave (up to 36% for nurses), and keeping those practitioners that remain in the frontline away from the point of burnout all while providing quality care to patients.
Supporting NHS Trust staff retention
To support Trusts, we could initially focus on staff retention by addressing the burnout pandemic sweeping the health sector. We know 70% of employees are burnt out, which is caused by excessive and prolonged emotional, physical, and mental stress. Developing the skill of stress management can help a person to change their perception about whether stress is useful so that they can begin to use it to their advantage (positive pressure) or to reduce the number of unhelpful stressors in their life before they become overwhelmed (e.g. simplification).
But any solution provided needs to support existing staff to manage stress now while challenges are ongoing and not wait until all the challenges have been overcome. And any solution needs to work as part of ‘business as usual’ so that staff can and will use it without an additional burden on time and resources.
One solution already proven to increase stress management skills is Fika, a digitally-delivered skills platform addressing workforce burnout, retention and resilience by improving stress management, compassionate leadership and psychological safety. Fika’s recently launched micro-training software plugs into a Trust’s existing meeting cadence ensuring high percentage reach in any cohort, providing fully guided, bite-sized training from our experts with no burden on managers. It can also be plugged into existing career pathway journeys.
Accessing appropriate training and development.
The Messenger report made two key observations: that quality leadership can make a significant difference in health and social care but also that the development of quality leadership and management is not adequately embedded in our health and care communities. It is evident that instilling a culture of teamwork, understanding and shared objectives across our care communities will result in better national public health outcomes and indeed better health for the staff delivering those.
It also recommends a new, national entry-level induction for all who join health and social care alongside a new, national mid-career programme for managers across health and social care. We know that these transition points (e.g. entering the NHS workforce or becoming a manager) can pose challenges for people as they adapt and learn their new role.
Any entry level induction needs to deliver a programme beyond the workload to ensure those recruited stay and are provided with right support, in a psychologically safe environment under the guidance of quality leadership. Our own research shows 40% of workers said contact with team and managers and better communication would have improved their onboarding experience.
We also know that less than 50% of leaders are trained in supporting staff with both a systems induction and a people induction. We know that people-related issues are a key reason why staff leave so a greater emphasis on the people side of onboarding must be included.
The key to unlocking a great induction experience is to ensure the managers/leaders delivering it are not only trained in how to deliver it but also why they are delivering it. Knowing why a series of structured one-to-ones are important in building psychologically safety and good connection makes it easier to free up time to schedule and attend them. Similarly, knowing that having a social or ice-breaker meeting with the team in the first week can positively impact retention is a stronger motivator for setting one up.
Building on the existing one-to-one structure already in use in NHS Trusts, a platform to help setup and actively attend guided one-to-one meetings with staff will really help both employees and managers to meet expectations alongside removing barriers they are facing. Similarly planned catch ups with team members and encouraging open conversations will foster stronger team bonds. Fika supports teams to enjoy better meetings, 1:1s, onboarding through fully guided, bite-size training from our experts, with no additional burden on managers.
At Fika we help your leaders, teams and new starters communicate effectively and build a great team culture where staff are happy to stay. Guided onboarding helps your hiring managers avoid retention challenges. By combining positive communication and connection experiences alongside training for leaders and staff in skills such as confidence and focus, new employees are welcomed into a psychologically safe and engaging place to work.
Christina Sothinathan, Fika’s NHS Navigator on the DigitalHealth.London Accelerator and Advanced Practice Physiotherapist, reflects on her experience and recent conversations with the NHS workforce.
Through my experience of working within the NHS, I’ve seen that compassionate leadership and psychological safety are currently lacking across all levels of management. This has led to an influx of exceptionally skilled and highly qualified clinicians moving into non-clinical roles as a result of burnout.
Current or future leaders are not provided with the training they need in how to create compassionate leadership and a psychologically safe culture. This is not only unfair on staff members who are supervised by these leaders or managers but also fails the leaders themselves and indeed the patients.
We know that culture, and problems with leadership can not only impact negatively on staff members leading to poor retention rates and burnout, but also patient safety.
Higher education institutes as well as NHS organisations need to embed all four pillars of advanced practice from the beginning of careers rather than focusing solely on clinical skills. Supporting our current and future workforce in delivering adequate leadership, education and research is key to addressing retention and burnout.
Variability in clinical roles
Job sculpting or portfolio careers which allow a degree of variability can prove useful in improving retention rates and reducing burnout. During my full-time clinical role, I always found it enjoyable partaking in leadership, mentoring and education activities as well as research which also served to improve my strategic and transformational skills. Creating variability within what can be a very demanding role, can be key to retaining staff. For example, I continue to keep up my clinical skills alongside my current role at DigitalHealth.London.
As an NHS Navigator at DigitalHealth.London, I continually strive to improve service delivery within the NHS by always having clinicians and patients at the forefront of my mind when working with Innovators such as Fika. I also continue to seek opportunities outside of my role within systems, regionally and nationally which bring about positive change for the workforce and patients, for example co-chairing the Health Innovation Network MSK Improvement Network and Facilitating HEE Leadership training.
Although digital solutions can go some way in offloading the over-burdened NHS workforce, we know that digital fatigue in healthcare professionals exists particularly when there have been failed attempts at digital transformation with low clinician engagement by senior stakeholders. We know that low accessibility to digital solutions in terms of skills and resources can act as a barrier to change so it is essential to put ‘people before technology’ and engage with clinicians, in order to ensure a co-design approach. More importantly, it’s vital now more than ever, to seek, train and support digital champions who will be pivotal in bringing everyone along the change journey.
I truly believe that modelling compassionate leadership behaviours and creating a psychologically safe space, for example by using an easy-to-use digital platform such as Fika, will go a long way in addressing the NHS’s workforce challenges.
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Fika is part of the sixth cohort of the DigitalHealth.London Accelerator programme. The DigitalHealth.London Accelerator is a collaborative programme funded by London’s three Academic Health Science Networks – UCL Partners, Imperial College Health Partners, and the Health Innovation Network, MedCity, CW+ and receives match funding from the European Regional Development Fund.