Staff Wellbeing: Innovative partnerships to enable staff to care well under pressure and thrive at work

Background: Current staff shortages and high rates of psychological ill-health in the health and social care (H&SC) workforce support the need for radical changes to create healthy workplaces where staff can flourish. Previous work suggests a focus on individuals is obscuring the need for system wide multi-strand culture change interventions. These need to include supportive interventions and preventative proactive measures with embedded monitoring and evaluation.

Aims:

• To work in partnership with 5 integrated care systems (ICSs) in 4 regions to change unhealthy workplaces, creating healthy ones where staff can flourish.

• Using realist methods, we will determine how multi-strand culture change interventions work (e.g. the levers required and mechanisms they trigger), in which contexts and for which staff.

• To leave a legacy of how to create healthy workplaces where staff can thrive, including capacity building in skills and knowledge for design and evaluation of interventions. Methods and setting:

Mixed methods realist informed research across 4 health and care regions in England; Surrey, Devon, NW London, and S Yorkshire. Identified gaps in knowledge will be prioritised in the first 24 months in 5 linked work packages (WP); to inform how healthy workplace interventions can be developed and evaluated in the final 3-years, including identifying the system levers to ensure sustainability.

WP1: Knowledge mobilisation and building system capacity: work to develop research and evaluation capacity and understand how best way to co-create and share learning across the workforce/nationally.

WP2: Forgotten staff: to analyse surveys and interview staff (in 5 ICSs) to better understand staff wellbeing needs of forgotten staff (including those seldom heard or previously excluded, e.g. marginalised/less visible roles).

WP3: Scoping international/new ideas/good practice: to review published reports and studies for healthy workplace initiatives, including outside UK and in other industries/ professions.

WP4: Workforce data metrics and linkage: to identify local/national databases containing NHS staff workforce and wellbeing data and explore how to link the data to better understand the effects of work on staff wellbeing.

WP5: Economic evaluation of staff wellbeing initiatives: to develop a framework to help employers assess the relative costs/benefits of different healthy workplace initiatives.

Co-design: Evidence from WPs1-5 will be shared for debate, advice and input with our CIE and ICS groups and other stakeholders throughout all WPs and bought together at a workshop at 18 months. Co-design principles will be used to develop 1-2 multi-strand culture change interventions for the final 3-5-years.

Team: Our H&SC partnerships are extensive, and we are a uniquely well-placed team. We have extensive subject expertise, realist, statistical, implementation science, co-production/design, EDI, patient and staff involvement and health economics expertise, with substantial real-world evaluation experience in H&SC settings.

Anticipated impact and dissemination: Our dissemination plan is ambitious, accessible, and novel (animation; guides, films) as well as traditional (academic papers, conferences, and events). Our partnership will have impact through evaluation of culture change in real-world ICS partnerships, leaving a strong legacy of knowledge and learning, including capacity building in skills and knowledge for intervention design and evaluation.