MPs investigated the toll of burnout and excessive workload on the mental wellbeing of NHS and care staff. Dean asked questions and heard from frontline workers on how working during the pandemic has affected their mental health as well as from BMA Chair Dr Chaand Nagpaul on the medical workforce and Vic Rayner, National Care Forum, on social care.
The session also focused on assessing current measures to support staff mental health, including those in the NHS People Plan, and identifying positive measures, hearing insights from practitioners and senior leaders of mental health care services such as Mind and Practitioner Health, an NHS service for its staff.
Dr Chaand Nagpaul CBE, BMA council chair
Denise Crouch, Macmillan Lead Cancer Nurse
Paul Farmer CBE, Chief Executive Officer, Mind
Dr Adrian James, President, Royal College of Psychiatrists
Professor Dame Clare Gerada, Medical Director, Practitioner Health
Vic Rayner, Executive Director, National Care Forum
Dean Russell Q1: My questions relate to the emotional burnout for staff. People often talk about fatigue. It has been an incredibly long year for our incredible NHS and social care staff; they are tired, fatigued physically and mentally but also emotionally. What is the wraparound support over the next few months that you see to help them get through both the second lockdown and what might come afterwards in terms of tiered systems?
Paul Farmer: I do not think there is any doubt that the mental health consequences of Covid are almost certainly going to last a considerably longer time than the physical health consequences for many people. It is important that the approach that is taken takes a long-term view because there are short, medium and long-term issues that people will be facing.
In the first instance, it is important for people to have permission to seek help. You have heard a lot from other witnesses about workload, job control and so on and so forth. Those are really important elements. Permission to seek help is going to be key. Other witnesses have also highlighted the importance of clarity about future workforce arrangements. That is important. At a granular, individual level, can we answer, “Does every single employee of the NHS, and indeed people who are subcontracted by the NHS, and every employee of the social care system, know where they can go to get help?” I wonder whether everybody really does. That is the first thing.
The second thing is that managers and supervisors, in whichever context we are talking about, have the tools to be able to spot the signs when somebody is struggling. You have heard from other witnesses that many NHS and social care staff have extraordinary levels of resilience. A lot of people thrive on the situations that they face on a daily basis, but everybody has their limit. Does everybody know where their individual limits are? Are supervisors and line managers able to spot the signs of the person in their team who may be struggling? Perhaps they become a bit less social. Perhaps the consequence of the digital space is that you have your Zoom face but you do not necessarily show your real face. That is the second question.
The third question, systematically, is, “Does each employer have the right set of metrics in place to understand the quality of wellbeing of their staff at this particular time?” Do we know, from pulse surveys or whatever it might be, how people are feeling, and what additional tools we might need to put in place to support them? We work with many employers across public, private and voluntary sectors. We have seen many employers step up to the mark in the last few months.
Finally, is there a clear pathway for access to clinical care? Does everybody know where Clare’s service is, if they are eligible for that? If you are not eligible for Clare’s service, where do you go for clinical help and support from the rest of the NHS.
Dean Russell Q2: One of the things we raised as a Committee with Claire Murdoch previously was about support for NHS and social care workers’ families and helping them provide guidance. They may well be spotting the signs in their mothers, wives, husbands and sons and so on. What guidance is being given to those families? With regard to those four points, I appreciate that it is a much lengthier time than we have in the Committee, but are the questions you have just raised being addressed?
Paul Farmer: On your question about families, there is a wider issue, which is the very significant surge that we are seeing in demand for our services from across the public. That is happening at the moment. Shout, the Crisis Text Line service, who are our partners in this, have seen a doubling of contacts in the last three weeks. Our Mind infoline saw a doubling of calls in the last two weeks. That is everyone—friends and family of people working in the NHS and beyond. I think it is important. We have seen services expanding their offer in companies to family members. It would be great if some of the services that are offered through the NHS—some of the apps that have been put online and others—were extended to family members of people who work in the NHS. I am particularly concerned about the social care area.