How can NHS and healthcare organisations prepare for winter pressures?
Winter pressures have long been a recognised phenomenon in the NHS. Many conditions, particularly those affecting the respiratory system, can be worsened or even caused by seasonal weather, indeed a report by The British Lung Foundation Report, Out in the Cold, found that there are some 80% more lung disease admissions in the months of December, January and February than in the warmer months of spring and summer.
Every winter, healthcare teams get ready to face the intense period ahead, and many hospitals will have an escalation plan for dealing with increased demand. This may include reducing elective activity, redeploying staff to acute areas or opening up additional bed spaces. But this year the situation is particularly challenging.
2022 – pressure doubles up
The COVID-19 pandemic has exacerbated existing issues over the last two years, resulting in many frontline staff feeling under intense pressure. A study carried out by the Royal College of Physicians in January 2022 reported that more than two thirds of doctors had felt overwhelmed at work at least once in a three week period, with just over one fifth stating they had felt overwhelmed almost every day. Similar issues are being experienced by the nursing workforce, with a survey carried out by the Nursing Times showing that almost two thirds of nurses felt that their mental health had deteriorated since the beginning of the pandemic. This level of continued pressure on staff contributes to burnout, psychological distress, increased rates of sickness and challenges with recruitment and retention.
As the NHS moves towards winter in 2022, health officials are predicting a COVID-19 spike alongside a resurgence of flu. The last two winters have seen relatively low levels of flu due to reduced social contact during the pandemic, but now restrictions have been largely lifted, and countries seasonally ahead of the UK such as Australia are already seeing earlier than usual flu spikes.
For many on the frontline, then, morale is low and tensions are high as we head towards the colder months. It might not be possible for senior leaders to significantly reduce demand or create additional acute capacity, so is there anything that healthcare organisations can do to ease the burden this winter? We know that at times of acute pressure, engaging the workforce and focusing on wellbeing is more important than ever, but it’s not an easy task.
Engagement and staff retention
Staff engagement may not directly influence external demands posed on the organisation, but we know that staff who feel engaged in their workplace are less likely to leave. A recent report by the Nuffield Trust for the BBC showed that one in nine nurses had left the NHS in the 12 months preceding June 2022 – a sobering total of 40,000 nursing staff. The recruitment process to replace these nurses is time-consuming and expensive, and if suitable replacement candidates cannot be found, the resulting rota gaps create additional pressure for remaining staff, potentially compromising the quality of patient care.
There are many factors at play here, and there are a number of levels of intervention that can be deployed to improve wellbeing at work. But fundamentally it is vital for managers to visibly listen to staff, to find out what they need and what would make them happier in the workplace. The reality, however, is that it can be extremely hard for leaders to engage each and every staff member face-to-face, especially when things are operationally very busy. How do you catch the staff who work nights, or other groups such as porters who might be hard to locate during their shifts as their work takes them all over the hospital, or indeed remote workers based in the community?
Staff engagement – the evidence
There is plenty of evidence to support the importance of staff engagement in running a successful, safe and stable organisation. High engagement healthcare organisations provide a demonstrably better service to patients, with higher levels of patient satisfaction and lower mortality rates, alongside improved financial stability. Organisations where staff feel engaged also show increased productivity and profitability and decreased absenteeism and patient incidents.
A King’s Fund report published in 2020, The Courage of Compassion, tells us that by providing staff with autonomy, a sense of belonging and the ability to contribute to improvements in their workplace, we can improve their experience of work and thus their level of engagement with the organisation. It may seem simplistic, but engaged staff are more committed to their work and therefore more likely to do a good job. And that engagement can start small but reap big rewards.
ImproveWell and staff experience
At ImproveWell, we firmly believe that small changes can trigger a ripple effect. By giving staff a voice, and providing a platform to make suggestions about how their workplace can be improved, organisations can involve the whole team in Quality Improvement.
Our experience working with many different healthcare organisations has shown us that the staff on the front-line are most often the ones who can unlock improvement solutions. During the busiest months of the year, the ImproveWell platform gives these staff the ability to offer real-time feedback at the touch of a button.
Organisations under pressure
During the early stages of the pandemic, we worked with surge hospitals in both London and Wales on their staff engagement, continuous improvement and rapid learning programmes. At both the NHS Nightingale Hospital London and the Dragon’s Heart Hospital in Cardiff, processes and systems were having to be set up very quickly, in uniquely difficult conditions with as little close contact as possible between staff.
At the Dragon’s Heart Hospital, a total of 208 improvement ideas were generated within just seven weeks of using ImproveWell, all of which were actioned through the improvement pipeline. At the Nightingale, leaders were able to garner real-time feedback on the morale and wellbeing of staff, via the ImproveWell app, during a very challenging time.
The ImproveWell solution enables staff to offer improvement ideas or feedback on how their working day has gone. This can be done at any time of the day or night and from anywhere, meaning that shift workers and staff working in remote areas are not excluded from the process.
When we started working with the maternity service at Royal Cornwall Hospitals NHS Trust in 2018, they were under a different kind of pressure, following a period of intense scrutiny, highly critical external reports and negative Care Quality Commission ratings. A successful pilot was followed by a two-year engagement project with ImproveWell. This resulted in the generation of a huge number of improvement ideas. This work also had a demonstrably positive impact on staff morale, sickness and absence rates, staff surveys and patient experience. This all contributed to improvements in service quality and the reputation of the unit locally and nationally, as evidenced in a report by the South West Academic Health Science Network.
Staff engagement and winter pressures
Our experience with partners around the world has shown us that in difficult times, staff engagement becomes even more important. Encouraging input from staff on improvement projects, and staff wellbeing should be a primary focus when staff are at risk of burnout from operational pressures. To find out more about how ImproveWell can help, or to book a demo, don’t hesitate to get in touch.
