Written evidence submitted by Kevin Daniels, Sara Connolly, Ritchie Woodard, Chris van Stolk, Jana Patey, Kevin Fong, Rachel France, Carol Vigurs and Mike Herd
NHS data on staff wellbeing shows that:
- Mental health is deteriorating with 47% of NHS staff reporting feeling unwell as a result of work-related stress in the twelve months to November 2021.
- The overall sickness absence rate for NHS staff in England has increased to 5.7% in October 2021 and 54% of staff (up from 46% in 2020) reported going to work in the previous three months despite feeling not well enough to perform their duties (presenteeism).
- Data collected during the pandemic showed high levels of symptoms of post-traumatic stress disorder (PTSD) among ICU staff (40%), nurses and midwives (between 29% and 45% depending when the measures were taken).
- 57% of healthcare workers said they were thinking of quitting, with the most common reason being the impact work is having on mental health.
- High staff vacancy and turnover rates.
We estimated the costs to the NHS of poor staff wellbeing using NHS data. This showed that:
- The NHS in England spends £6.20 billion a year on bank/agency staff.
- Staff absences in England equate to 19,570,137 full-time equivalent days lost per year, or 15 days per staff member.
- Stress and poor mental health are the main factors leading to sickness absence.
- Poor mental health and wellbeing costs
the NHS an estimated £12.1 billion a year (estimated cost of presenteeism £6.07 billion, staff absence £3.79 billion, and cost of the use of bank/agency staff £2.24 billion).
- By tackling poor mental health and wellbeing and reducing people voluntarily leaving the NHS could save up to £1 billion under some of the scenarios modelled.
There are robust scientific studies that have established organisational and management factors as causes of wellbeing and there is evidence from other sectors that changing how work is organised, scheduled, performed and/or managed improves staff wellbeing.
We undertook a rapid systematic evidence review of organisational and management interventions which had been tried in the NHS reviewing studies published from 2010 onwards. We also assessed the cost-effectiveness of the interventions we found where we could find robust information to do so. We identified twelve studies of relevant interventions undertaken in the NHS: two were focused on systemic change, three on changing aspects to the psychosocial work environment, two on providing forms of workplace support, one on changes to how working schedules (shifts) were managed, two were focused on making changes to the physical workplace environment, one on automation and one on virtual/home- based working. Two out of twelve were concerned with responses to Covid-19 (one on changes to the physical environment and one on the introduction of virtual/home-based working).
- Actions focused on systemic/culture change, how working schedules are managed and improving aspects of the working environment have positive effects on staff wellbeing.
- Actions focused on improving social support, automating processes and virtual working also have positive effects, at least for some people. Actions focused on improving the psychosocial work environment were less likely to result in improved wellbeing.
- Several of these actions have some evidence on cost-effectiveness and suggest a positive return of £2 per £1 on the initial investment made.
Investing in staff wellbeing could enhance productivity and value for money. Change is affordable because of the longer- term returns achieved.
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