Table 6 Recommendations for how employers should support and care for their healthcare staff

Core principles

1

There is no health without mental health

2

The mental health of their staff is the core concern of all healthcare employers because the quality of care for patients depends on having healthy and effective staff. Employers and staff should champion actions that help to support the wellbeing, psychosocial care, and mental healthcare of staff. Clinical errors are reduced in such an environment

Practical actions by employers

3

Healthcare employers should:

a. Offer an accessible, stepped programme of wellbeing, psychosocial and mental health care for all staff who need it consisting of:

 i. Defined, universal and continuing support for staff wellbeing that is integral to job plans and the way in which organisations manage staff and conduct governance

 ii. Psychosocial interventions that are readily available, without referral, for staff who are struggling

 iii. Specialist mental health assessments and treatments that are available for staff who need them that enable staff to be referred rapidly for assessment and treatment when necessary

b. Recognise the importance of secondary stressors (e.g., long commutes to and from work-bases when fatigued, unsatisfactory accommodation, and poor access to showers and hot food) and act to reduce them to a minimum

c. Recognise the moral struggles that staff may experience in demanding situations and provide the help they may need to cope with the ethical challenges in their work

d. Enable departments to create peer support programmes and employing trained mental health practitioners to offer supervision and support for peer supporters

e. Integrate these arrangements into processes of workforce and workplace development, and emergency planning and preparedness

Teams and leadership

4

Working in teams is integral to delivering high quality care for patients and promoting the mental health of staff

a. This means that employers and senior staff should work to ensure all team members:

 i. Feel connected and supported by their colleagues

 ii. Have a buddy of their choosing

 iii. Work within teams that have stable relationships

 iv. Have well-functioning communications

v. Are well-trained

b. Where and when possible, team development should be supported by co-location of members, alignment of work schedules and enable team members to express their views about their preferences about with whom they work

c. Employers and senior staff should recognise that teams are not merely groups of people but have shared identities. This requires substantial planning, preparedness, training, and support

d. Working jointly in situations that need the combined and coordinated work of several agencies is often required of organisations that respond to incidents. Often, teams are composed of people from a range of agencies, each having its own structure and culture. This requires staff in emergency medicine and related specialties to work in effective ways across not only disciplinary but also organisational cultures. Training should enable staff to work harmoniously and effectively with staff in partner agencies

e. Working in situations that require the combined and coordinated work of several agencies is often required of organisations that respond to incidents. Often, teams are composed of people from a range of agencies, each having its own structure and culture. This requires staff in emergency medicine and related specialties to work in effective ways across not only disciplinary but also organisational cultures. Training should enable staff to work harmoniously and effectively with staff in partner agencies

f. Teams should be well-led by people who are selected for having appropriate skills and receive continuing support and training

g. Leaders should be selected and trained in the process of emergency planning and preparedness

Emergency planning and preparedness

5

a. Psychosocial care should be regarded as an essential part of emergency responses and recovery and, therefore, must be an equal consideration in planning. The process should include experienced planners, people with experience of working across agency boundaries and mental health specialists in advisory structures at all levels

b. Psychosocial care should be regarded as an essential part of emergency responses and recovery and, therefore, must be an equal consideration in planning. The process should include experienced planners, people with experience of working across agency boundaries and mental health specialists in advisory structures at all levels

c. Horizon scanning, assessment, and surveillance are tools to try to predict when unusual demands may occur that are likely to tax emergency planning and preparedness and frontline staff. Their use must extend to the potential psychosocial and mental health impacts of events on staff to enable their preparation to meet unusual demands

d. Training in the requirements of the emergency plan should focus on the process of emergency planning rather than the exact nature of plans. Processes identified in every emergency plan must be rehearsed and tested in realistic exercises with people in key positions in host and partner organisations to enable them to build relationships and develop experience of effective engagement and interoperability