With all the talk of vaccine success, falling case rates and a roadmap to normality, you could be forgiven for thinking the light at the end of the COVID-19 tunnel is shining bright. However, for those in primary care, this ‘end’ of the pandemic is likely to usher in another wave of pressures – pent up demand, a backlog of delayed referrals, and a potentially large cohort of newly at-risk people because of economic pressures and expected ongoing rise in unemployment.
This, in turn, means there’s no rest in sight for GP practice staff – making the need to manage the wellbeing of staff, not to mention yourself, as acute as ever.
A strong consensus exists among mental health professionals, as we emerge from the darkest days of the pandemic, that it has never been more important to shift away from the managing mental illness towards proactively looking after mental wellbeing. This is an approach the BMA agrees with, recognising that it may take some time for staff to realise the impact of the COVID-19 crisis on their mental wellbeing.
As we enter the next period, there needs to be a broader focus on preventive actions and measures designed to keep individuals, families and communities well. It will be important to recognise the distinctive needs of our colleagues who already had mental wellbeing difficulties pre-COVID-19 (approximately 20-25% of the population every year), as well as a ‘new’ cohort who find themselves unexpectedly at risk as the pandemic’s broader psycho-social-economic impacts begin to bite.
Warning signs to look out for, according to the Intensive Care Society, include:
|Phases||Issues and likely impact||Needs and recommended approach|
|End Phase: Immediate aftermath
|Exhaustion and post trauma recovery / stress||Debriefing.
Staff 1-1 and group sessions.
Learning and preparation for the future.
Organise thanks and reward. Look out for signs of PTSD in staff:
• on edge and hyper arousal, poor sleep
• flashbacks or re-experiencing
• avoidance of reminders
|Long term||Some ongoing PTSD
Reflection and learning
With the above in mind, what practical, proactive steps can practice managers take to promote wellbeing in the post-COVID-19 world? Practice Index asked a number of PMs for their suggestions:
Encourage people to talk
Our colleagues may well be dealing with partners who are facing redundancy, role changes, or permanent changes to working locations/patterns, for example. Or they may be struggling with the loss of loved ones. As such, it will be important to consider the effects of these dynamics on their performance and work life. “The key for me is to be available, be discreet and be sympathetic. Often just letting people talk is all it takes to resolve a situation as there’s nothing more damaging than bottling problems up,” one PM told us. “We try create a sense of individual and collective agency at our practice – this workplace culture is vital – as it encourages people to open up and helps us to genuinely find solutions together.”
Time to chat is time well spent
Following on from the above, another PM suggested there’s no better time to be flexible and understanding of the needs of employees chat to each other. “It’s these informal chats where people can share any worries, concerns or anxieties and can look out for each other and spot signs of struggle,” they told us.
Another worry related to the pandemic could be financial. We were told about one practice nurse who ended up taking long-term sick leave because their husband had lost his job, creating worries about mortgage payments. “Once we found about the problem, we added a financial helpline service to our benefits package,” the practice’s assistant PM said. “It doesn’t cost us much – you can get access for nothing through some providers – and I know of at least three members of staff who have used it, including our nurse, who thankfully is now back at work.”
Flexible about time off
The BMA recommends that staff who need to take time off or would like to work flexibly should be supported. Following intensive levels of high workload, employers need to ensure that staff can take time off and those who would like to work flexibly are supported to do so. A consistent and fair policy for staff using annual leave entitlement is needed which ensures that those who have worked for an extended period during the pandemic are able to take a break when they need it most.
“Thanks to the support of our partners, who have agreed to pay staff for some extra hours, we’ve managed to add a bit of spare capacity to our staffing rosters, to cover any unexpected annual and sick leave, as well as flexible working,” a PM commented to us. “If we have more cover than we need, there’s always jobs to be done!”
Mental health training
Consider investing in some mental health training to improve awareness of mental health warning signs and how to offer support. Find out whether any of your staff (they don’t need to be line managers) would like to become Mental Health First Aiders.
Provide plenty of info
Provide your staff with information about how to look after their own wellbeing. The Five steps to wellbeing published by Chapter Mental Health was recommended to us by more than one PM.
The rise and rise of technology in practices is seemingly unstoppable – and this includes wellbeing. Media reports say that all 70 non-clinical and clinical staff at the Amicus Health practice in Devon have been given a wearable ‘mood tracking’ device as part of a new wellbeing initiative. The practice is taking part in an eight-week trial of the ‘Moodbeam One’ device, which allows users to log how they feel in any moment by pushing a single button. The data collected by an accompanying app can then be used to see how practice staff are feeling and coping, and enable employers to provide appropriate support.
Introduce relaxation spaces
Finally, the BMA’s Mental Wellbeing Charter recommends providing spaces to rest and socialise, ensuring access to break rooms where staff can socialise, relax, sleep and prepare food.
Say thank you
“It sounds simple, but it’s amazing how far a thank you goes,” another PM said. “We’re sending flowers for birthdays, surprising staff with a box of chocolates every now and again and just generally making them feel valued. It goes a long, long way to relieving the stress we all find ourselves in.”
Investing in mental wellbeing should extend well beyond money, but if you do need to convince a partner that they need to invest, here’s some good news. The latest research shows that for businesses investing into the mental health of their employees, the average return on investment is £5 for every £1 spent, with figures as high as £9 for every £1 spent in some cases.