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Caring for carers: psychological support for NHS staff

Julian Groves 17 April 2020

Julian Groves discusses the essential psychological support structures being put in place for NHS workers.

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As well as the very moving Clap for our Carers campaign to show our support and gratitude for people providing care to others in the current crisis, the NHS has launched an initiative to deliver practical and psychological support for healthcare staff. 

The Guardian reported that plans will see NHS staff given ‘free access to a programme of more than 1,500 specialists, online therapy and group counselling sessions. They will also receive practical and financial assistance as well as specialist bereavement, psychological support and help with sleep problems.’

The report quotes the president of the British Psychological Society, David Murphy, saying ‘The coronavirus crisis has placed unprecedented demands on staff working in health and social care. Not only are they facing long hours, intense work and a risk of infection, but they are also managing psychological distress of patients, offering care at the end of life, and supporting bereaved families. This is true for both clinical staff and non-clinical staff working at the frontline.’

Leaving aside thoughts in my mind about the critical supplies of PPE (and on the other hand, how positive it is that the wellbeing of NHS staff is at last right up there on the health service agenda), it is wonderful to see this planning by the NHS coming together so quickly, and seemingly comprehensively. 

From a decade of helping over 200 organisations run Schwartz Rounds, we know from experience, as well as a great deal of research, the impact that the simplicity of story-telling with an audience in a well-facilitated space can have. Indeed, major research undertaken by Jill Maben showed that Rounds can halve rates of psychological distress among regular attenders. As our new online intervention Team Time has much in common with the Rounds, we think it will be an effective support for staff. However, we are left contemplating where it will fit in with the proposed programme of support announced by the NHS. 

We have spent the last two weeks training over 350 existing Schwartz Rounds facilitators to run Team Time. My fantastic colleagues, Aggie, Bev and Rhiannon, had the privilege of hearing from health and care staff about the everyday stresses and strains of their working lives during these online training events. They heard stories of the break-up of teams as people are redeployed; of extra hours being put in; of the damage that unintentionally insensitive work banter can do to relationships; and of the collision of professional and personal lives amongst people who are working at home. But as well as these stories, there has been a common strand of discussion in each session about how best to implement Team Time, to make sure it is the safe and right way to support staff. 

The issue of psychological safety needs to be carefully framed and responded to. There is understandable caution over those colleagues who are at the very frontline, directly treating Covid patients, being involved in more open reflective sessions. Depending on their individual responses to their experience, many will find it unhelpful at present. Equally the ‘baseline’, if you like, of everyone’s thoughts and feelings is different to where it was only a month ago, with our lives having been turned upside down by the crisis. We believe that this is more reason for care staff to engage with something like Team Time and accept that emotions might be raw, but that the sharing of them can help. 

The British Psychological Society is clear in its guidance, which points out that we should all remember ‘this situation is unprecedented; it is okay to not be okay.’ It suggests that organisations do not mandate direct psychological interventions, as they are not helpful to everyone in the midst of crisis. Instead it suggests psychological support should be made available in different ways. Story-telling in Team Time is, we think, one of these ‘different ways’. 

In the Covid Trauma Response Working Group’s ‘Rapid Guidance’ it is suggested that organisations provide an opportunity for staff to talk about their experience, in order to enhance support and social cohesion. The guidance says ‘these sessions should not involve anyone being mandated to talk about their thoughts or feelings. It is important for organisations to provide these opportunities, but for staff to be free to decide whether to attend or not.’ 

Team Time can be one of these opportunities. We are looking forward to gathering evidence on its impact as sessions begin. Team Time shares many features with Schwartz Rounds, which we know has a robust evidence base behind it. Many of the mechanisms that make Schwartz Rounds so effective will be present in Team Time. We look forward to embarking on this new initiative and playing our part in supporting carers through these challenging times.