NHS Workplace Research Articles

What is the journey that follows our personal training analyses? Reflections on the post-analytic phase of development and some of the challenges of the modern NHS workplace

ABSTRACT In this paper, the author further explores and theorises themes from a recent autoethnographical essay ‘Dangerous journey: memories of containment in Cuba’ in which he detailed the immediate demanding period that followed the end of his own analysis – an event which occurred some time after the completion of his formal training. To study this very particular time-period in professional life, he draws on literature on endings in child psychotherapy and the progression of personal training analyses in the psychoanalytic professions, while also referencing discussions held with a range of child psychotherapy colleagues. The reader of this paper is invited to enquire why there are no child psychotherapy publications and a near-void in wider psychoanalytic publications on this important caesura, coupled with a lack of descriptions of the challenges of working in current NHS systems. The author also draws on his experiences to provide a brief, general commentary on such challenges. He hopes that the paper may encourage further writing in the profession on the place of personal analyses within (and often for a time after) the training – especially the possible meanings when ending them – and more broadly of their enduring place in the lives of child psychotherapists post-terminus.

Experiences of menopause in the Welsh NHS workplace: a focus group study

BackgroundDespite an increased desire to improve women's experiences, the evidence base around how best to support female employees experiencing the menopause is currently lacking. NHS Wales has a workforce with a significant proportion of older female workers, many of whom will experience menopause symptoms. This work aims to explore the impact of menopause symptoms on the working lives of NHS staff in Wales. MethodsFor this service improvement study, four focus groups were held between Jan 12, and March 10, 2023. Women who experienced symptoms related to menopause were invited to participate via a local women's network. 14 women with lived experience of menopause took part, with an average of three women per group. Informed consent was given by participants for this service improvement exercise. Participants worked in both clinical and non-clinical roles in the NHS in Wales. Participants were aged between 34 and 59 years. A semi-structured facilitation approach was used, with women asked to describe their menopause experience and their role in the organisation. Transcripts were analysed using the framework approach and reported using the COREQ reporting checklist. FindingsMenopause symptom experience was multifaceted and varied and dependent on factors such as medical history, social support, and personal management strategies. All women involved in the focus groups felt that their symptoms had negatively impacted their experience. Various symptom management strategies had been used with varying levels of success. Some women were reticent to ask for support at work, despite believing the workplace response would be positive. InterpretationPeer support is well received by women in the workplace, but it is crucial that opportunities for peer support in the workplace are delivered in a culture where women feel they are able to step away from their core duties to attend and engage with opportunities such as Menopause Café's and lunchtime learning sessions. Further work is needed as participants in these focus groups might not be representative of the full NHS and broader workforce. Conducting focus groups entirely online might also have influenced the group dynamics. FundingNone.

Towards ‘Racialising’ the Union Agenda on the Front Lines of Healthcare Professions

A persistent problem in trade unions is the discrepancy/tension that exists between their progressive national equality-seeking agenda and the translation of equality principles into workplace activism and their application to members’ everyday working lives. Building on the notion of ‘feminising’ the union agenda, this article explores professional unions’ efforts towards ‘racialising’ the agenda, which is a neglected equality focus in extant literature. The study is located within nursing and midwifery in NHS workplaces where the existence of racism has long been recognised by all employment relations actors. It investigates how the national union anti-racism project is implemented by workplace union representatives. While it reveals recognition of the existence of workplace racism among union representatives, a degree of denial and discomfort also exists. This, combined with the absence of the empowering union strategies that might be expected, hinders the delivery of a racially inclusive union agenda on the front lines of healthcare.

Period policies: why every NHS workplace needs one

Period policies: why every NHS workplace needs one

NHS workplace health and wellbeing during COVID-19.

NHS workplace health and wellbeing during COVID-19.

Exploring communities of practice in the NHS: A core medical trainee experience

A community of practice was described by Lave and Wenger as a mutual engagement using a shared repertoire of resources to attain a shared goal. This study explored the extent to which NHS workplaces function as communities of practice for core medical trainees. All core medical trainees in one region were invited to a semi-structured interview. A framework was produced using communities of practice themes and a hybrid deductive-inductive method used for data analysis. NHS workplaces function as communities of practice by enabling engagement and by formation of mutual relationships. Joint enterprise was evidenced by multidisciplinary team working. Full participation was limited by service provision and short training rotations. Trainee attendance in clinic and procedure lists should be facilitated. Trainees should be enabled to 'act up' as registrar. Flexibility is needed in jobs by allowing swaps between trainees and the facilitation of 'taster weeks'.

Tackling racial bias in NHS workplaces.

Sam Foster, Chief Nurse, Oxford University Hospitals, explains how initiatives, such as the West Midlands cultural ambassador programme, can bring positive changes for black and minority ethnic staff.

Exploring the disclosure decisions made by physiotherapists with a specific learning difficulty

ObjectivesTo explore the disclosure decisions made in the workplace by physiotherapy staff with a specific learning difficulty (SpLD). Design & settingAn exploratory qualitative design was used, which was informed by the social model of disability. The research was undertaken in North West England. It is presented according to the Consolidated Criteria for Reporting Qualitative Research. ParticipantsA purposive sample of eight physiotherapists recognised as having a SpLD were recruited. All participants had studied on one of two programmes at a university in England between 2004–2012. Their NHS workplace experience was from across the UK. Data generationIn-depth, semi-structured interviews were undertaken within the university setting or via telephone. Interviews lasted 40 to 70minutes and were digitally recorded. An interview guide was used to direct the interview. Data analysisInterview data were transcribed verbatim and analysed using thematic analysis. FindingsFour participants were female. The mean number of years qualified as a physiotherapist was 4.5years (SD=2.27). Three themes were identified: ‘Disclosing during the workplace application’; ‘Positive about disabled people scheme’; ‘Disclosing in the workplace’. ConclusionsDisclosure of dyslexia is a selective process and is a central dilemma in the lives of individuals who have a concealable stigmatised identity. As a consequence, physiotherapy staff with dyslexia may choose to conceal their disability and not disclose to their employer. In order for staff with dyslexia to get the support they need in the workplace, disclosure is recommended. A number of recommendations have been made to facilitate the disclosure process.

Influences on GP coping and resilience: a qualitative study in primary care.

'Neoliberal' work policies, austerity, NHS restructuring, and increased GP consultation rates provide the backdrop against increasing reports of GP burnout and an impending shortage of GPs. To explore GPs' experiences of workplace challenges and stresses, and their coping strategies, particularly focusing on understanding the impact of recent NHS workplace change. Study design was qualitative, with data collected from two focus groups and seven one-to-one telephone interviews. Focus groups and one-to-one telephone interviews explored the experiences of GPs currently practising in England, recruited through convenience sampling. Data were collected using a semi-structured interview approach and analysed using thematic analysis. There were 22 GP participants recruited: focus groups (n = 15) and interviews (n = 7). Interviewees understood GPs to be under intense and historically unprecedented pressures, which were tied to the contexts in which they work, with important moral implications for 'good' doctoring. Many reported that being a full-time GP was too stressful: work-related stress led to mood changes, sleep disruption, increases in anxiety, and tensions with loved ones. Some had subsequently sought ways to downsize their clinical workload. Workplace change resulted in little time for the things that helped GP resilience: a good work-life balance and better contact with colleagues. Although some GPs were coping better than others, GPs acknowledged that there was only so much an individual GP could do to manage their stress, given the external work issues they faced. GPs experience their emotional lives and stresses as being meaningfully shaped by NHS factors. To support GPs to provide effective care, resilience building should move beyond the individual to include systemic work issues.

To disclose or not to disclose? Benchmarking disclosure of a specific learning difficulty in physiotherapy education and the NHS workplace

Relevance: Firstly, we report the incidence of disclosure of a specific learning difficulty (SpLD) by physiotherapy students in a Higher Education Institute (HEI), making it relevant to the congress theme, Education. Secondly, we compare this to reports of disclosure in the NHS workplace, challenging managers to address the apparent discrepancy. This makes it relevant to the congress theme, Policy, Strategy and Influencing (in the workplace).

Not what the doctor ordered.

British Journal of Community NursingVol. 21, No. 10 EditorialNot what the doctor orderedLauran ElsdenLauran ElsdenSearch for more papers by this authorLauran ElsdenPublished Online:7 Oct 2016https://doi.org/10.12968/bjcn.2016.21.10.489AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Royal College of Nursing (2013) Beyond breaking point? A survey report of RCN members on health, wellbeing and stress. http://bit.ly/2bLLcAP (accessed 1 September 2016) Google ScholarNHS England (2015) Simon Stevens announces major drive to improve health in NHS workplace. http://bit.ly/2bSYJFO (accessed 1 September 2016) Google ScholarKing's Fund (2016) Understanding quality in district nursing services: Learning from patients, carers and staff. http://bit.ly/2bFelPp (accessed 1 September 2016) Google Scholar FiguresReferencesRelatedDetails 2 October 2016Volume 21Issue 10ISSN (print): 1462-4753ISSN (online): 2052-2215 Metrics History Published online 7 October 2016 Published in print 2 October 2016 Information© MA Healthcare LimitedPDF download

“Them and us” attitude hinders trainees’ leadership development

Traditional professional hierarchies, abusive behaviour, and a “them and us” attitude are persistent barriers to the development of medical trainees as leaders, researchers say. Lisi Gordon of the School of Medicine at the University of Dundee and colleagues say they gained fresh insight into the way “leadership and followership” were experienced in NHS workplaces by analysing medical trainees’ personal stories. Their examination of interviews with 65 trainees highlighted the factors that can help or impede their development as medical leaders and identified barriers in the wider health system. The research underlined the persistence of traditional medical and interprofessional hierarchies and certain “abusive” types of behaviour. Gordon told BMJ Careers, “Sometimes the hierarchies or the systems, structures, or protocols don’t necessarily allow trainees to take on leadership as much as they would like. But the …

Disabled, male, and older workers are “far less engaged” than other groups, report says

Disabled workers, as well as male and older employees, are “far less engaged” than other groups of staff, a study of the NHS and other workplaces has found. The researchers said that employers should view raising engagement levels in tandem with issues of diversity and inclusion, to drive up organisational performance and employee wellbeing. The Diverse Voices study was carried out by the non-profit organisation IPA and the consultancy Astar-Fanshawe.1 The study sought to examine the relation between effective employee engagement and diversity and inclusion. Nita Clarke, IPA director, said that employers needed to look at employee engagement and at diversity and inclusion as “two sides of the same coin.” The researchers said that developing engagement was a “two way process” between employers and employees to improve performance. The research consisted of a literature review and data analysis of large scale employee …

NHS Employers selects 25 organisations to promote equality and diversity

NHS Employers has chosen 25 organisations to develop and promote equality in the NHS workplace in 2015-16. The 25 were selected from 42 that had applied to be members of a partnership scheme. NHS Employers said that membership would help these organisations “network with each other and the wider NHS, expanding on the success of previous years’ partners in influencing policy and improving performance.” The 25 organisations will …

Pilots for NMC’s proposals will extend beyond NHS workplaces

Pilots for NMC’s proposals will extend beyond NHS workplaces

Stonewall list shows increased diversity in NHS workplaces

Stonewall list shows increased diversity in NHS workplaces

Five-year workplace wellness intervention in the NHS

Poor health and well-being has been observed among NHS staff and has become a key focus in current public health policy. The objective of this study was to deliver and evaluate a five-year employee wellness programme aimed at improving the health and well-being of employees in a large NHS workplace. A theory-driven multi-level ecological workplace wellness intervention was delivered including health campaigns, provision of facilities and health-promotion activities to encourage employees to make healthy lifestyle choices and sustained behaviour changes. An employee questionnaire survey was distributed at baseline (n = 1,452) and at five years (n = 1,134), including measures of physical activity, BMI, diet, self-efficacy, social support, perceived general health and mood, smoking behaviours, self-reported sickness absence, perceived work performance and job satisfaction. Samples were comparable at baseline and follow-up. At five years, significantly more respondents actively travelled (by walking or cycling both to work and for non-work trips) and more were active while at work. Significantly more respondents met current recommendations for physical activity at five years than at baseline. Fewer employers reported 'lack of time' as a barrier to being physically active following the intervention. Significantly lower sickness absence, greater job satisfaction and greater organisational commitment was reported at five years than at baseline. Improvements in health behaviours, reductions in sickness absence and improvements in job satisfaction and organisational commitment were observed following five years of a workplace wellness intervention for NHS employees. These findings suggest that health-promoting programmes should be embedded within NHS infrastructure.

Workplace intervention to promote stair‐use in an NHS setting

Purpose – Increasing physical activity (PA) is an international public health priority. This study aims to assess the impact of an environmental stair‐use intervention using “point of decision” prompts with varying messages in an NHS workplace in the UK.Design/methodology/approach – Observational data were collected using a covert method (infra‐red sensors) in an interrupted time‐series design over an eight‐week period. Intervention consisted of posters displaying encouraging messages in the entrance to two stairways of an acute NHS hospital. The hospital site is a public building accessible to patients, staff (n=∼7,000), students and the general public. Questionnaires (n=221) assessed employee self‐reports of and attitudes towards stair‐use.Findings – Following 24‐hour observational counts (n=143,514) no statistically significant differences were seen in either stair climbing or descent on either stairway through the introduction and removal of promotional posters. A number of determinants and barriers t...

The effects of a graduated aerobic exercise programme on cardiovascular disease risk factors in the NHS workplace: a randomised controlled trial

BackgroundSufficient levels of physical activity provide cardio-protective benefit. However within developed society sedentary work and inflexible working hours promotes physical inactivity. Consequently to ensure a healthy workforce there is a requirement for exercise strategies adaptable to occupational time constraint. This study examined the effect of a 12 week aerobic exercise training intervention programme implemented during working hours on the cardiovascular profile of a sedentary hospital workforce.MethodsTwenty healthy, sedentary full-time staff members of the North West London Hospital Trust cytology unit were randomly assigned to an exercise (n = 12; mean ± SD age 41 ± 8 years, body mass 69 ± 12 kg) or control (n = 8; mean ± SD age 42 ± 8 years, body mass 69 ± 12 kg) group. The exercise group was prescribed a progressive aerobic exercise-training programme to be performed 4 times a week for 8 weeks (initial intensity 65% peak oxygen consumption (VO2 peak)) and to be conducted without further advice for another 4 weeks. The control was instructed to maintain their current physical activity level. Oxygen economy at 2 minutes (2minVO2), 4 minutes (4minVO2), VO2 peak, systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, C-reactive protein (CRP), fasting glucose (GLU) and total cholesterol (TC) were determined in both groups pre-intervention and at 4 week intervals. Both groups completed a weekly Leisure Time Questionnaire to quantify additional exercise load.ResultsThe exercise group demonstrated an increase from baseline for VO2 peak at week 4 (5.8 ± 6.3 %) and 8 (5.0 ± 8.7 %) (P < 0.05). 2minVO2 was reduced from baseline at week 4 (-10.2 ± 10.3 %), 8 (-16.8 ± 10.6 %) and 12 (-15.1 ± 8.7 %), and 4minVO2 at week 8 (-10.7 ± 7.9 %) and 12 (-6.8 ± 9.2) (P < 0.05). There was also a reduction from baseline in CRP at week 4 (-0.4 ± 0.6 mg·L-1) and 8 (-0.9 ± 0.8 mg·L-1) (P < 0.05). The control group showed no such improvements.ConclusionThis is the first objectively monitored RCT to show that moderate exercise can be successfully incorporated into working hours, to significantly improve physical capacity and cardiovascular health.

Workplace Bullying in the NHS Workplace Bullying in the NHS

Workplace Bullying in the NHS Workplace Bullying in the NHS