Emotional Wellbeing Begins in the North

Transcription

1 Emotional Wellbeing Begins in the North LIZ KELL, SENIOR LECTURER, UCLAN, CHAIR OF NORTH WEST PWP PROFESSIONAL NETWORK GITA BHUTANI, CHAIR, PSYCHOLOGICAL PROFESSIONS NETWORK, ASSOCIATE DIRECTOR FOR PSYCHOLOGICAL PROFESSIONS, LANCASHIRE CARE NHS FT

2 The PPN Who we are Psychological Professions Network A workforce network supported by Health Education England in the North West We are: Clinical psychologists Cognitive behaviour therapists Counsellors Psychological Wellbeing Practitioners And smaller groups

3 The PPN What we do Articulate and champion equality between mental health and physical health Support delivery of the priorities for workforce development and education Work with national bodies to support plans around increased access to psychological therapies Influence workforce transformation Share knowledge and expertise across health & care Creating opportunities to share, learn and innovate More information available on

4 The Wellbeing Survey A joint project the British Psychological Society, Division of Clinical Psychology & New Savoy Conference 2009 Staff Wellbeing Tool based on European Social Survey Questionnaire (NEF 2009) Survey promoted through professional networks Survey focused on feelings about work as well as collecting demographic information Participants increased from 852 (in 2014) to 1106 (in 2015) to 1227 (in 2016) Findings are consistent across the years

5 The Wellbeing Collaborative Charter for Psychological Staff Wellbeing Collaborative learning network Promoting partnership to develop enabling environments for shared learning Pathfinders HOP-MHP: Honest Open Proud for MH Professionals Katrina Scior, UCL Employee Wellbeing Service Benna Waite & Adrian Neal, Aneurin Bevin UHB Psychological Wellbeing Practitioners Liz Kell, PPN and University of Central Lancashire

6 Wellbeing Survey 2017 Trainee clinical psychologists at University of Wales have developed a more psychometrically robust tool This survey is now available at: tbc

7 PWP wellbeing survey Based on the original Staff Wellbeing Survey Completed by 173 PWPs across the North of England in 2016 Questions in relation to 3 main domains: Personal Wellbeing Social Wellbeing Wellbeing at Work

8 Personal and Social Wellbeing 75% of respondents reported good health at least often Nearly 75% reported time spent with immediate family as often enjoyable More than 1/3 feel like a failure at least some of the time 75% often had someone to discuss personal matters with More than 1/3 only felt positive about themselves some of the time or less 70% often felt they were treated with respect Nearly ½ felt depressed at least some of the time in the last week 50% of the comments related to work issues

9 Wellbeing at work 2/3 often/always found their job interesting 75% satisfied with overall quality of life 82% of respondents never (or rarely) felt subjected to personal harassment through bullying 2% accused of bullying 30% had observed bullying of others 15% experienced discrimination from patients/relatives 40% in relation to age, 21% gender, 21% ethnicity 2/3 of respondents often found the job stressful 50% rarely or never satisfied with the amount of time they spent on administration 50% rarely or never satisfied with amount of time spent meeting performance targets + nearly ¾ feel pressured into meeting targets 50% often or always satisfied with amount of time they have for supervision 20% satisfied with the amount of time spent on CPD

10 Influence less than ½ felt them doing a good job was acknowledged by their manager Only 1/3 of respondents feel able to voice opinions and have influence Only 1/3 feel involved in decisions which affect them in their area of work Less than one third felt they were involved in decisions directly affecting the public Only 1/3 feel they have sufficient opportunities to ask managers about changes at work Less than ¼ were satisfied with the career opportunities available to them

11 The skills to do the job 2/3 of respondents felt they had the right skills to work with the patients on their caseload which means 1/3 don t: not having supervision that meets IAPT requirements working with increasingly complex caseloads including through service models where everyone has to go through step 2 first working with PTSD and severe OCD with no additional training often encouraged to work with complex clients who will not benefit from Step 2 to meet performance and target requirements

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13 Themes from the PWP wellbeing survey World Café Event PWP Wellbeing Working with complexity Career development and opportunity Influence Attended by approx. 80 PWPs and Senior PWPs Appreciative Inquiry approach in relation to the 4 key themes What is already working What do we need to do more of Short term actions Long term recommendations

14 PWP wellbeing Some identified good practice but large variation in different services in relation to key areas: Good, open communication channels Sense of team and peer support Flexibility to do different things e.g. involvement in group delivery Access to CPD Access to services which promote staff wellbeing

15 PWP wellbeing actions & recommendations Short term: Long term: Anonymous suggestions/concerns process (with required response) Team events e.g. fundraising Breakfast/lunch get together permitted time Review of job roles huge variation currently Staff room/space to support wellbeing activities Service signed off by national team as fit to have PWPs ensuring basic structures in place Mindfulness/relaxation at start of team meetings Buddy system to encourage peer support Managers asking how staff are and seeking staff solutions Signed wellbeing agreement (similar to Mind s Mindful employer) specific to IAPT services linked to national charter and specific details for different roles Sufficient and reliable supervision prioritised and not cancelled unless absolutely necessary

16 Working with Complexity All PWPs work with complex cases on a regular basis Many PWP core skills still useful, but lack of organisational understanding or support for differences involved e.g. more flexibility and creativity Importance of keeping things simple and signposting case management approach Managing expectations of patients and service PWP key skills: including common factor skills developed during training, Additional skills to build upon core skills: emotional wellbeing effectively engage in signposting, highly effective time management skills, managing expectations, use of (& access to) supervision Additional training may be needed for other skills: managing high expressed emotion, intricacies of adapting interventions without blurring lines of fidelity to PWP model

17 Working with Complexity - recommendations Criteria for what is appropriate for step 2 and what might be different with step 2 interventions working with complexity Time and support for peer supervision and to share best practice Access to specialist clinical consultation CPD opportunities specifically in relation to complexity in house and/or formal Access to training e.g. basic counselling skills re managing patient distress Assessment and signposting skills specifically in relation to complexity MDT approach to managing complexity Champion roles with clear guidance as to expectations of this

18 Career development and opportunity Challenges in relation to funding, competition for development opportunities and significant lack of opportunities compared to High Intensity with no real structure to progress through Step 2 workforce in the third sector (larger proportion than step 3 workforce) further isolated from wider developments General belief that PWP career development is frowned upon interpreted as staff wanting to leave and should be stopped but no consideration of development within the role which might help retention rates Lack of professional status further contributes PWP as stepping stone to core professions and recruited on fixed term contracts with no guarantee of job at end further contributes to this

19 Career development recommendations More opportunities to access training and regular CPD clinical and supervision/management Develop the breadth of the PWP role within the role more specialist roles and potential band 6 opportunities (not just senior PWP ) Right support to do the job well decent equipment, dedicated admin time Increased recognition for the role - Attitudes/culture parity of esteem between step 2 and 3 Role clarity and standardised guidelines for CPD access and caseload sizes more consistency Further research in breadth of Low Intensity Interventions Opportunities for PWPs to progress to more senior roles in management, leadership and commissioning is a core profession still a necessary essential criteria?

20 Influence Decisions made at high levels within services far removed from day-to-day delivery, particularly at PWP level Some examples of good practice where managers listen to and are willing to take ideas on board from PWPs, but very dependent on individual personality of the manner Discussions need to be meaningful and lead to actions PWPs isolated and busy weeks restricted their opportunity to be involved in decision making even when, in theory, staff engagement was undertaken Attitude to PWPs changed depended on whether they are recognised for their flexibility and hard work or dismissed as just step 2

21 Influence (cont.) Within smaller services, (and smaller organisations) more opportunity for influence including more direct contact with e.g. Lead GPs Overall need for improved understanding of the PWP role and the value of including PWPs in decision making: PWPs feel greater sense of belonging and commitment to service Sense of achievement and development of skills for PWPs Improved patient experience with PWPs better able to reflect patient voice Better understanding of the meaning behind the data understand individual performance as well as whole service data Potential for new and innovative solutions from within the PWP workforce which are currently missed

22 Influence - recommendations Planned time e.g. workshops to enable influence in relation to change Importance of real understanding of PWP role e.g. shadow a PWP day Regular meetings which allow time for conversation and sharing ideas Managers to be more committed to listening to step 2 considerations and actively seeking their opinions Involvement of PWPs in meetings with commissioners to improve knowledge of process, the role, and the meaning behind the data Willingness to try suggestions as a trial rather than just enforcing change More focus on team decisions rather than a 1-person approach Opportunities for PWPs to progress to more senior roles in leadership, management and commissioning is there a need for a core profession

23 Next Steps Lots of recommendations but who can move these forward? Is there a role for digital pathways in helping us work smarter? Will digital pathways help PWPs take more control? What other support is needed?

24 Thank you for listening!