Employing approximately 6700 employees we work to improve people’s lives by minimising the impact of mental ill-health or a learning disability. As a Trust we recognise that anyone can experience mental ill health, including our staff. Because of this we have put in place effective support mechanisms that are available to all staff regardless of role, grade or position. The Trust has 5 core values which are; Commitment to quality, Respect, Involvement, Wellbeing and Teamwork.
What We Did
Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) provides a range of mental health, learning disability and eating disorders services around County Durham, the Tees Valley, Scarborough, Whitby, Ryedale, Harrogate, Hambleton, Richmondshire and the Vale of York and Selby.
Employing approximately 6700 employees we work to improve people’s lives by minimising the impact of mental ill-health or a learning disability. As a Trust we recognise that anyone can experience mental ill health, including our staff. Because of this we have put in place effective support mechanisms that are available to all staff regardless of role, grade or position.
The Trust has 5 core values which are; Commitment to quality, Respect, Involvement, Wellbeing and Teamwork.
We promote and support the wellbeing of users of our services, their carers, families and staff.
- Demonstrate responsibility for our own, as well as others, wellbeing
- Demonstrate understanding of individual and collective needs
- Respond to needs in a timely and sensitive manner or direct to those who can help
- Be pro-active toward addressing wellbeing issues.
We take pride in our approach of reducing the impact of mental ill health, this combined with drive for continual improvement and positive cultural change results in healthier working environments for our staff which can only lead to better care, empathy and compassion for the communities we serve.
“Always show kindness, mental ill health is a lonely dark place”
All quotes are from staff feedback and evaluation of the TEWV ESS service.
The Employee Support Service was designed to support staff with mental ill health and their managers. The service works within the principles of the Mindful Employer Charter. The Trust has been an advocate of mentally healthier workplaces since 2009.
The service sits within the Trust’s Health and Wellbeing Team. It maintains its independence from managers, staff and Human Resources. The service launched in October 2011. Mental ill health was and is the largest cause of sickness absence in the Trust.
It was believed that with the right support in place the majority of staff who had experienced mental ill health could return to work and continue to make a positive contribution at work.
The team supports staff to return to work by conducting stress risk assessments, phased return plans, explores reasonable adjustments, signposts staff to appropriate services and / or support outside the Trust’s remit, provides self-help tools, information and resources and works with staff to help them understand the importance of maintaining a positive work life balance. The service also provides a listening service as this can be one of the best forms of therapy. The team works very hard to ensure that TEWV is a healthier and happier place to work.
Support is also offered as a preventative measure to help staff maintain their wellbeing and remain at work. Staff and their managers have fed back that support from the service has helped staff to return back to work sooner and in many cases with ongoing support staff remain at work. The Employee Support Service contributes to the reduction of long and short term sickness absence within the Trust. Proactive support enables staff to return to work with a robust support framework which maximises the success of return to work plans.
As the service evolved it was acknowledged that staff needed support and help with not only their mental health but with their physical health and wellbeing being in the wider sense. It was also acknowledged that physical ill health can have a negative impact on mental health and that mental ill health can have a negative effect on physical health. To date the service has supported staff with issues including bereavement, domestic abuse, debt, addiction, trauma, physical health and relationship issues.
The Team cover an area of 4000 square miles and travel to support staff at a location of the staff member’s choice. The Trust boundary recently expanded when the Trust merged with York and Selby in 2016. Entry to the service is through a number of routes including; self-referral, staff can refer without their manager’s knowledge, manager referral, or through the Sickness Absence Team or Occupational Health who can refer staff with enduring physical, medical or mental ill health.
The Employee Support Service has now entered its sixth year achieving excellent outcomes for staff that have accessed the service. There have been in excess of 2000 referrals since 2011, feedback and evaluation show consistent results, in that the support offered has been invaluable to staff members, their managers and teams.
Staff have fed back that the team’s approach and compassionate manner has played an important part of their recovery and helped them when they are at their most vulnerable (please see quotes). The team also provides proactive support to teams across the Trust, raising awareness about the importance of health, wellbeing and resilience
Other Information about the service includes:
- In year 5, 59% of those who accessed the service were at work and 39% were off sick at the point of referral and 2% of staff did not disclose.
- In year 5 there was a significant increase in the number of referrals 22% more referrals than in year 4, this trend continues into year 6
- There have been 1097 face to face appointments, which is a significant increase to previous years. This is an average of 2.2 appointments per referral
- There have been 945 telephone contacts compared to 598 in year 4 and 1034 email correspondence
- Appointments continue to range from 30 minutes to 2 hours, averaging out at 1 hour 30 minutes (this does not include travel time)
- The Employee Support Officer spends an estimated 7 hours per week travelling across the Trust
“Take small steps and remember you can recover”
Proactive support includes;
- Supporting teams who are going through organisational change
- Stress management courses
- Health and Wellbeing session at Trust staff inductions
- Health and Wellbeing Sessions on the Trust’s Leadership and Management Courses, Personal Effectiveness Courses and Embedding (the Trust’s) Values
- Workshops for teams who provide care for people with complex needs
- Working with teams that are experiencing significantly higher stress levels
“Becoming unwell can happen to anyone, don’t judge and certainly don’t punish yourself if you find yourself in this position.”
The quotes below are taken from our staff with lived experience leaflet, ‘Turning Tables’.
“My confidence completely went; I felt I was a bad nurse, a bad Dad, a bad person. I went off sick and felt so guilty that I was letting my colleagues and patients down. It wasn’t until someone told me that I needed to show myself the same compassion that I do for others that I could start to recover.” Staff Nurse, Teesside
“I honestly never thought it would happen to me, I have been a nurse for 16 years and thought I was very resilient. I noticed that my mood had dipped and I lost interest in all of my hobbies, but I just kept going. I told myself to pull myself together and that I should know how to pick myself back up, I did do this for a living.
It wasn’t until one day when I couldn’t get out of bed that I knew I needed some help. During my illness I visited some very dark places and it was very scary. I want to share a message of hope, hope that you can get well, hope that you can rebuild your life and hope that you can be a better you again.” Staff Nurse, North Yorkshire
“My anxiety reached a point where I was no longer able to work, take my children to school or even leave my house. With a little time, patience and a whole lot of kindness I managed to reclaim my life. I had to accept help and had to accept that I was on a tricky journey, but I can honestly say that it has made me a better support worker and a stronger person.” Health Care Assistant, Darlington
“I was very emotional, found myself crying all the time. I was very judgmental on myself couldn’t show myself any compassion or kindness. It is so hard turning the mirror around” S, Durham
Wider Active Support
The Trust has a Health and Wellbeing Strategy Group that focuses on the overall health of the organisation, the Employee Support Service feeds into the Strategy Group so that the organisation is able to identify and report on ‘key themes’ so that the Trust is better able to understand what support staff need.
“Don’t be so hard on yourself, everyone slips, everyone falls.”
The Employee Support Service also works in partnership with Occupational Health, the Employee Psychology Service, the Trust Mindfulness Team, Staff Retreats, the Staff Engagement Team, Human Resource Teams, the Health and Safety Team and signpost access to free counselling through a contract with an independent provider which is part of the Trust’s Occupational Health Provision.
The service works with employees, their managers and organisational departments for a ‘best outcome’ for all. The service only works if TEWV employees engage and work together. The team is led by a member of staff with extensive experience in employee relations who is supported by a member of staff with extensive equality, diversity and human rights experience to ensure that the service is able to engage with specialist teams and can meet the needs of staff identifying with protected groups.
The Employee Support Officers work co-productively with employees, Organisational Development, HR Operations, the Sickness Absence Team, and the Trusts Experts by Experience Team, seeking the best outcome for each person’s individual circumstance. Occasionally the team works in partnership with the emergency services, G.P’s and Crisis Resolution Teams.
The team have a designated NHS mail account and can refer staff into the Trust’s Employee Psychology Service – This is a confidential in house psychology service that provides additional support to staff who have work related stress and mental ill health, it is in its second year of a pilot.
Looking back / Challenges Faced
One of the key issues during the early days of the service was around building trust and confidence with our staff so that they felt able to access the service without feeling judged. The confidential aspect of the service was critical in building this trust with our staff.
Other challenges include:
- A significant amount of time is spent travelling due to the size of the Trust
- Referral rates continue to rise year on year
- The Trust has expanded twice in the last 5 years which has had a knock on effect on the number of referrals due to organisational change and the increase in size of the Trust.
“I wasn’t sure of the benefits to be gained, when it was recommended by Occupational Health but my experience with the Employee Support Service has been entirely positive and I have felt a real benefit from the contact I have had. There is also reassurance that I can get in touch when things might not be going so well in the future. Thanks.”
“You know me, have known me for a long time – don’t be scared to talk to me. We are friends and colleagues; I would like to think we know each other well. Reach out when you need me and I’ll do the same for you” Health Care Assistant, North Yorkshire
Number of referrals into the Employee Support Service 2011/12 to 2015/16 *Employee Support Officer (ESO)
Number of staff who accessed the Employee Support Service
Number of staff at work at the point of referral/self-referral
Number of staff off sick at the point of referral/self-referral
Table: Number of staff accessing service by NHS band and gender
The above table shows that most contact was made by Bands 3, 5 and 6 staff and table 5 shows that the majority of contacts were made by female staff. These figures accurately reflect the demographic makeup of the organisation.
The Employee Support Service has grown in recent years from one to two Employee Support Officers. The Trust has invested in a sustainable and valuable service which continues to evolve and be an important part of the support available for our staff. Referral rates have increased year on year, which we believe reflects the success and confidence in the service as well as being a possible indicator of the increasing demands on NHS staff. The service has the full support of the Director of Human Resources and Trust Board of Directors.
The TEWV Employee Support Service is helping to keep our wards staffed, community teams out in the community and corporate staff at work ensuring that we can continue to provide excellent care whilst being mindful of the health of our employees.
The below tables are responses to evaluation questions that are sent out to staff following use of the Employee Support Service 2015/2016.
|Did the support you received meet your expectations?|
|Answer Options||Response Percent|
|If you were at work when you accessed support did this help you to remain at work?|
|Answer Options||Response Percent|
|If you were off work when you accessed support did this help you to return to work?|
|Answer Options||Response Percent|
|Would you recommend the service to a friend or colleague?|
|Answer Options||Response Percent|
“The Employee Support Officer was extremely approachable and supportive and followed up even after our last meeting with an email and if I ever needed to access this service again I would be happy to do so. It certainly helped remove some of the stigma that I felt was attached to having a mental health problem when working in mental health!”
Key Themes of Summary of feedback received:
- Staff feel better supported
- Helpful that the service is independent
- Staff appreciate that the service is flexible
- Helped staff to return to work
- Helped staff to remain at work
- Staff feel valued by the Trust
“I have found it really useful to have someone who I can talk to about the issues that I am experiencing at work. It has helped to have someone other than my manager to discuss this with and I have been given some useful information which will help me in the future”
“I wish the service was here last year when I was really poorly it would have helped me try and stay at work, I am glad that I have this support now”
“This is the most supported I have felt during all my employment at the trust”
“You (Employee Support Officer) have helped me to return to work, it would have taken a lot longer to build up the confidence to get back to work.”
“Thank you for all your (Employee Support Officer) support it is really helpful at the moment when I am not feeling well”
“Having the opportunity to have some time with someone to discuss the issues I am experiencing it is helping me to work through my problems”
“I have found working with you (Employee Support Officer) a pleasure, your support has been great, thank you”
“The ESO was very understanding, listened and was non-judgmental in her approach. It was helpful to be able to talk to somebody independent of my work place. She made positive and helpful recommendations for getting back to work.”
“The support I received was invaluable, when attempts were made to contact the employee support team and a message was left they always returned my calls in a timely and appropriate manner. The employee support officer was open, honest, and supportive and allowed the necessary time to enable constructive discussions.”
“The support I received prevented my depression becoming worse than it was, the help is first class.”
“Emotional support, practical advice and someone to turn to, feeling supported and advice re counselling, which I attended and the opportunity to attend the retreat. The ESO was professional, friendly and kind. She supported me through a very difficult time and transition in my life at times when I thought I wouldn’t get through it. She empathised with my situation and made me feel that I could get through it.”
“I have nothing but high praise for the support received the ESO was kind and considerate but honest also she gave me the confidence to apply for another job and helped me feel better about my capabilities at a time I struggled.”
“The support I had was second to none.” “Excellent support at a really stressful time”
The Employee Support Service enables staff to return to work sooner and with support packages in place. In the longer term staff that have been off work with long term physical or mental ill health have being able to sustain their attendance at work for longer periods of time between absences, and when they have been off they have returned to work sooner.
Staff that have accessed the service previously are more likely to refer their colleagues and / or contact the employee support service when they begin to feel unwell again. This results in support being accessed proactively in many cases by staff. Outcomes in terms of staff experience can be viewed throughout this submission. Please also see section 6.
“I am proud of the service we have developed to enable staff to have an independent and safe space to explore their situation and gain confidence to move forward”.
Sheila Jones, Head of Staff Health and Wellbeing TEWV
The Employee Support Service was an entirely new concept 5 years ago; we were keen to develop the service before sharing our findings. However, we now feel that the time is right to share what we have learned. Indeed, the reason for our award submission is that we would like to share our findings, promoting mentally healthier, mindful working environments that have a positive impact on mental health and wellbeing.
We delivered a presentation to Tees Valley Public Health in November 2016 and held a TEWV Health and Wellbeing Conference in June 2015. We provide in house training and bespoke support / training for staff and their managers. The Employee Support Service has continued to be well utilised by staff and managers. The feedback received is extremely positive and demonstrates how valued it is to those who use it. The service continues to work successfully with The Sickness Absence Team, Occupational Health, The Employee Psychology Service and the Mindfulness for Staff Project. This collectively shows the Trust’s commitment to staff health and wellbeing.
In year 6 the team hope to continue to support individuals and develop further supportive and preventative interventions. We have also been involved in a Quality Improvement Event where we have reviewed the service requirements and we are in the process of developing
Key Performance Indicators so that we can ensure that we continue to deliver an exemplar service whilst ensuring that we can respond promptly to staff that need our support.
Is there any other information you would like to add?
We hope that by sharing our experience with you that other organisations will adopt and invest in employee support for their staff, learning from our experiences to date. Mentally healthier workplaces are places where everyone can thrive. We believe that it is in these environments that creativity, innovation, inclusivity, teamwork and high quality mental healthcare is provided to the communities we serve.
As an NHS service provider we do not manufacture a product, our product is the health care we provide and we wholeheartedly believe that health care is better when our staff feel valued and are well.