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.
Co-Production
From start: No
During process: Yes
In evaluation: Yes
Evaluation
Peer: Yes
Academic: No
PP Collaborative: Yes
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Cheryl Ing - Employee Support Service Lead - Tees, Esk and Wear Valleys NHS Foundation Trust
Please briefly describe your project, group, team or service, outliningwhat you do and why it makes a difference
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 and Investors in People. The Trust has been an advocate of mentally healthier workplaces since 2009.
In December 2014 we were awarded the ‘Gold Standard’ by Investors in People (the highest level of accreditation). This is a nationally recognised people management standard which assesses how well organisations manage and develop their staff. The Employee Support Service has contributed to the standard of this award.
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 covers an area of 4000 square miles and travels to support staff at a location of the staff member’s choice. The Trust boundary 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 service sits within the Trust’s Health and Wellbeing Team. It maintains its independence from managers, staff and Human Resources which we feel is very important. The service launched in October 2011. Mental ill health was and still 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 experience mental ill health could return to work and continue to make positive contributions to the work we do at TEWV (Tees, Esk and Wear Valleys NHS Foundation Trust).
The team supports staff that are unwell and helps them to engage with the organisation. Some staff lose their confidence when they are unwell, this can have a big impact, especially when they are unwell due to their mental health. We help them to regain their confidence and reconnect them to back to the organisation and work which is an important part of their lives.
We work with staff, conducting stress risk assessments, phased return plans, explore reasonable adjustments, signpost staff to appropriate services and / or support outside the Trust’s remit, provides self-help tools and toolkits, information and resources and works with staff to help them understand the importance of maintaining a positive work life balance. All of this in done in co-production with our staff, we want our staff to feel valued and we want their experience of us and their return to be as positive as it can be. We also provide 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.
We are always there for our staff and we maximise our contribution by ensuring that our staff know this. We have supported thousands of TEWV NHS staff over the years, many of whom continue to access the service today, as and when they need to. We feel that for a relatively small resource, we have a huge impact across our organisation and what can be better than healthy valued staff.
The Employee Support Service has now entered its seventh year achieving excellent outcomes for staff that have accessed the service. There have been in excess of 3200 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 consistently fed back that the team’s approach and compassionate manner has been a vital part of their recovery and helped them when they felt they were at their most vulnerable (please see quotes). The team also provides proactive support to teams across the Trust, delivering sessions at Trust Staff Induction, raising awareness about the importance of mental health, wellbeing and resilience.
“I feel that without this support I would not have been able to return to my normal work routine.”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 personally felt I wasn’t just a number”
What makes your service stand out from others? Please provide an example of this.
There are many things that we believe make our service stand out. These can range from some of the successes we have had with staff who have been very unwell, to the sheer size and scope of what we do.
· Provide 1:1 Support, listening, advice and guidance, signposting
· Refer staff into our Employee Psychology Service – for work related stress/trauma
· Support staff to access counselling services
· Work with our Occupational Health Service Providers to ensure staff can access therapies such as CBT, CAT and EMDR
· Design and provide training for induction, team sessions, leadership courses, embedding the values courses
· Participate in listening sessions at our staff retreat
· Support teams experiencing a bereavement, support teams through change, support teams experiencing difficulties What we are most proud of are those moments when people move from being in a bad place to a better place, when people’s lives become better and you can visibly see the difference you are making, a smile, a twinkle in their eyes, their sense of humour returns and their whole demeanour changes and you know that they are on the way back from that dark place. As far as we are aware no other NHS Trust has a service of this type (although we have been approached by several NHS Trusts asking us how we do it), we continue to see larger numbers of staff accessing our service, due partly to the increasing stress levels that are being seen across NHS services. Our reputation for providing a non-judgemental independent service that works in line with NHS Codes of Confidentiality means that many of our referrals come via word of mouth from colleagues and managers.
“The support I received afforded me the time to recover, reducing my anxieties relating to my return to work.”Table 1: Number of referrals into the Employee Support Service 2011/12 to 2017/18 *Employee Support Officer (ESO)
Year 1
1 *ESO
Year 2
1 ESO
Year 3
1 ESO
Year 4
Service Expansion
2 ESO
Year 5
2 ESO
Year 7
2 ESO
Number of staff who accessed the Employee Support Service 138 244 326
405
494
891
(+ 792 year 6)
Number of staff at work at the point of referral/self-referral 63 115 158
227
284
605
Number of staff off sick at the point of referral/self-referral 59 109 144
150
209
286
Other 16
20
24
28
1
0
How do you ensure an effective, safe, compassionate and sustainable workforce?
The Trust works 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.
Well-being
We promote and support the wellbeing of users of our services, their carers, families and staff.
Behaviours
• 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 all our staff which can only lead to better care, better outcomes and empathy and compassion for the communities we serve.
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.
We continue to provide training on areas such as Stressbusting, Wellbeing and Resilience and have recently developed a wellbeing toolkit which we are piloting currently. We are also looking at designing a manager’s toolkit to help guide our manager’s support their staff.
‘We promote our service and provide information for staff so that they are able to choose how and when they access our service. We provide support for all staff and this includes staff who have existing lived experience in regard to mental health or have been newly diagnosed with a mental health condition, it is vital that we are able to support NHS staff working in mental health environments to ensure that they are able understand how important it is to bring their whole self to work and how this positively impacts on their role and the care they provide, it also demonstrates that we are an inclusive organisation and that our greatest asset is our people’.
“Non-judgemental attitude, listening, compassionate approach, wealth of knowledge and support”
When a member of staff is very unwell we may need to involve services or local G.P’s, we take our ‘Duty of Care’ very seriously and we will do whatever it is we need to do that is within the Trusts gift or our own to help our colleagues get, remain or stay well.
The training we provide enables staff to recognise when they need to pay more attention to their wellbeing. Work and life moves at such a fast pace it can be incredibly easy to forget yourself. We help staff to reconnect to themselves enabling them to be proactive where their health and wellbeing are concerned.
We continuously reflect on the service we provide and we engage with and co-produce with our colleagues to improve it. We have a Health and Wellbeing Strategy Group that meets quarterly and is chaired by a Director. We produce an annual report to ensure that we inform the Trust Board of Directors of any issues or trends in staff health and wellbeing.
Who is in your team?
Cheryl Ing 7 1 1
Tracey Marston 6 1 1
How do you work with the wider system?
We have introduced and signposted staff to other services including, addiction services, bereavement counselling, debt management, housing, food banks, carer support groups and services and many others. We also complete referral forms to our in-house Employee Psychology Service which helps staff with issues such as assaults, work related stress, anxiety, and trauma. We work with our Occupational Health provider to ensure that our staff are getting the very best support from this service. We work with our partners in housing, and social care when necessary.
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.
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.
“Quick and timely support when needed.”
Do you use co-production approaches? If so, please illustrate how you involve individuals, families and carers to drive improvement and deliver services?
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.
A quick example of co-production with staff
We are about to start some work on staff wellbeing checks for all our services and departments. We will work with staff and ask them what they would like included in the checks, how they would like to be asked about their wellbeing and what options managers could utilise if say for example someone attended work but was having a bad time at home.
We are also going to engage with our Trusts Diversity Engagement Group to engage with staff that have long term health conditions including physical and mental health, so we can better understand their needs. We will also evaluate this work and see where it can be improved.
Currently, we are evaluating our Wellbeing Toolkit – Feedback from staff is positive in the main, though we are concerned that some staff may not engage with it. We feel promoting the toolkit with some feedback from staff peers that have used it with success might encourage others to give it a go.
“I think TEWV do a great job, I was made to feel I was important”
Do you share your work with others? If so, please tell us how
We don’t outwardly publicise our work, but we do want people to know about our service which is one of the reasons we entered the Positive Practice Awards. Since we first entered the awards we have received requests from other NHS organisations to talk about what we do and how we do it. In year 7 the team hopes to continue to support organisations, teams and individuals and develop further supportive and preventative interventions.
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
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.
“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
We evaluate our service using Survey Monkey to send out evaluations to staff that have accessed the service. We utilise the feedback to develop and improve our service. We also evaluate any tools/products we design and pilot to ascertain if they are providing positive outcomes for our staff
This and other information is used to inform the Trust Board of Directors so that they are better informed and able to understand the issues our staff are experiencing.
Quantitative Feedback
Did the support you received meet your expectations?
Answer Options Response Percent
Yes 90.5%
No 0%
Not sure of what to expect 9.5%
If you were at work when you accessed support did this help you to remain at work?
Answer Options Response Percent
Yes 84%
No 16%
If you were off work when you accessed support did this help you to return to work?
Answer Options Response Percent
Yes 43%
No 0%
N/A (at work) 57%
Would you recommend the service to a friend or colleague?
Answer Options Response Percent
Yes 100%
No 0%
Unsure 0%
Qualitative Feedback
“I have used this service when off sick after losing my son, when off sick for depression and for support during a disciplinary matter. The team are incredibly knowledgeable and supportive. They are able to signpost to services and advise. I would recommend this service (and have done) to any of my colleagues” “I cannot speak highly enough of this service. I was provided counselling which helped me address my issues, even though the ESO was and still is a very busy lady she was always contactable be a shoulder to cry on and also tell you what was needed which I really needed. As I mentioned in one of the previous boxes if it wasn’t for the service I was given I would have lost my job because I had simply checked out and didn’t care anymore. Three years later I have moved up bands, in a very nice place mind wise and happy. I think the trust should be extremely proud of this service.”
“Truly excellent. The support was more than I expected, underpinned by a sense that the person engaging with me was congruent and genuine.”
“I feel the service provided is an essential tool in assisting individuals who are currently on sickness. I personally felt I wasn’t just a number as the support I received afforded me the time to recover, reducing my anxieties relating to my return to work.” “I have already recommended the service to several work colleagues. I think staff are extremely lucky to have this service available to them. The ESO was responsive when I emailed her, she visited me at home where I felt more comfortable and was always there to listen, which was always much appreciated. She referred me to the employee psychology service, which I also found extremely valuable. Between ESO, EPS and the Sickness Team in HR I felt listened and supported where my Line Manager had failed to do this. I think this is a fantastic service”
“The support I received helped me to realise that I wasn’t alone, in terms of others suffering from similar problems”
“I met with Employee support to discuss aspects of work which had contributed to my increased stress levels & to identify possible strategies for managing these differently & avoiding a return of these feelings. I met with a counsellor & also went on a retreat stay. The Retreat stay was really helpful in providing a space for reflection & discovery and also for finding my own inner resources.”
“Regular contacts, non-judgemental attitude, listening, compassionate approach, wealth of knowledge and support, with genuine understanding. The ESS service is an important aspect for all employees, and being a member of staff for 20 years in the trust, I really needed the support at the time I did.”
How will you ensure that your service continues to deliver good mental health care?
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.
How many people do you see?
We see people in a number of different ways, for example:
· During 2017/18 (April to March 2018) we had 891 staff referrals
· 721 were 1:1 (individual referrals)
· We also see small groups of staff and individuals when we support the Trusts Friends and Family Test work to help improve team wellbeing (170 referred were in small staff groups)
How do people access the service?
People access our service through a variety of routes including: · Self-referral
· Manager referral
· Sickness Absence Team Referral
· Occupational Health Referral
· Colleague referral
Staff can contact us by: · Email
· Mobile phone
· Skype (coming soon) There are a number of ways we promote our services, including:
· Mandatory training – e-learning our contact details are included on the Trusts Equality, Diversity and Human Rights Training which all staff complete
· We have web pages on our internal Trust website InTouch · We produce leaflets and information, we also advertise our service on E-bulletin our Trusts weekly newsletter
· We deliver a session at Trust Staff Induction
How long do people wait to start receiving care?
We make contact with 85% of our staff within 1-3 days and 13% of staff between 3-5 days and 2% staff over 5 days – (This is usually because they are on holiday or in hospital etc. so we cannot get hold of them)
We see approx. 40% of our staff within 1 week of referral; we see approx. 40%of our staff at week 2 and approx. 20% of staff between weeks 3 and 4. This can be for a multitude of reasons including:
· They are on holiday
· They are very unwell and want to wait a short while before engaging
· We cannot fit them in due to other commitments
· They cannot fit us in due to their commitments
How do you ensure you provide timely access?
We ensure that we have a telephone conversation with the staff member at the earliest opportunity. From this we ascertain:
· The nature of the referral
· The severity and if any immediate action/s are needed
· Identify: is it is work related/home/personal or a bit of everything?
· How long the appointment needs to be and where – so for example: if an Employee Psychology Referral is needed it will need to be in a private place. E.g. home or a private room at work.
· Any contact information they need/we need
· Anyone else affected
· Anything we need them to do (such as a personal reflection) before we meet
· Anything we need to do (such as prepare documentation, leaflets, support information etc.)
· We prioritise based on need and availability so for example someone experiencing trauma at work, such as a serious assault will receive an immediate response from our service. We do move less urgent appointments if an urgent request comes in and we need to see someone quickly.
*Please note we are not a clinical service
What is your service doing to identify mental health inequalities that exist in your local area?
We report to and inform our Trust Board of Directors about the key reason/s our staff refer into the service. By making our Trust Board aware we believe we are demonstrating that we have a diverse staff group that can help meet the needs of the communities we serve. We provide reports to our Trust Board of Directors about access rates, referral reasons etc. This information is anonymised and staff cannot be identified. We also signpost staff who have accessed our service to the Trusts Diversity Engagement Group that meets to take forward inclusion and equality for staff working for the Trust.
We: · Collect and analyse data
· Work with individuals and teams to understand and meet their needs
· Report openly and honestly about themes and trends to our Trust Board of Directors
· Work with individual staff on stigma issues relating to their own mental health
What inequalities have you identified regarding access to, and receipt and experience of, mental health care?
People who deliver mental health care may find it personally very difficult to access care. This is why it is incredibly important to continue to talk about mental health in an open way, recognising that nurses, doctors and health care assistants are just as susceptible to experiencing mental ill health as anyone else.
What is your service doing to address and advance equality
Our service embraces Equalities Legislation and recognises that the work that continues, particularly in relation to the Protected Characteristic of Disability. Mental Health is covered by the Act, it could be argued that society does not recognise it in the same way as a physical disability, indeed many people do not like the term disability (in relation to mental health) but from a legislative perspective this is where people who experience enduring mental ill health are protected, reasonable adjustments are and should continue to be equally attainable by people who experience mental ill health. There is still much work to do but in our small way we do what we can to ensure that our service upholds the duties of the Act by: · Working with individuals and groups to understand and meet their needs
· Reducing stigma and raising awareness
· Empowering people with mental ill health and those who do not have mental ill health to be successful, accepting, compassionate and positive about theirs and other people’s mental health
How do you meet the needs of people using the service and how could you improve on this?
We always ask people what they need and we accommodate people by meeting them somewhere accessible and where they feel most comfortable. We evaluate our service and our materials to ensure that we continue to develop and improve our service in respect of this.We also help ensure that staff can access reasonable adjustments at work and we have done a lot of work with staff identify as Dyslexic this year.
What support do you offer families and carers?
We often encounter staff that are carers for family members with mental ill health, learning disability or physical/medical illness. The first thing we do is ensure that they are aware of the support that is out there for them and then we will source additional information for them.
We also recognise how hard this can be for someone who is at work and may be struggling both emotionally and in relation to how they can manage both work and caring responsibilities.
Further information
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.
Population details
We provide a range of mental health, learning disability and eating disorder services for the people living in County Durham and Darlington, the Tees Valley and most of North Yorkshire.
With over 6,700 staff and an annual operating income of over £300 million we deliver our services by working in partnership with local authorities and clinical commissioning groups, a wide range of other providers including voluntary organisations and the private sector, as well as service users, their carers and the public.
TEWV serves patients across a large geographical area. Our main towns and cities are Durham, Darlington, Middlesbrough, Scarborough, Whitby, Harrogate, Ripon, Selby and the Vale of York and there are numerous smaller seaside and market towns scattered throughout our patch. We are also in the catchment area for the largest concentration of armed forces personnel in the UK (Catterick Garrison).
