Workforce burnout and resilience in the NHS and social care

House of Commons Health and Social Care Committee | May 2021 | Second Report of Session 2021–22 Report, together with formal minutes relating to the report

The Covid-19 pandemic had increased workforce pressures exponentially. In July 2020 the House of Commons
Health and Social Care Committee set out its inquiry into workforce burnout and resilience, to consider the scale of the problem and the factors underlying workforce burnout. Chapters in this report look at workforce culture and how it needs to change to better support staff in the health and care sector; the effect of the covid-19 pandemic on workforce burnout and resilience; and the specific pressures that have been placed on staff from Black, Asian and minority ethnic backgrounds both before and as a result of the pandemic. In the final chapter of the report, the Committee also considers need for better workforce planning to ensure that the health and care sector has the level of staff that it needs.

Workforce burnout and resilience in the NHS and social care

UK Parliament Committees Overhaul needed to tackle NHS and social care workforce burnout emergency

In the news:

BBC News NHS and social care staff burnout at an emergency level – report

BMA: Moral distress and moral injury Recognising and tackling it for UK doctors

BMA | June 2021 | Moral distress and moral injury Recognising and tackling it for UK doctors

This report is based on the findings of the BMA’s review of moral distress in the UK medical workforce. This included interviews and discussions with doctors, analysis of academic research, and the first ever pan-profession survey of doctors in the UK on moral distress

Moral distress is defined simply by the BMA as the feeling of unease stemming from situations where institutionally required behaviour does not align with moral principles. Moral injury can arise where sustained moral distress leads to impaired function or longer-term psychological harm. It has also been linked to severe mental health issues;
– Both terms are increasingly being applied to physicians in high-resource health settings

Source BMA

Moral distress and moral injury Recognising and tackling it for UK doctors

See also

BMJ Covid 19: Eight in 10 doctors have experienced moral distress during pandemic, BMA survey finds

Improving communication between health care professionals and patients in the NHS in England

NHS England | July 2021 | Improving communication between health care professionals and patients in the NHS in England

A systematic review of the international literature on interventions to improve clinician-patient communication has been undertaken by consultancy company SQW . Its aim was to identify interventions that have previously demonstrated a positive difference to patient experience and clinical outcomes, while also reducing financial demands on the health system. The options identified needed to be interventions that policy makers, commissioners and service managers across the NHS could replicate accurately, with a reasonable return on their investment and at a manageable level of implementation risk. This review was commissioned by Sir Simon Stevens

The SR had two principal aims:

• Whether this evidence now supports systematic investment in improving clinician/patient communication across NHS Acute Trusts in England
• If so, what particular intervention or interventions to target

Of the options identified by the literature review, this report recommends that NHS England & NHS Improvement initially invest in a single intervention: introducing patient-centred goals of care conversations with patients presenting in Acute Medical Units (AMUs) and Surgical Assessment Units (SAUs) who are at risk of dying in the next 12 months and/or are at risk of serious clinical deterioration and death during their presentation.

The full publication is available from NHS England Improving communication between health care professionals and patients in the NHS in England report

It’s also available as a summary report Improving communication between health care professionals and patients in the NHS in England

How to Measure the Value of Virtual Health Care

Harvard Business Review | July 2021 | How to Measure the Value of Virtual Health Care

The American Medical Association (AMA) and Manatt Health, a legal and consulting firm, have developed a framework for assessing the value of digitally enabled care.

The framework can be used by care providers to develop and evaluate new digitally-enabled-care models, by payers to inform coverage and payment decisions, and by policymakers to establish regulations that guide the future of virtual care.

The framework encompasses six dimensions: clinical outcomes, quality, and safety; access to care; patient and family experience; clinician experience; financial and operational impact; and health equity.

How to measure the Value of Virtual Health Care

Managing high frequency users of an electronic consultation system in primary care: a quality improvement project

Leung, K. & Qureshi, S.| 2021| Managing high frequency users of an electronic consultation system in primary care: a quality improvement project | BMJ Open Quality | 10| e001310|  doi: 10.1136/bmjoq-2020-001310

This project evaluated the number of high frequency users (identified as 10 or more consultations a month) of Dr iQ- an online consultation platform in one busy inner city practice over a 5-month period.

There were concerns from the clinical team about whether these patients’ health needs were being met and whether they were suited to the platform. The authors of this project proposed to evaluate the number of high frequency users of Dr iQ monthly over a 5-month period. Our aim was to decrease the subsequent monthly usage frequency of all Dr iQ high frequency users from 10 or more consultations to less than 10 consultations.

They report in their findings that prompt intervention of high frequency users through a multistep approach involving an initial telephone interview assessing their health needs, followed by case discussion in a multidisciplinary team setting and subsequent regular telephone or face-to-face consultations with a named clinician is effective in decreasing high frequency use.

Managing high frequency users of an electronic consultation system in primary care: a quality improvement project