Tom Houston is healthcare client partner at Gobeyond Partners, part of the Webhelp group. This is Tom’s latest article, originally published on gobeyondpartners.com looks at burnout in the NHS and how thinking from outside the healthcare sector can provide potential solutions.
Pressures on clinical teams across the NHS have never been higher, but it’s not just the pandemic that is to blame.
Last year, one NHS worker resigned every five minutes* due to burnout, post-traumatic stress disorder, or the need to restore their work-life balance. As a result, one in ten nursing posts is now empty, and there are almost 100,000 total vacancies across the NHS, with an even higher number in social care.
After two difficult years of battling the pandemic, it’s understandable why people are leaving the NHS, but this exodus is also having a detrimental effect on the quality of care — more than a quarter of UK adults say they or an immediate family member had received poor care as a result of the workforce problems, according to The Guardian.
While direct pressures from the pandemic appear to be easing, the NHS is now facing a backlog of 6 million elective procedures that brings its own set of challenges. Still, looking outwards, the UK’s healthcare sector can benefit significantly from new technological innovations that other industries use to solve similar crises. Let’s explore this idea in more depth.
* Based on the weekly total sourced from this article, divided by 5 days, 7.5 hrs a day and 60 mins
How did the NHS get here?
A critical factor behind staff burnout is work-related stress and poor mental health, which can be linked to a lack of flexibility in work patterns. Poor work-life balance is increasingly being cited as a reason for leaving the NHS, accounting for 10% of leavers in 2019, compared to just 4% in 2011.
In a typical NHS Trust prior to March 2020, you would have expected an average staff absence rate of between 4% and 5%, which is equivalent to everyone taking one sick day a month. However, in some areas, such as maternity, there’s a disturbing upward trend, with rates now averaging 7.1%.
Almost one-third of NHS staff often think about leaving the organisation, according to this year’s staff survey. The Nuffield Trust also reported a 50% increase in the proportion of doctors considering leaving the NHS this year compared to 2019.
With workforce management and organisational development teams under immense pressure to stem this exodus and support clinical teams, the NHS must look at other ways to solve the challenge beyond the usual performance management strategies.
Proven initiatives to alleviate burnout
Repairing the damage done by the lack of national-level workforce planning and investment is no easy task — for example, the Health Foundation estimates the NHS would need more than 300,000 more full-time equivalent staff by 2031 than in 2021 just to deliver the level of care seen in 2018 and 2019.
So, what specific things can we do to alleviate burnout in the short term? For starters, there are already examples of NHS providers placing significant organisational focus on a range of support strategies, including:
- Health and wellbeing champions
These are people from all demographics and roles who work at all levels of the NHS to promote and identify local or national health and wellbeing support programmes for colleagues.
- Nurse retention programmes
One such programme in Lincolnshire led to the identification of rotational posts for a set of roles within various disciplines. The team introduced a legacy nurse initiative to support newly qualified nurses with information sharing, a mentorship programme, and a buddy system. They also introduced insight days to allow staff to spend time working on different wards before opting to make a permanent move.
- Improved e-rostering and effective job planning
By enhancing existing WFM platforms and processes, NHS providers can ensure the proper staffing at the right time, boost productivity, and encourage shift patterns with a steadier workflow to create a calmer working environment. However, the benefits are lost amidst ever-growing vacancy pressures.
While these strategies and tools can alleviate some of the pressures of a dwindling workforce, the improvements still do not go far enough to solve the broader burnout crisis.
That’s where innovation and outside inspiration come in.
Looking outwards for an innovative source of help
Traditionally within the NHS, it can take a long time to accept and roll out innovations at scale, but when the solutions are already out there, with proven seismic impacts in other sectors, adoption should become an easier pill to swallow.
One unlikely area we can look for inspiration is the fast-changing world of social media and the content moderators who assess the videos, photos, live streams, and other content being shared across these platforms. Content moderators share much in common with A&E staff, working long hours on antisocial shifts and dealing with distressing incidents, including witnessing harm and injury. Over time, too much exposure to these incidents can significantly affect mental well-being.
The social media sector has taken this issue to heart and harnessed the benefits of machine learning — a subset of artificial intelligence (AI) — to solve the problem. At Gobeyond Partners we have worked closely with one of the leading social media platforms to develop machine learning to support their teams. The project involved using technology to help identify team members who might be at risk of burnout, and to act before it happens. This approach resulted in reductions in sickness and absences across 2021, with further reductions in the numbers of content moderators choosing to leave the organisation.
This machine learning involves analysing many factors linked to a person’s wellbeing. In the context of the NHS, these could include measures such as a person’s tenure in the role, the number of night shifts worked in a set period, the number of deaths or emergency escalations they experienced during their shift, or the time since their last holiday, to name a few. By analysing factors like these over time, it is possible to develop a predictive model that learns which factors — or combinations of factors — are most closely linked to a team member needing to go on sickness leave.
Applying machine learning tools and principles to the NHS
The big question is, can AI tools like those used in social media help the NHS achieve its own reduction in sickness absence days and staff attrition?
The availability of key metrics will determine how effective machine learning can be, but early indications suggest that NHS providers have enough information available to obtain greater insight and accuracy than other sectors could achieve. However, providers should offer a clear opt-out to all staff and ensure that the process is run entirely separately from existing performance management initiatives.
The critical takeaway for NHS providers is to leverage AI for its live, continuous learning capabilities, allowing it to continually improve its ability to predict where, when, and who is at greatest risk of burnout. This automated learning should be directly supplemented by individuals providing input about their wellbeing via a straightforward app if they wish to do so. Specialist-trained professionals can then offer and instigate care conversations with individuals who may be at risk, with psychologist input where required.
Fix burnout; Support the NHS, its people and its patients
While a high proportion of turnover will always be driven by age-linked retirement and geographical relocation, if the NHS could achieve even half of the retention improvements seen in social media, it would result in a seismic slowdown in national staff shortages over time, providing renewed hope of achieving workforce sustainability.
People in the NHS are working as hard as they can with the resource they have to address staff wellbeing and increasing burnout, but by looking beyond traditional means to find a solution, we can take care of our staff on a whole new level.
So let’s take bold steps, embrace proven success stories, and consider the benefits of machine learning and AI to help us improve the NHS and give its people and patients a better and more caring experience.
Tom Houston has over 20 years of consulting and transformation leadership experience, 12 of which have been exclusively supporting the NHS. He helps healthcare organisations to plan for and deliver sustainable services and to transform experiences for patients and staff.
To learn more about our project to bring world-class machine learning (AI) driven staff wellbeing support to the NHS, please get in touch.