UK Covid-19 Inquiry Module 3 report: Scottish Government response

Recommendation 10 - Psychological and emotional support for healthcare workers

Chair’s recommendation:

The UK Government, Scottish Government, Welsh Government and Northern Ireland Executive, working with healthcare employers and professional bodies, should put in place plans to deliver effective support for healthcare workers at scale from the outset of a pandemic. Plans should cover the nature and level of support that will be provided during and after a pandemic.

All four governments should develop a programme of peer support visits that can, from the outset of a pandemic, be targeted towards areas of acute hospitals under considerable strain. The purpose of the visits should be to support front-line staff, collect insights on the pressures that healthcare workers are facing and understand what further support they might need.

Scottish Government response:

The Scottish Government accepts this recommendation in principle. The learnings of the pandemic have informed the development to our current wellbeing offer, and staff wellbeing will be an urgent and early priority in the event of a future pandemic. Feedback from CIREG has also highlighted the importance of ensuring that staff wellbeing is an early and urgent priority in any future pandemic response.

We recognise that wellbeing is essential to delivering safe, high-quality care and supporting our health and social care workforce to deliver better outcomes for patients and communities. Through the Staff Governance Standard, Health Boards are already required to recognise that staff wellbeing should be paramount in the design and operation of services. We know that investing in wellbeing helps retain staff, reduce absence, and build a sustainable workforce.

We have maintained the wellbeing programmes which were introduced during the Covid-19 pandemic. Over £2.5 million is invested annually through boards in national wellbeing programmes that support staff mental health, return to work and retention, and improve patient safety and care, in addition to the work boards do at a local level. Wellbeing services include a 24/7 compassionate listening service via the National Wellbeing Helpline (delivered by NHS 24), self-service resources through the National Wellbeing Hub, and access to psychological interventions and therapies. In addition, registered staff can receive confidential mental health support through the Workforce Specialist Service. In the event of another pandemic, we would look to build on this work, scaling it up rapidly to meet demand.

In a future pandemic, we propose to closely monitor staff wellbeing and morale through regular online surveys, and building on the regular conversations that already take place with board level wellbeing champions, in order to ensure the wellbeing work we do is timely and based on need.

Through the Nursing and Midwifery Taskforce (NMT), we have commenced work which would contribute to this recommendation: how to enable reflective support when nurses and midwives face traumatic situations at work; and ensuring access to reflective practice, peer support, or restorative supervision at a time that is suitable for staff. We will build on and learn from this, expanding it to other areas of the workforce and increasing provision in the case of another pandemic.

In relation to peer visits, the learning during Covid-19 highlighted the importance of manager support and peer connection especially for those working from home and those redeployed. Capacity and infection control measures would need to be taken into account when facilitating ‘peer visits’ and the approach would require flexibility.

We will work with Health Boards to develop a list of appropriately trained peer supporters and reflective practice facilitators, within health and social care, which would enable us to set up peer support groups in short order (in person or online as appropriate) to enable staff a regular opportunity to reflect upon and redress their psychological and emotional experiences.

Four nations engagement has already begun on these areas, and while delivery will take place on a devolved basis given the structures already in place, information and good practice sharing will continue between the four nations.

Actions and implementation timescale(s):

We will maintain existing levels of wellbeing provision and rapidly build on this should a pandemic occur.

We will work to begin delivery of the two NMT recommendations by the end of 2027, building on the learning and expanding across the workforce should it prove successful over the course of the parliament.

Upon the onset of a future pandemic, we will liaise with board level wellbeing champions via the Wellbeing Champions Network which currently meets on a quarterly basis, to inform additional wellbeing support for staff. We will also put in place checks on staff wellbeing through online surveys to inform targeted interventions that meet the wellbeing needs of staff.

We will work with Boards to develop a list of appropriately trained peer supporters and reflective practice facilitators by March 2027, ensuring this is kept up to date thereafter.

Accountable Officer:

The Director General for Health and Social Care will be accountable for the implementation of the Scottish elements of this recommendation, with day-to-day responsibility sitting with Health Workforce Directorate of the Scottish Government, working alongside health boards and other partners.