Retention Charter action 2.2

Action 2.2: Promote staff health and wellbeing and provide support, at an early stage, for those experiencing work-related stress, burnout, or ill health.
Action 2.2 is part of Domain 2 of the RCPsych's Retention Charter for employers - which relates to supporting psychiatrists' mental and physical health.

What stage is your organisation at?

Use this maturity matrix to assess what stage your organisation is at, in terms of Action 2.2. 

  • The organisation recognises that workplace stress is a systemic issue that can impact all psychiatrists and signposts them to a range of wellbeing support from various services, including both local and national resources.
  • The organisation actively reduces ‘blame culture’ and builds trust amongst Psychiatrists by acknowledging and communicating the wide range of stressors in the health service (e.g. stretched finances, workforce shortages, complex service structures and organisational change, increasing societal expectations) and what it is doing to help combat these.
  • Training is routinely offered for managers/supervisors to equip them with the skills to recognise psychiatrists displaying early signs of impaired wellbeing and effectively support them.
  • The organisation has a nominated Health and Wellbeing Guardian that attends board-level meetings, ensuring that staff health and wellbeing is central to organisational strategy.

  • Specific interventions are routinely offered within the organisation to help psychiatrists effectively manage stress and promote positive wellbeing such as psychoeducation, mindfulness, reflective groups, Schwartz rounds, job planning reviews, and healthy lifestyle interventions.
  • Supportive wellbeing conversations routinely take place within team meetings to promote peer support, alongside being discussed during individual supervision sessions.
  • A no-blame, fair learning culture exists for staff affected by safety incidents with an emphasis on co-produced learning, a systems-based learning response, and supporting staff to feel confident raising issues.
  • Named health and wellbeing champions exist across services and teams, with mechanisms in place to support people in these roles and develop their knowledge/skills.

  • A supportive culture exists where psychiatrists feel confident and able to discuss experiencing early signs of stress and/or burnout with their managers/supervisors and seek support at an early stage.
  • The organisation adopts a person-centred approach and creative solutions for promoting staff wellbeing, with evidence of staff co-designing and leading wellbeing initiatives.
  • Barriers to psychiatrists accessing relevant health and wellbeing support and services are regularly reviewed, and actions taken to reduce stigma and eliminate these barriers.
  • Bespoke support services are available for staff affected by traumatic events, such as patient suicide, patient homicide, violence, adverse incidents, or referrals to the regulator.

Advice and recommendations

  • Create a folder of local and national resources to support the wellbeing of psychiatrists and ensure that this is readily accessible and visible on the organisation’s intranet. 
  • Ensure that funding is ringfenced for staff health and wellbeing initiatives, such as creative arts and humanities and healthy lifestyle interventions.
  • Send regular communications to Psychiatrists acknowledging workplace stressors, including within the wider health service, and highlighting what the organisation and wider healthcare system are doing to address them.
  • Seek feedback from psychiatrists to understand any barriers to them accessing health and wellbeing support and work collaboratively with them to reduce these.
  • Ensure that systems are in place to support and promote confidential reflective practice amongst peers.
  • Organise team-level and creative organisation-wide health and wellbeing initiatives and advertise these through various means such as email communications, the intranet, and social media.
  • Provide training for supervisors/managers which focuses on spotting early signs of stress amongst Psychiatrists, increasing awareness of relevant policies and health and wellbeing support available within and outside of the organisation, and how to support Psychiatrists on an individual basis. This could include review of job plans, workload, and working arrangements including opportunities to work in new settings/and or teams as appropriate.
  • Caseload reviews are routinely conducted to ensure that workloads are appropriate and to proactively prevent Psychiatrists feeling overwhelmed or experiencing symptoms of burnout. These caseload reviews consider additional resources and time needed for managing clinical complexity.
  • Ensure that systems and policies are in place to proactively support psychiatrists experiencing potentially stressful events/processes such as those involved in adverse incidents, coroners case/s, and/or referrals to the regulator. This should include access to individual psychological support, compassionate communication, additional supervision and mentoring as required, and regular reviews of wellbeing. Learning from adverse incidents should be emphasised and such learning should be co-produced with staff.
  • Ensure that systems and policies are in place to proactively support psychiatrists who experience the suicide of a patient, homicide by a patient, or violence at work. For example, consider appointment of an ‘organisational pastoral suicide role’ who oversees and supervises how the organisation supports Psychiatrists following the loss of a patient by suicide.

Links and resources

Examples of good practice

Psychological support for staff working with patients during the pandemic

Professor Matthew Broome at the Institute for Mental Health (IMH) has described how clinical academics worked with University Hospitals Birmingham (UHB) and Birmingham and Solihull Mental Health NHS Foundation Trust to deliver psychological support for NHS staff working with patients with COVID-19 during the pandemic.

A crisis and triage service was also established in UHB for clinicians experiencing acute mental distress.

Videos to support staff during the pandemic

South Tees Hospital NHS Foundation Trust created a series of videos to help staff recover from the stresses, pressures and traumas of the COVID-19 pandemic.