Action for Care-worker Wellbeing
Not wishing to rain on your parade of World Mental Health Day positivity, but there’s something wrong with our care of the people delivering the services we’re all relying on.
The wellbeing of care-workers has emerged as an important policy and employment relations issue over the last ten years. In addition to the occupational hazards of the caring professions working with people in distress, the impact of structural and financial pressures to deliver public service in a context of reduced staffing levels and subsequent work intensification is recognised as a significant downward pressure on frontline staff wellbeing. Financial cuts to health and social care services have led to a consistent rise in temporary, non-clinical and externalised labour in the sector that is linked to an increase in the under utilisation of staff skills and the de-professionalisation of clinical roles. This in turn has led to the growth of precarious work in the sector, characterised by uncertainty, instability and insecurity.
This has huge consequences for our nation’s mental health. Working like this leads to burn-out, sickness and absence in care workers representing a huge cost in human and economic terms. Stressful, demoralising and oppressive working conditions reduces performance, morale and efficiency, and ultimately our capacities to care.
On the 10th October a group of progressive people – from professional and service user backgrounds – will meet to design a national ACW campaign to support the mental health of care-workers. As the campaign evolves during 2018-2019 we’ll keep you posted about how to get involved.
Action for Care-worker Wellbeing
Action for Care-worker Wellbeing (ACW) is a multi-professional group of key UK caring professions in the NHS and social work. The purpose of the group is to provide a forum for exploring whole-systems policy solutions to the increasing and worsening cases of stress, burn-out, and mental and physical illness within the social work and NHS workforce.
ACW was established in autumn 2017 by senior managers and representatives from the NHS (Royal College of Psychiatry, Royal College of Nursing (RCN), Royal College of Paramedics), Dr Elizabeth Cotton, an academic expert in mental health issues within the workplace, and the British Association of Social Workers, the UK professional body for social work. The impetus for establishing ACW came from former employees in health and social care who had experienced mental breakdown due to stress in the workplace.
In the NHS and social work, it is recognised that stress and burnout have a detrimental impact on productivity and have financial and personal costs. For instance, Public Health England estimates that the cost to the NHS of workforce absence due to poor health is £2.4bn a year – accounting for around £1 in every £40 of the total budget. This figure excludes the cost of treat or the additional expenditure on agency staff who are contracted on short-term basis to replace staff absent due to ill health from stress., In social care it was estimated that in 2016-17, there was a 27.8% turnover of staff and 6.6% vacancy rate and a recent study found high levels of stress, ‘presenteeism’ and adverse working conditions in social work.
There have been discrete initiatives to address these issues by professional groups within the NHS but it is acknowledged that there has been limited success. In social work, there have been longstanding concerns about high vacancy and turnover rates but no coordinated central government policy to mitigate these. However, there is a strong argument that these issues should be addressed through a whole systems perspective, with policies encompassing all professions within health and social care. This is because these sectors mutually influence each other and there are similar causes of stress and burnout. Furthermore staff in the caring professionals report common experiences of capped pay, increasing demand for services met by a diminishing workforce, and they are all regulated professions.
Uniqueness of ACW
ACW is unique because it is arguably the first formal, unified, multi-professional advisory and policy-oriented group to have, as its central aim, the protection and support of the national professional care-force. This forum will provide a unique context for the professional and academic sectors to collate evidence, raise awareness, initiate and lead debates; and define the safety and professional standards relating to care workers well-being.
Key objectives of ACW
- Leading public debate about the well-being issues affecting professionals
- Challenging the stigma associated with mental health and psychological problems within the care-force, highlighting the need for regulatory protections
- Identifying common problems faced within the care-force; developing and promoting policy interventions to address them
- Collating and disseminating data about the working conditions of professional care workers, drawing on their own experiences
- Challenging decision makers, employers and regulators to establish evidence-based workforce support practices and regulations that facilitate genuine well-being, planning and development across the professional care workforce.
Stress and ill-health within the health and social care sector must be addressed because of the evolving ‘perfect storm’ of rising demand for services, decreasing workforce – likely to be exacerbated by Brexit – and increasing staff turnover and worker attrition. These have personal impact on the existing care-force and arguably lead to higher overall cost of running services.
The personal and economic cost of care-worker distress
One personal cost of increasing stress is suicide among professionals as encapsulated in the table below, which is an analysis of suicide by occupational group conducted by the Office for National Statistics
Profession Males Females
Medical practitioners 59 22
Psychologists 9 6
Pharmacists 10 13
Medical radiographers 5 2
Podiatrists 2 1
Health professionals 2 6
Physiotherapists 3 7
Occupational therapists 4 10
Speech and language therapists 0 4
Therapy professionals n.e.c. 4 8
Nurses 64 148
Midwives 0 6
Social Workers 18 15
Paramedics 17 3
The Samaritans calculate that each death by suicide costs about £1m per death. Based on this estimate, the total economic cost of suicide within the care workforce from 2011 to 2015 is approximately £500m.
In addition to the above, the Health and Safety Executive (HSE) has published estimated cost of ill health within UK public services, which is reproduced below.
Workplace injury and ill health impose costs: both ‘financial’ (for example in terms of lost output and healthcare) and ‘human’ (a monetary valuation of the effects on quality of life, and for fatalities, loss of life). Taken together, this gives the total cost to society.
The total cost of workplace injury and new cases of work-related ill health in public services in 2015/16 is estimated to be £5.2 billion (£1.5 billion injury, £3.8 billion ill health). This accounts for around 35% of the total cost across all industries – £14.9 billion.
This cost is shared between individuals (mainly arising from the monetary valuation of the human costs), employers (e.g. sick pay costs, insurance premiums, and production disturbance) and government/taxpayers (e.g. state benefits payments and healthcare costs).
As the Action for Care-worker Wellbeing campaign develops information will be posted on the BASW website.
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