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Healthier Working Lives ;

Analysis: Health and Social Care Workforce Research Study

An industry leading research study by the NIHR Policy research unit in health and social care workforce is the Health and Social Care Workforce Research Study that has conducted six online surveys - May-July 2020; November 2020-January 2021; May-July 2021; November 2021-February 2022; May-July 2022; November 2022-January 2023.

These surveys have been supplemented by a series of focus groups with two groups:

  1. Managers, employers and regulators of nurses, midwives, allied health professionals, social care workers and social workers
  2. Frontline workers – nurses, midwives, allied health professionals, social care workers and social workers.

The study focuses on mental well-being, quality of working life, burnout and coping strategies in nurses, midwives, allied health professionals, social care workers and social workers from across the UK, with the aim of providing evidence-based recommendations for supporting the workforce not just during COVID-19, but also during business-as-usual times.

While the survey found many staff had made use of employer’s support services, not everyone sees them as accessible or helpful. Investment is still needed here; the report’s authors recommend.

Source: Health and Social Care Workforce Research Study. This infographic, illustrating findings from Phase 3, is available to download, as are infographics from Phases 1 and 5 (see under Outputs, below).

The study has published reports and executive summaries from each of the six online surveys and several articles in peer-reviewed journals (all open access) as well as a book chapter.

Phase 6 Report March 2023

COVID-19’s Third Anniversary: Their Story of Wellbeing and Coping from the Health and Social Care Workforce. (Posted on March 10, 2023 by Stephen Martineau)

 The Health and Social Care Workforce Wellbeing and Coping Study has published its Phase 6 Report and Executive Summary. Researchers found the workforce faces continuing substantial pressure, staff shortages and is finding it difficult to cope. In this post, we summarise our findings.

The 6th Phase of this UK-wide multi-disciplinary study explored the impact of providing health and social care in the post-pandemic era from November 2022 until January 2023. We received 14,400 survey responses from social workers, social care workers, nurses, midwives, and allied health professionals. We conducted 18 focus groups with frontline workers, managers, and Human Resource professionals.

The study provides a unique opportunity to gain in-depth understanding of how the pre- and post-pandemic times have impacted on health and social care workers’ working life, as well as effects on their own health and well-being.

Our Phase 6 report presents survey findings collected over the six-months from the end of 2022 and up to early 2023. They reflect a difficult time of unprecedented industrial action in the NHS and continuing pressures on health and social care services. During this Phase, life was returning to pre-pandemic norms for most people in society, there were few remaining public restrictions, the use of face masks had generally ceased, although still being recommended in health and social care encounters and settings.

Health and social care services were therefore adapting themselves to a post-pandemic time at the same time as still caring directly for people with illnesses related to Covid-19, and delays in seeking healthcare. Other impacts of the pandemic have placed increasing pressures on health and care services, such as sickness absences, staff vacancies, and retention problems, with mental health problems and new conditions such as ‘Long-Covid’, now affecting workforce stability.

Multiple workplace factors are described as a ‘vicious cycle’. For example, increased job-related pressures, exacerbated by staffing shortages and vacancies (increased use of agency or locum staff) add to job stress and this affects staff’s mental health and well-being. Some respondents indicate lasting or new depression and anxiety, or long-standing distress or trauma because of working through the pandemic.

While the survey found many staff had made use of employer’s support services, not everyone sees them as accessible or helpful. Investment is still needed here; the report’s authors recommend.

Key Findings summary

Impact of COVID-19 on service pressures at end of 2022/start of 2023

  • A tiny minority (2.9%) reported that their service had not been impacted (services stepped down/changed due to COVID-19)
  • Over half of all respondents (58.1%) reporting feeling overwhelmed by increased and continued pressures.
  • Social workers and social care workers were the most overwhelmed occupational groups in terms of impact measured in this study (68.4% of social workers and 57.1% of social care workers).
  • Significant percentages of nurses (47.7%), midwives (39.4%) and allied health professionals (37.0%) also expressed feeling overwhelmed by increased pressures.

Intention to Leave Employer

  • Nearly half of the respondents UK-wide (43.0%) had considered changing their employer, with the highest proportion of these being from England (51.5%), closely followed by Northern Ireland (43.3%), Scotland (41.3%) and Wales (31.9%).
  • Within social work, 48.9% of respondents considered changing their employer followed by nurses (42.7%), AHPs (42.3%), midwives (41.4%), and social care workers (39.1%).

Intention to Leave Occupation

  • Over a third of the respondents UK-wide (39.6%) also had considered changing their occupation with the highest proportion of these being from Scotland (43.4%), followed closely by England (42.0%), Northern Ireland (38.8%), and Wales (27.7%).
  • Within social care workers, 44.2% considered changing their occupation during the pandemic, followed closely by midwives (41.4%), nurses (37.6%), within both, social workers and AHPs, 36.2% of respondents considered changing their occupation.

Intention to leave: Lower Quality of Work Life, Higher Burnout, and lower Wellbeing.

  • Both mental well-being and quality of working life deteriorated from Phase 1 to Phase 6 of the study.
  • Respondents who stated that they were intending to leave their employer and occupation reported lower well-being and work-related quality of life scores and higher burnout scores than those who did not intend to leave their employer or occupation.
  • Feelings about a lack of reward is evident in this survey’s responses and reports of seeking new employment suggested a rising rate of resignations and retirement intentions.
  • Respondents reporting client-related burnout, suggested that they were no longer feeling that their work with patients or service users was personally rewarding, and were more likely to have considered changing their job.

What have workforce told us about what they need for wellbeing and retention?

The survey findings suggest robust and reliable support systems/services are needed among all health and social care employers to stabilise the workforce, increase retention, and promote wellbeing at work.

Positive examples of supportive interventions have included working within capacity, safe workloads, supportive working culture, co-worker support, camaraderie, team support, manager support, and support for managers.

The reliance on managers to provide such support requires adequate and sustained support for managers themselves. This was confirmed by our focus group participants who confirmed that the main support people benefit from is each other. Therefore, building teams and support for teams are critically important.

More recent care workforce research here

McFadden, P. et al. (2022) ‘Mental well-being and quality of working life in UK social workers before and during the COVID-19 pandemic: A propensity score matching study’, The British Journal of Social Work, 52(5), pp. 2814–2833. https://doi.org/10.1093/bjsw/bcab198.

McFadden, P et al. (2023) Social Workers well-being, quality of working life and coping while working during and post-pandemic: Main findings from the UK and Northern Ireland Surveys. Belfast: University of Ulster Press. https://kclpure.kcl.ac.uk/portal/files/202521211/McFadden_et_al_2023_Occupation_of_Social_Work.pdf.

Ravalier, J. et al. (2023) ‘Working conditions and well-being in UK social care and social work during COVID-19’, Journal of Social Work, 23(2), pp. 165–188. https://doi.org/10.1177/14680173221109483.

Ravalier, J.M. et al. (2023) ‘Working Conditions and well-being across the COVID Pandemic in UK Social (Care) Workers’, The British Journal of Social Work, 53(2), pp. 1225–1242. https://doi.org/10.1093/bjsw/bcac214.

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