ÌÀÍ·ÌõÎÛÁÏ

How we collected evidence

In April 2023, we carried out a survey of all 42 ICS in England. We asked them about their current health and wellbeing provision and plans for future funding.

We wanted to understand:

• whether they continue to receive any funding for the mental health and wellbeing hubs set up during the pandemic
• the types of support being offered to ÌÀÍ·ÌõÎÛÁÏ staff by the hubs 
• the impact of the hubs on staff wellbeing 

We'll repeat this survey in April 2025, to better understand how the provision of support has changed over time. 

What we learnt

Several hubs that had remained open said they would be offering reduced services due to funding being withdrawn. Several ICS continue to offer services despite their hub’s closure, such as occupational health, employee assistance programmes and talking therapy services. 

From the feedback provided, the hubs seem to have had a positive impact on those who accessed them. Most hubs said that users were better able to return to work and remain well at work after accessing the hubs. Some hubs had close to a 100% satisfaction rate.

The support offered to staff through the hubs generally included:

• individual mental health consultations 
• referral to local mental health services 
• in-house support services 
• online training 
• team support sessions 
• individual and group therapy sessions 
• support and training for managers on topics such as compassionate leadership and workplace wellbeing  

Wider support was also available for issues such as:

• burnout 
• mindfulness 
• menopause 
• incident response 
• reflective leadership support 
• financial and cost of living advice 
• virtual exercises 
• specific support for long COVID (including group support and neuropsychological assessment) 

There was limited clear feedback on the impact of the hubs from those who responded. Not all hubs provided detail regarding feedback they received from service users.

There’s limited data available on the usage rates for health and wellbeing hubs. Respondents did not provide data showing what percentage of their staff had accessed the hubs. It’s also difficult to understand how well the hubs were advertised, and how many staff were aware of the services offered.

While it appears that hubs provided good support and had positive impacts on those who accessed them, it’s unclear what percentage of the total ÌÀÍ·ÌõÎÛÁÏ workforce is represented by their service users.

The pandemic has significantly affected wellbeing among ÌÀÍ·ÌõÎÛÁÏ staff. Ill-health, burnout, reduced working hours and early retirement have all increased.  

Registered nurses’ exhaustion can lead to emotional and cognitive detachment from work. This can lead to increases in patient infections and nurse workload. Nurses working in hospitals with fewer registered nurses per patient were more likely to report higher levels of burnout and intent to leave their job. Nurses are experiencing moral injury through sustained exposure to unsafe working conditions, and this may lead to more post-traumatic stress disorder and other mental health conditions within the workforce.  

We have previously raised concerns about the closure of the hubs. Support for ÌÀÍ·ÌõÎÛÁÏ staff is critical to combatting rising rates of suicide, burnout, mental ill-health and sickness absence.

Rates of sickness absence and attrition are lower in workplaces where nurses are being supported in relation to their mental health and wellbeing. 

The cost of funding access to services such as counselling and talking therapy are considerably lower than the cost associated with recruitment of new staff to replace those who are burned out, on extended sick leave or have left the profession altogether.

The current levels of support being provided in the wake of hub closures is inadequate to meet the mental health and wellbeing needs of nurses. The most recent data on staff sickness from NHS England shows that more than 1.5 million nurse and health visitor days were lost in 2022 due to anxiety, stress, depression and other psychiatric illness. On average, 1 in every 5 sickness days were lost due to mental health issues. 

We have previously called on the government to urgently provide funding for dedicated mental health service provision for ÌÀÍ·ÌõÎÛÁÏ staff. If the government doesn’t view the hubs as successful or effective value for money, then it must provide alternative services.  

Responses to our survey indicate that, while some ICS would continue to offer reduced services or alternative services, these were not consistent across ICS, and it was not clear that they would be provided in all cases. It’s crucial that, regardless of which ICS a nurse works in, they have access to quality, timely support for their mental health and wellbeing to allow them to return to and remain in work.

Integrated Care System leaders should: 

• Clearly advertise the support available to staff, and make sure it’s easily accessible 
• Urgently prioritise the provision of additional mental health and wellbeing support when allocating budget for services 

Service providers should:

Use the RCN Workforce Standards to support a safe and effective ÌÀÍ·ÌõÎÛÁÏ workforce. Ensure nurse leaders are involved in workforce planning, setting staffing establishments and developing individuals within their workforce. The relevant standard is: 

• The health and wellbeing of nurses is fundamental to the quality of care they can provide. Supporting the ÌÀÍ·ÌõÎÛÁÏ workforce to practice selfcare will help improve recruitment to the profession as well as support retention of the current workforce.