A new report from the Healthcare Safety Investigation Branch (HSIB) outlines the most important factors for supporting staff in the wake of safety incidents, against the backdrop of the COVID-19 pandemic.
The report, Support for staff following patient safety incidents, reinforces the importance of effective staff support for those suffering high levels of psychological harm, as it has a direct impact on patient care. Evidence behind the key findings comes from current/relevant research and the insights of HSIB’s investigators, who interview NHS staff and could also share experience in sectors such as aviation, military and policing.
The report details three different examples of staff support approaches – two in Trusts in England and a medical centre in the US. The findings were then grouped into four key themes which identified the most important areas for successfully developing programmes.
- Context – the culture and leadership of the organisation and normalisation of the need for support.
- Individualisation – identification of staff members or groups at particular risk, offering different routes for support.
- Delivery – accessibility out of hours, proactive delivery and resourcing of peer supporters.
- Investigations – a clear focus on learning, clear timelines and communication and participation of individuals in resulting service improvements.
The report features a first-hand account from a junior doctor which charts the impact that a patient safety incident had on his life and his experiences of support. Excerpts from the story emphasise the importance of creating a ‘normalised’ culture around accessing support.
It also shines a light on the burden staff carry with them as they continue to care for patients The doctor said: “I knew deep down that my actions were not responsible for this patient’s death, but the conduct of the interview cast severe self-doubt once again. At the time, I felt torn between seeking help and just keeping quiet. I felt that seeking support would be an admission of wrong-doing and inadequacy.
“The aftermath of a patient safety incident quite rightly prioritises the patient affected and their family. It should be remembered though, that the staff involved in the incident will continue to care for others with a burden of emotion, as it was never their intention for things to go wrong.”
Dr. Lesley Kay, deputy medical director at HSIB, commented: “We recognise the challenges faced by organisations when developing programmes to meet the differing needs of all staff – both in the short term, immediately after incidents and the longer term, the process of being involved in investigations or inquests.
"Our report is aimed at helping the health system by providing detailed analysis and pinpointing some important factors that could underpin any programme or initiative that supports staff after safety incidents. It shows that the principles for effectively supporting staff overlap with those set out in our recent report focused on the importance of the family and patient voice in investigations.
"Providing the best level of support to all minimises distress and psychological harm, reduces the risk of further negative impact on patient care and improves safety across the NHS. This is particularly important as the COVID-19 pandemic places enormous pressure on services and has brought the wellbeing and safety of staff to the fore.”
