Creating Good Wellbeing Cultures
Supporting our Line Managers to embed cultures which create wellbeing in teams, so that colleagues can stay and thrive and deliver excellent patient care.
Created in partnership with: NHS England North West
Lancashire and South Cumbria Integrated Care Board
Greater Manchester
Cheshire and Merseyside
Why Wellbeing Matters
Background:
The North West experiences poorer population health outcomes than other regions in England. This leads to higher sickness absence rates but also challenges caused by presenteeism (staff in work when they do not feel well enough to be).
The Annual NHS Staff Survey repeatedly shows that colleagues feel burnt out and lack the energy for personal relationships. Professor Michael West (Professor of Organisational Psychology) warns, “We risk damaging the health and wellbeing of the people we ask to deliver our services,” and reminds us that “Compassion and compassionate leadership do not require learning new skills - it’s reminding ourselves of who we truly are.”
In response to feedback, the North West Growing Occupational Health & Wellbeing Delivery Group, facilitated by North West NHS England, developed a multi-media resource to guide managers in:
• Creating purposeful wellbeing cultures, and
• Making more informed Occupational Health referrals/fitness for work assessments.
Intended outcomes:
• Empower Line Managers, in terms of creating cultures which support wellbeing in their teams, enabling team member’s wellbeing needs being supported earlier.
• Support a better-quality Occupational Health referral/Fitness for Work assessment submitted, enabling experts to provide more timely and accurate advice to Line Managers.
• Reduce the number of referrals being returned for additional information.
• Release capacity in Occupational Health/Employee Health & Wellbeing team to move from a more re-active to a pro-active focus.
Strategic alignment:
This work aligns with the 10 Year Health Plan for England and The Darzi report’s call to shift from “sickness to prevention”, also the national Growing Occupational Health & Wellbeing Together Strategy, which urges integrated care systems to expand Occupational Health & Wellbeing services as a strategic priority.
It complements internal Organisational wellbeing initiatives led by Health & Wellbeing Guardians and supported by national resources such as the NHS England Health & Wellbeing Framework, the Wellbeing Community, Looking After Your Team’s Health and Wellbeing Guide and the NHS England Flexible Working Toolkits
Resources
These resources were created with expert input by Occupational Health & Wellbeing specialists from all three of our North West Integrated Care Systems. The resources include:
Resource Purpose
Good Wellbeing Cultures Flipbook, including:
1. Training Animation (duration – 2 mins)
Includes all resources developed to empower our Line Managers to support colleague wellbeing at the earliest opportunity.
Designed to be embedded into existing leadership development or standalone training.
Who Can Use
All Line Managers across our health and care organisations
2. Line Manager Guide (interactive PDF)
3. Line Manager Guide (OPAS-G2 Digital Platform)
Consisting of 7 questions, to encourage Line Managers to consider the options available to them to support their member of staff to stay in work or return to work sooner
All Line Managers across our health and care organisations
4. Guidance When Making A Referral
Pre-submission form built into the OPAS-G2 digital platform for Occupational Health referrals/Fitness for Work assessments.
Includes additional consideration when completing a referral.
All Line Managers across our health and care organisations. Organisations build into the workflow to providing prescreening guidance and support for managers when completing a referral.
Organisations using Civica (OPAS-G2) as their digital platform for Occupational Health referrals/Fitness for Work assessments.
All Line Managers across our health and care organisations
The Line Manager Guide is designed for use across health and social care. It is interactive and editable, so while the principles remain the same, organisations can freely use the resources in whichever way works best for their current need, adding in their links to local supportive resources and saving their own version.
We commissioned Civica to develop this additional workflow into their OPAS-G2 referral system as over 50% of our North West organisations use this digital platform. This functionality will be available nationally for all organisations using the platform.
Other digital platforms exist and may incorporate a similar pre-screening workflow to
Training Animation
This supporting animation is designed to be embedded into existing leadership development or standalone training.
Creating cultures where colleagues are able to stay well and thrive in work is the responsibility of everyone - the individual, their Line Manager and the Organisation
This animation focusses on the importance of ‘the conversation’, building awareness of the options that are available to a Line Manager to determine how best to support a staff member’s health concern.
Supporting Line Manager capability, in terms of creating cultures in teams that support wellbeing, will release capacity in Occupational Health/Employee Health & Wellbeing teams. When an Occupational Health referral/Fitness for Work assessment is required, if it is well-informed, it will maximise the chance of receiving helpful and relevant advice in a timelier manner.
Line Manager Guide
(The Interactive PDF)
Overview:
This is the core resource. Organisations can take this in whole or part and add into their existing policy or process. It consists of 7 questions, which encourage Line Managers to consider the options available to them to support their member of staff to stay in work or return to work sooner. A conversation with their staff member will help a Line Manager to understand what they need to consider and inform their next steps of support. It is not always the case that an Occupational Health referral/Fitness for Work assessment is the most appropriate first step in providing early health and wellbeing support.
Key Features:
• The document has been designed to be generic, useable and editable by any Organisation to suit their needs.
• There are multiple points where an Organisation will need to add in links to local processes and supportive advice. Line Managers can click on these links to access the local support guidance they may need.
Line Managers may find the information they require to support their staff member without the need for a referral/fitness for work assessment, however when one is required, it will be better informed.
A well-informed referral/fitness for work assessment reduces the return rate and the wait time between submission and receiving expert advice, and will improve the quality of advice given.
Line Managers will also be able to offer interim support to their staff member whilst waiting for an Occupational Health referral/Fitness for Work assessment outcome from their Occupational Health/Employee Health & Wellbeing services experts.
**Please find a link to the Line Manger guide**
Download a copy to enable you to add all relevant local processes and support links into the document.
Line Manager Guide
(OPAS-G2 Digital Platform)
North West NHS England and leads from our three Integrated Care Systems commissioned Civica UK Ltd to build a free-to-use, enhanced functionality into OPAS-G2 as a part of the workflow for a Line Manager completing an Occupational Health referral/Fitness for Work assessment. Other systems are in use and can provide similar pre-screening and support, however OPAS-G2 is used by over 50% of our North West Trust & ICB Organisations.
Key features:
• This functionality will guide managers through various questions and options to consider before submitting a referral/fitness for work assessment. This further enquiry will create a more informed referral when one is necessary.
• There are multiple points where organisation’s should add links to local processes/support. Line Managers can click on these links to access additional supportive advice and guidance.
• Managers are be able to save and return to the form.
• Any organisation using OPAS-G2 nationally, will have access to this new functionality.
✓ Please find a video produced by Civica showing the enhanced functionality in the system.
✓ Please find instructions on how to add the pre-submission form into the live OPAS-G2 environment, including adding your local support links
✓ Please find instructions on building an evaluation into the OPAS-G2 system
✓ Supportive communications can be found on page 12
Guidance When Making an
Occupational Health Referral / Fitness For Work Assessment
(Below is an example – click here for a version enabling you to add local support links).
There may be a number of reasons why you need to make an Occupational Health referral for a team member. As a line manager, it's important that you discuss this with your team member – either with a face-to-face, MS Teams, or telephone calland have their consent to proceed.
When making a referral, ensure that you have the agreement of your team member and they fully understand the reasons for the referral. You will also need the details about your team member to hand, including full name, date of birth, and contact details. Remember, if they are absent from work or not accessing work emails, then this may be a home email and phone number.
It`s worth remembering that 24% of the working age population is disabled. It`s important to keep colleagues well at work and enable and support them to work to their full potential. Our statutory duties (Equality Act 2010) require us to provide reasonable adjustments, many of which are cost effective and can be simple changes to hours, duties, equipment used, etc. As in all other scenarios an inclusive, supportive and in-depth conversation to fully explore and identify specific needs should be the first step, many colleagues are aware of what they need. If further advice and support is needed, consider asking Occupation Health/Employee Health & Wellbeing specialists to help identify additional, specific needs. Please do not use referrals/fitness for work
To help the Occupational Health/Employee Health & Wellbeing team process your referral effectively, you need to be clear about the cause, and the outcome that you are looking to achieve, so provide plenty of detail about why you are referring your team member, and any supporting information.
Your Wellness Action Plan may help provide the detail you need, such as adjustments already in place, if there has been any absent periods, or the kind of support that has been provided previously.
A Stress Risk Assessment can help clarify the issue and guide how best to support your colleague.
You will need to consider what you are asking the Occupational Health/Employee Health & Wellbeing team to respond to, such as:
• ’whatworkplaceadjustmentsormodificationsdoIneedtoputinplace forthiscolleague’
• ‘canyoupleaseadvisehowwecanbestsupportourcolleagueinthe workplace’
• ‘canyouconfirmthattheyarefitforwork’or‘whatshouldareturn-toworkplaninclude?’
These questions will vary and be specific to your colleague and their individual set of circumstances. As a Line Manager, you will need to be mindful of the information you provide to allow Occupational Health/Employee Health & Wellbeing Service professionals to provide an appropriate and timely response.
You should take the time to provide all relevant information you feel would support the referral, so the best supporting advice can be provided for your team member.
It's important that you consider the equity of access that your team member needs. Have a discussion with your team member about any factors that may influence their access to health and wellbeing services, including:
• Cultural considerations: Some colleagues may have cultural or religious preferences that impact their approach to their health. Occasionally, there may be some language needs – interpretation or sign language. Make sure you take these into consideration when making the referral and provide information where relevant.
• Adjustments: Ensure that you consider all adjustment needs of your team members. This may include any physical needs or neurodiverse conditions, including mobility, visual impairment, style of information sharing.
• Working patterns: You should include any working patterns, non-working days, shift patterns or locations that may impact on the access to Occupational Health/Employee Health & Wellbeing services. Some colleagues may be working shifts onsite, or work more mobile, whilst others may spend their working day from home. Consider location and working patterns which may restrict attending appointments, especially if the ill health prohibits travel to appointments - online or telephone appointments may help accommodate this and should be included as a request on your referral.
• Life factors: There can be a number of societal considerations that also impact your team members ability to fully access services, such as their financial wellbeing, transport issues, childcare or caring responsibilities, that may restrict their availability, then it's useful to include these in a referral to help the Occupational Health/Employee Health & Wellbeing specialists make arrangements.
Remember: It is important that you avoid any assumptions or bias in your understanding of what your team member needs, and you should remain focused on their health and work-related needs, without judgment or prejudice. It is your responsibility as a Line Manager to make sure that there is equitable access to Occupational Health/Employee Health & Wellbeing services, as well as all wider support available.
Finally, include any wider information that you are aware of, if relevant to the referral. This may include access to wider support or universal services, such as through a GP, counselling through EAP, or wider community-based provision. This may be related to any underlying health conditions or ongoing support they are accessing, such as navigating menopause or therapy sessions.
Please note - it is not your role or responsibility as a Line Manager to request this information, only if the individual chooses to share this with you and only share summary details if it is relevant to your referral.
Implementation Resources
Communication
Drafts
Draft communications have been developed to support the rollout and integration of the resources into a Line Managers workflow when supporting a colleague with a health concern. Whichever digital platform your Organisation is using for Occupational Health referrals/Fitness for Work assessments, the principles to creating good wellbeing cultures are the same.
Communication Drafts to support the integration of the Line Manager Guide (Interactive PDF)
Communication Drafts to support the integration of the Line Manager Guide (OPASG2 Digital Platform)
Please use and amend these drafts in the best way to suit your Organisational need. It is important you add in local context and information.
Evaluation Template
During the testing phase of the content on a digital platform, we developed evaluation questions to gain feedback from Line Managers, staff members, and Occupational Health/Employee Health & Wellbeing service specialists.
If you would like to evaluate the benefits of this additional workflow, we have included suggested evaluation questions.
Following user testing on the digital platform, we received feedback from both Line Managers, Occupational Health/Employee Health & Wellbeing Service specialists and staff members:
- Line Managers highlighted that working through the form was more time consuming, however many could see the benefit of the additional information to support a quality referral and help provide/signpost their member of staff to earlier support.
- Occupational Health/Employee Health & Wellbeing Service specialists acknowledged that an improved quality of referral was submitted.
- Staff members overall felt their concerns were accurately represented in the referral and had the opportunity to discuss their concerns with their Line Manager before a referral was made.
Recent evaluation from a Trust who has built this workflow into their referral process have seen a reduction in returned referrals due to insufficient relevant information, from over 50% to just over 20% in 3 months.
Next Steps…
• Consider how your organisation would benefit from including these resources in existing processes.
• Embed the supporting animation and tools into Leadership Development Programmes.
• Share with, and support Line Managers to use as part of their workflow to supporting their staff member to stay in work/return to work sooner, and to improve the quality of referrals.
• Evaluate impact using suggested evaluation questions.
Contact Information
For further information, please contact: Jude Hever North West Health & Wellbeing Manager Email: j.hever@nhs.net