Developing systemic resilience for our flexible workforce

Juliette Cosgrove, Chief Nurse & Head of Clinical Governance at NHS Professionals, argues that a focus on flexible worker resilience is needed to support those who support the NHS

Resilience as a concept has taken on a new importance and meaning since the beginning of the pandemic, as healthcare workers cope with a rapid rise in physical and emotional demands from the pressures of Covid-19.

Change has been fast. As a leader of the UK’s Ventilator Challenge team put it: “We had to deliver 2.5 years’ work in six weeks.” Add to this the extra physical demands from continual wearing of PPE and the need to provide emotional care for patients and their families, especially when visiting and contact is restricted. Flexible working in itself comes with additional challenges, including working with a different team in often new surroundings and sometimes carrying out new or unfamiliar duties.

It is vital we remember that no person is an island. While we might often talk of boosting individual resilience, it is potentially short-lived if the support is not focussed on the whole team, the healthcare setting and the larger community. To continue responding and adapting to both ongoing change and unexpected disruptions, a robust organisational and systemic resilience needs to be in place – one that can keep improving and supporting resilience.

Building resilience
When it comes to the individual, building resilience is important for mental health. Research carried out last year highlighted that nearly 60 per cent of frontline health and social care workers met the criteria for either anxiety, depression or PTSD. Yet, while everyone can respond differently to a situation and find things hard at times, there is action we can take to increase our capacity to cope with stress.

In his book, Emotional Intelligence at Work, psychologist Dr Jo Maddocks outlines the capabilities of resilient people. These include: the ability to manage feelings and behaviour in times of stress, rather than exaggerating problems; viewing any mistakes as learning opportunities, rather than becoming despondent or taking things to heart; and being flexible and trying different strategies.

In building and reinforcing these capabilities, different tactics work for different people, but there are techniques that we can all utilise to increase our capacity to cope with stress. These include: ensuring you take a break or time away from your duties; talking to a friend or colleague about a problem – often, this can make all the difference; standing up for yourself, although sometimes a challenge, to build self-confidence; and expressing your opinions clearly and directly.

Growing individual resilience is vital in our current times – but all the more critical is ensuring the whole system surrounding the individual supports this. Resilient individuals can take on additional stress only as long as tools, resources and strong team support exist for them to do the job.

Systemic resilience
When we're better prepared, and situations or processes are planned, then people feel more confident in their abilities at work, which in turn influences their resilience and wellbeing. It is clear there is a need to address the systemic sources of stress that contribute to workplace adversity to ensure that improving resilience is not the sole responsibility of the individual and is actively supported by the NHS.

Organisational resilience isn’t just a challenge for the NHS. Research conducted by Cranfield School of Management reveals that only just under one third (29 per cent) of business leaders trust that their organisations have fully embedded resilience practices, even though 88 per cent think that resilience is a priority for their organisation, and indispensable for long-term growth (80 per cent).

A research article within International Journal of Health Policy and Management describes organisational resilience as ‘an emergent property that develops in complex systems as a precursor and response to stressors and risks. Understanding system resilience is a central part of organisational development and design practice, and a key strategic activity undertaken by leaders across the people profession’. The three key factors of system resilience that leaders might want to consider when developing organisational resilience include: leadership capability, organisational culture and human capital.

Of course, effective leadership is key to ensuring all the factors listed above are in place. In order to support individual resilience, organisation and team leaders also need to be able to develop their own resilience and the way they support others. Initiatives like the NHS Leadership Academy has been specifically designed to develop senior leaders, and those looking to progress into a leadership role. This programme offers support and learning to build personal resilience, confidence and the leadership capabilities needed within the NHS.

Another key factor at play is culture and the need to ensure every team member feels valued and supported. Having the basics in place is a critical element of this, and a relatively simple one to achieve for flexible and substantive workers alike. Proper inductions, a welcome to a new trust, and signposting of known sources for additional support, as well as a simple thank you for a job well done, are all important to support resilience. Taking time to recognise a colleague’s achievement is another good way to boost morale and can improve team resilience.

In addition, it is important that career development opportunities are clear and accessible – ensuring flexible workers, as well as their substantive colleagues can continue to learn new skills and progress their career. We’re working hard at NHS Professionals to develop career pathways for our Bank Members. For example, a project to develop the specialist nature of the flexible nurse role, and support for Healthcare Assistants to progress into nursing.

As Chief Nurse at NHS Professionals, I work closely with NHS trusts, alongside the NHSP team. We look at ways to increase workforce capacity so that there are more people available at critical times. We assess how we can use the skills, experience and knowledge of Bank Members in the right places to further build resilience across the NHS, to attract more people to join us, and encourage those who have already stepped forward to stay.

Workforce capacity
Even the most resilient of individuals can be derailed by stress. But healthcare work should never be about surviving. Our approach to resilience needs to be focussed on helping healthcare professionals thrive in work, as well as in life as a whole.

The pandemic has highlighted the importance of a workforce that is able to flex up and down with demand. It has also emphasised the importance that, with stress affecting people in such different ways, healthcare organisations can deploy a range of tactics to support the resilience of flexible and substantive workers alike. Not only during current challenges, but also for the future.

We’re now in a position to assess the transformation that has already taken place as a result of the pandemic and make further improvements. What is vital is that we work together, on every level, to build a more resilient workforce for the future, for flexible workers, our Bank Members and all those who work across the NHS.

For advice on managing stress and building resilience, visit the health and wellbeing section of the NHS Professionals website.