Applying principles for psychological support to maintain wellbeing and enhance recovery during and beyond the Covid-19.

1. Psychological support to maintain wellbeing
and enhance recovery during and beyond
COVID19
Virtual Community Meeting
20th May 4pm
Welcome to our weekly wellbeing webinars:
The health and wellbeing of our NHS people during the
Covid-19 response

2. Introduce yourself in the chat box
Say:
• Who you are
• Where you are today
• Your job role
• What are you hoping to learn today?
• Send to “all participants”
To join the wellbeing community list, click on
the link at
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3. Our Wellbeing Community: https://tribe.horizonsnhs.com/

4. To join the mailing list of people who get the
information about this community:
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Building a Wellbeing Community

5. Introduce yourself in the chat box
Say:
• Who you are
• Where you are today
• Your job role
• What are you hoping to learn today?
• Send to “all participants”
To join the wellbeing community list, click on
the link at
http://horizonsnhs.com/caring4nhspeople/

6. What is your main role in supporting the wellbeing
of NHS people and/or people in partner
organisations?
Pick the MAIN one
POLL
If you are on YouTube or the poll doesn’t work for you on Zoom, write your number in the chatbox
1. Health and wellbeing lead
2. Occupational Health
3. Trade Union or Professional Association
4. Organisation Development (OD)
5. Diversity and Inclusion lead
6. Clinical psychologist
7. Workforce/HR
8. Line manager/leader/non-exec
9. Coach
10. Other (please specify in the chatbox)

7. Psychological support to maintain wellbeing
and enhance recovery during and beyond
COVID19
Virtual Community Meeting
20th May 4pm
Welcome to our weekly wellbeing webinars:
The health and wellbeing of our NHS people during the
Covid-19 response

8. 8 |
• Offer support, ideas, knowledge and wisdom to those with a role in
supporting the health and wellbeing of people working in health and care
• Share the range of wellbeing support activities that are available to people
working in health and care
• Connect with each other and collectively build our community of those who
support the health and wellbeing of our NHS people
Aims of the Wednesday sessions
To:

9. • Welcome – Elizabeth Nyawade & Zoe Lord
• Update on the National Support Offer – Dr Sonya Wallbank
• Principles for Psychological Support and Interventions – Dr Nick Grey
• Supporting UK Healthcare Workers in the Ebola Treatment Centres Sierra Leone
– Dr Idit Albert
• Common Rooms Offer – Alan Nobbs
• Call to action & closing remarks - Elizabeth Nyawade & Zoe Lord

10. The team today
Chat box facilitators
Dr Sonya
Wallbank
Contributors
Zoe Lord
Facilitators
Social Media
Leigh Kendall
Elizabeth Nyawade
Louise Pratt
Paul Woodley
Technical hosts
Zarah Mowhabuth
Tej Riat
YouTube host
Ian Baines
Dr Idit AlbertDr Nick Grey Alan Nobbs
Cheryl Samuels
Helen Bevan

11. An update on
the National
Wellbeing Offer
Dr Sonya Wallbank
Health and Wellbeing Clinical
Lead, NHS England &
Improvement

12. Coming
next:
NHS Staff Health and Wellbeing
support COVID-19
2186
20:00-22:00
peak hours
<
>
96,000
Visitors
129,394
Page
visits
• Anxiety and loneliness are
being talked about on the
local and national lines
• Self isolation, distancing
and not being able to
attend work are
contributing
• Concerns about domestic
violence and suicidal
thinking rising
• Stress reactions to the
demands of new roles,
different expectations and
in some cases returning to
BAU
- Free coaching
support from a range
of providers
including emergency
response support
- Recovery package
– bite size videos
and responding to a
holistic – how are
you
Priority mental
health pathways
established – KCL
how am I tool
Citizens Advice
national offer
Relate services
national offer
16 mins
People.nhs.uk website
• Most download content:
How to support staff
during Ramadan
• ABC of resilience
• 10 minute pause space
1025
108,697
8300
What we learning?
How will we know if
it is making a
difference?
• Qualitative evaluation
outline for experiences
and impact

13. 13 |
DemandsandactivityNegativeimpacts
Time
Peak of Active
phase
Peak of system
recovery – focus
on throughput
Activity demands
begin to settle
Shock Wave 2:
I am still working
as hard but now
out of the public
eye. Readjusting
to what work is
Shock Wave 1: What
have I just
experienced. Physical
demands reduced
leaving space for
psychological focus
Shock Wave 3:
I am unwell with the
impact of what I have
been through

14. 14 |
Resilience is not the absence of distress or difficulty
Following adversity, change or challenge not showing
emotion is not displaying resilience
As human beings we are capable of amazing things even in the
face of dire adversity
Resilience is the ability to adapt and grow following adversity
Feeling intense negative emotions and knowing how to manage
these not just push them away is key to growth
Getting up to try again another day is the core of resilience

15. @people_nhs
#Caring4NHSpeople
Stay in touch and up to date
https://people.nhs.uk
Our Wellbeing Community:
https://tribe.horizonsnhs.com/

16. POLL
If you are on YouTube or the poll doesn’t work for you on Zoom, write your number in the chatbox
What support resources have you called upon done to help look
after your own health and wellbeing during these current times?
Tick all that apply
1. Existing family, social and/or community networks
2. Existing work / professional networks
3. Local organisational Health and wellbeing support resources
4. Regional Health and wellbeing support resources
5. National Health and wellbeing support resources
6. Other (please note in the chatbox in you feel able to share)

17. Of all of the things your employer,
regional and national team have put
together to support wellbeing,
what are the top three things that you
hope can stay?

18. Dr Idit Albert
Consultant Clinical Psychologist
Joint Clinical Lead for the
Psychology Support Programme
for Covid-19
Dr Nick Grey
Consultant Clinical Psychologist
Joint Clinical Lead for the
Psychology Support Programme
for Covid-19
Psychological Support

19. Principles for Psychological
Support and Interventions for
NHS Staff in response to the
Covid-19 Pandemic
Nick Grey, Idit Albert, Adrian Whittington

20. • These principles are being refined and finalised by NHSE/I
• This is a preview and we welcome any feedback
• The purpose of the principles is to have an agreed
framework for aligning local, regional and national responses
to best evidence.
• NHSE/I is committed to ensuring swift and prioritised access
to psychological interventions for all NHS staff who require it.

21. Evidence based practice
research
evidence
service
user
preference
clinical
expertise

22. Psychological
interventions
Psychosocial
Support
Social Support
Basic needs
(PPE, realistic shifts, chance to rest
and eat, sleep etc.)

23. Supporting staff from Black and Minority
Ethnic communities
• Likely that the BAME staff will have greater needs for
psychological support than white majority staff but that
given structural inequalities they will be less likely to access
this support.
• Team leaders should prioritise checking in on the wellbeing
of BAME staff and provide additional support and
signposting where appropriate. This might include
signposting to BAME specific mental health services which
may be better able to meet their particular needs at a time
of heightened psycho-social pressures.
• In some settings members of minority faith groups might
benefit from additional support from chaplaincy services
which can take into account the way that the challenges of
working during the pandemic might need a response that
incorporates their spiritual background.

24. Social support
• Applicable throughout pandemic
• Needs to be actively encouraged
• Personal social support
• Family and friends
• Occupational social support
• Clear communication
• Compassionate leadership
• Chances to catch up with each other
• Additional opportunities to be together
• Diversity recognised and acted on
• Attention to staff who may be especially
vulnerable
Psychological
interventions
Psychosocial
Support
Social Support
Basic needs
(PPE, realistic shifts, chance to rest
and eat, sleep etc.)

25. Psychosocial support
• At all stages of pandemic
• Facilitating self-care, coping and
problem solving
• Provision of information
• Normalising emotional reactions
• Advice on wellbeing resources
• How to access help
• Active listening without
expectation people should talk
about their feelings
• Active monitoring, rather than
watchful waiting
Psychological
interventions
Psychosocial
Support
Social Support
Basic needs
(PPE, realistic shifts, chance to rest
and eat, sleep etc.)

26. Psychological Interventions
• After opportunity for rest and recovery
assessment by mental health practitioner
• Bereavement counselling
• Psychological debriefing should not be
offered
• Evidence-based psychological therapies
should be offered as recommended by NICE
• Delivered by practitioners with approved
registrations and qualification in the specific
therapy
• Consider the cultural background of people,
including values and spiritual perspectives
• Unproven psychological interventions should
not be offered to NHS staff
Psychological
interventions
Psychosocial
Support
Social Support
Basic needs
(PPE, realistic shifts, chance to rest
and eat, sleep etc.)

27. • Expectation for most is natural recovery with social support
• Don’t rush in with psychological interventions
• Psychosocial support, and psychological interventions, will need to
be culturally adapted and culturally responsive
• Persistent psychological difficulties can be treated effectively with
evidence-based psychological therapies from a qualified and
registered practitioner
• These principles to be finalised and disseminated
@nickdgrey
nick.grey1@nhs.net
nick.grey@sussexpartnership.nhs.uk

28. Applying Principles for
Psychological Care
During a Health Crisis
A case example:
A programme to support
UK Health Care Workers
Volunteered in the Ebola
Treatment Centres in
Sierra Leone

29. Psychological
Support
• Ongoing psychosocial support over the telephone or
skype
• Active listening
• Normalising reactions to distress
• Encourage staff to look after themselves
• Problem solving
• The offer for psychosocial support continued during
and after the deployment
• NHS governance (South London and Maudsley NHS
Trust) and Peer supervision for volunteer
psychologists
• With DfiD’s support we were able to develop and offer
a psychological support programme to Sierra Leonean
HCWs.

30. We learnt that:
Health care professionals valued their deployment
• They all said that they would repeat the experience
• 45% reported positive growth on a Post Trauma
Growth questionnaire
Post deployment the majority (62%) exhibited some
clinically significate mental health symptoms
• Higher levels of Alcohol misuse ( 30% ) and of PTSD
(7%)
• A smaller proportion (17%) had more significant
difficulties in multiple areas and were in contact with
their occupational health for post deployment
difficulties

31. Challenges During
Deployment
• Exposure to traumatic scenes and
disease (91%)
“We had piles and piles of rotting bodies
and nowhere to put them… there were
times it felt like the whole world’s going
to die ”
• Death of children

32. Organisational issues (75%)
• Problems with leaderships, teams relations
• Problems with resources
• Long hours and exhaustion
• Moral and ethical dilemmas
• Perceived lack of job control, poor job
definition
• Poor communication within and across
agencies
• Sense of helplessness, futility of work

33. Fear of Ebola
• Others avoiding them because of fear of
contracting
Ebola
“A lot of people instead of saying that they don’t want to see me, I
felt like they would ignore me like they just wouldn’t answer my
calls. There was quite a lot of this stuff going on at that time.”
HCP-007
• Fear of getting Ebola
“It’s harder cannulating somebody with three pairs of gloves on
where your peripheral vision is rubbish because you’ve got goggles
on and all the restrictions you have especially with dehydrated
patients.” HCP-004
“…my biggest worry was getting a needle stick injury when I was
cannulating.” HCP-010

34. Post-
Deployment
Back in the UK
• HCWs reported more challenges returning to
work in the NHS post deployment than the
challenges of responding to Ebola during
deployment
• Adjusting back to work with NHS patients
• Guilt and self doubt
• Sleep difficulties

35. The Most
Common
Source of
Support is
Social
• Team Support – a sense of comradeship, felt able
to talk with team about personal problems
• Organisational support- more practical than
emotional
BUT
• Families were a less helpful source of support as
HCWs felt that they needed to protect their
families from becoming upset

36. Feedback on the Programme
• Service users found it helpful and those that did not use the service said that they felt comforted by the
idea that it existed
“it’s an important service and one that really should be mandatory for anyone kind of deploying for an
emergency like an Ebola outbreak…where there’s just a lot of human suffering that you’re dealing with and...I
think some people process it better by just talking to someone just a little bit more disconnected, who might
have a little bit more of a kind of objective perspective.”
• 67% said that they didn’t use it
“I think…I wasn’t really acknowledging to myself at that moment how strung out I was because I was so much
in survival mode and get on, push on, and make the most of it. So I didn’t think it [contacting a psychologist]
would have occurred to me at that point” – HCW 11
• HCWs Requested support for their families

37. The Ebola Psychological Support Service
illustrates that:
• Evidence for best practice care could be offered in
unprecedented circumstances
• By qualified and supervised practitioners
• Adaptations were made to the service delivery – to meet the
needs of service users and adjust to the circumstances
Idit.albert@slam.nhs.uk

38. Common Rooms
Alan Nobbs
Head of Design & Development,
Covid19 Workforce Health and
Wellbeing Support Team

39. Supporting our teams throughCOVID-19
Confidential bereavement
support
• A team of fully qualified and
trained bereavement specialists are
available to support you with
breavement and wellbeing issues
to loss experienced through your
work
• You will be offered up to three
sessions with the same counsellor
and onward support to our staff
mental health services if needed.
Tel: 0300 303 4434 (8am-8pm)
Confidential group support
in our common room
• Connect with other professionals in closed
professional groups or ‘open to all’ sessions
• Hosted by experienced group leaders and
overseen by experienced clinical leaders
• Small group format to provide opportunities to
meet, share, slow down and reflect on your
own purpose and wellbeing.
Visit: https://www.practitionerhealth.
nhs.uk/upcoming-events#
#supportourNHSpeople
Staff Common Rooms – www.people.nhs.uk
Join staff common rooms

40. Supporting our teams throughCOVID-19
#supportourNHSpeople

41. In Conversation with…
Alan Nobbs
Head of Design & Development,
Covid19 Workforce Health and
Wellbeing Support Team
Dr Idit Albert
Consultant Clinical Psychologist
Joint Clinical Lead for the
Psychology Support Programme
for Covid-19
Dr Nick Grey
Consultant Clinical Psychologist
Joint Clinical Lead for the
Psychology Support Programme
for Covid-19

42. Very helpfulNot helpful
To what extent has today’s session been useful in
your own role supporting staff health and wellbeing
during and after Covid-19?
POLL
If you are on YouTube or the poll doesn’t work for you on Zoom, write your number in the chatbox

43. Please share in the chat box
one practical action are you
going to take following our
session today.