A total of 63 participants provided insights on the effectiveness of Resilience Hubs for keyworkers during the COVID-19 pandemic.
Hubs were generally perceived as effective in supporting keyworkers, with clients reporting very positive experiences.
Flexibility and adaptability to local needs were highly valued by users of the Hubs.
Keyworkers were more likely to access support when they clearly understood the available services and appreciated the confidentiality offered.
Confusion regarding the distinction between Hubs and other support services hindered some keyworkers from enrolling.
Negative workplace cultures and lack of managerial support were barriers that discouraged engagement with mental health resources.
Black, Asian, and minority ethnic keyworkers expressed that the Hubs did not consistently meet their specific needs.
Simplified
OBJECTIVES: Evaluate the implementation of Hubs providing access to psychological support for health and social care keyworkers affected by the COVID-19 pandemic.
DESIGN: Qualitative interviews informed by to understand how the Hub model became embedded into normal practice, and factors that disrupted normalisation of this approach.
SETTING: Three Resilience Hubs in the North of England.
PARTICIPANTS: Hub staff, keyworkers who accessed Hub support (Hub clients), keyworkers who had not accessed a Hub, and wider stakeholders involved in the provision of staff support within the health and care system (N=63).
RESULTS: Hubs were generally seen as an effective way of supporting keyworkers, and Hub clients typically described very positive experiences. Flexibility and adaptability to local needs were strongly valued. Keyworkers accessed support when they understood the offer, valuing a confidential service that was separate from their organisation. Confusion about how Hubs differed from other support prevented some from enrolling. Beliefs about job roles, unsupportive managers, negative workplace cultures and systemic issues prevented keyworkers from valuing mental health support. Lack of support from managers discouraged keyworker engagement with Hubs. Black, Asian and minority ethnic keyworkers impacted by racism felt that the Hubs did not always meet their needs.
CONCLUSIONS: Hubs were seen as a valuable, responsive and distinct part of the health and care system. Findings highlight the importance of improving promotion and accessibility of Hubs, and continuation of confidential Hub support. Policy implications for the wider health and care sector include the central importance of genuine promotion of and value placed on mental health support by health and social care management, and the creation of psychologically safe work environments. Diversity and cultural competency training is needed to better reach under-represented communities. Findings are consistent with the international literature, therefore, likely to have applicability outside of the current context.
Key numbers
63
Participants Interviewed
Includes Hub clients, non-Hub keyworkers, Hub staff, and wider stakeholders.
10 of 19
Hub Clients with Clinical Roles
53% of Hub clients identified as having clinical roles.
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Competing interests: PF has previously been a member of NIHR HTA Prioritisation Committee and is a current member of NIHR HTS Clinical Evaluation and Trials funding Committee. DH has previously been a member of NIHR Research for Patient Benefit, Yorks & NE Regional Advisory Committee, and is a current member of NIHR Health Technology Assessment Clinical Evaluation and Trials Funding Committee (2019-2024). FV has received an NIHR Advanced Fellowship in a clinical research area unrelated to the Resilience Hubs. FV, PF, DH, and GB are Investigators/Co-Investigators in several other NIHR projects funded by various funding streams (RfPB, HTA, EME, HS&DR). AB is an honorary member of the National Mental Health & Wellbeing expert reference group at NHS England and NHS Improvement. AB, JW, KM and FV are members of the Greater Manchester Psychosocial Board, and JW, RW and KM are members of the Greater Manchester Expert Reference Group. GB is Interim co-chair of the National Institute of Health & Care Excellence (NICE) Quality Standards Advisory Committee. PF is clinical advisor to National Clinical Audit of Psychosis at Royal College of Psychiatry and Board member of International Early Psychosis Association. GB, AB, HTC, KM, FH, MS, RW and JW have all held senior clinical and/or operational roles at the Hub sites involved in this study. PF has previously led research to evaluate the original Resilience Hub service set up to support those affected by the 2017 Manchester Arena bombing, in which DH and KA were also involved. KA has also held a research and evaluation role at a second Hub involved in this project.
