Implementing psychological support for health and social care staff affected by the COVID-19 pandemic: a qualitative exploration of staff well-being hubs (‘Resilience Hubs’) using normalisation process theory

Aug 23, 2023BMJ open

Using staff well-being centers to support health and social care workers during COVID-19: a study of how these centers become part of routine support

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Long Covid on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

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.

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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

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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Implementing psychological support for health and social care staff affected by the COVID-19 pandemic: a qualitative exploration of staff well-being hubs (‘Resilience Hubs’) using normalisation process theory

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