Avon Partnership Occupational Health Service SUPPORT FOR THE

Avon Partnership Occupational Health Service SUPPORT FOR THE WELLBEING OF UK JUNIOR DOCTORS • • ROBIN PHILIPP PAM THORNE TOM PARSONS (CHEE, BRISTOL ROYAL INFIRMARY, UK ) www. apohs. nhs. uk Investing in Good Health at Work

Current OH Developments In Context • Marmot - Inequalities • Black - Sickness absence • Boorman - H & W/being NHS w/force • RSPH – International Conference • RSPH – PFF Memorandum of Understanding – NZCPHM – NZ Drs HAS Investing in Good Health at Work

5 High Impact Changes for Health & Wellbeing APOHS • Strong leadership ; • An evidence-based Health & Wellbeing Improvement Plan; • Build management capability & capacity at all levels; • Engage staff at all levels with health education, encouragement & support; • Use an NHS OHS that offers a targeted, proactive & accredited support system for staff & organisations. Investing in Good Health at Work

Building A Picture Within the NHS • Effects of the European Working Time Directive • S/A – 30% increase • Consultant and junior Dr staff satisfaction • Clinical Medicine 2010; Vol. 10(2) & (4) Investing in Good Health at Work

Investing in Good Health at Work

Investing in Good Health at Work

Earlier Relevant Publications (CHEE) • Improved Communication needs • Nuffield Trust reports – Arts & Humanities 24% personally & 37% in their work (79 Medical Registrars) • What helps people love their job • Would complementary therapies be welcomed in the workplace – 41% (53) SHOs • Fostering the art of wellbeing Investing in Good Health at Work

Completed Studies • 3 Point Prevalence studies • 3 Cohort studies • Response rates > 90% Investing in Good Health at Work

Figure 1. Self-rated well-being. Percentage of respondents 11% 2% 43% 37% 30% 37% 13% 17% 2% 8% Investing in Good Health at Work

Figure 2. Awareness and use of existing/available resources Investing in Good Health at Work

Issues Identified • • • NON-ORGANISATIONAL: Support Communication New self-help resources ORGANISATIONAL: Hours, annual leave, relocation expenses • Staffing levels • Job design (IT systems & work patterns) Investing in Good Health at Work

Self-assessed well-being at start and finish of training year Investing in Good Health at Work

Table 1. Differences between year groups in expectations at start of training year Factors expected to threaten WB more by F 1 s: • Emotional demands (p<0. 01, Mann-Whitney U test) • Patient suffering and death (p<0. 01, Mann-Whitney U test) • On call work (p<0. 05, Mann-Whitney U test) • Possibility of being sued (p<0. 05, Mann-Whitney U test) Investing in Good Health at Work

Table 2. Differences between year groups at end of respective training years Factors enhancing WB more for F 2 s than F 1 s: • Having responsibility (p<0. 01, Mann-Whitney U test) • System of career progression (p<0. 01, Mann-Whitney U test) Factors more threatening to WB for F 1 s: • Patients’ suffering and death (p<0. 05, Mann-Whitney U test) Factors more threatening to WB for F 2 s: • Personal safety (p<0. 05, Mann-Whitney U test) Investing in Good Health at Work

Table 3. Differences between expectation and experience for F 1 s (Wilcoxon signed ranks tests) Factors enhancing WB less than expected • Availability of learning opportunities (p<0. 01) • Experience of patients’ suffering and death (p<0. 01) • System of career progression (p<0. 01) • Physical demands of the work (p<0. 01) • Being valued by nurses (p<0. 05) • Emotional demands of the work (p<0. 01) • Being valued by non-clinical staff (p<0. 05) • Personal safety (p<0. 01) • Factors threatening WB less Possibility of being sued (p<0. 01)

Table 4. Differences between expectation and experience for F 2 s (Wilcoxon signed ranks tests) Factors enhancing WB less than expected • Being valued by nurse colleagues (p<0. 05) Factors more threatening to WB than expected • Availability of learning opportunities (p<0. 05)

Self-Help Resources in NHS OHS: Towards a standard: 3 steps in the audit • What there is in each NHS OHS • What OHPs and OHNs think should be there • What NHS doctors and other groups of NHS staff think should be there Investing in Good Health at Work

Self-Help resources: What Drs think (The Top 10) [%-ages] • • Imm, vacc, chemo for work exposures Managing personal Stress Advice on sleep hygiene, rest, p/nap Counselling support Pregnancy & work Males Females 85 85 83 88 75 74 74 62 95 92 Investing in Good Health at Work

Self-Help Resources: What Doctors Think (The Top 10) [%-ages] • Immun, vacc, chemo for general health • Emotional resilience & coping skills • Alcohol & Drugs • Cigarette smoking • Physio advice/treat. Males Females 68 69 66 62 62 60 Investing in Good Health at Work 67 65 48 77

Self-Help Resources: What Drs think: Lesser Recognised Tools [%-ages] • Religious / other • Spiritual Guidance / support • Complementary ther. • Uses of the arts • Staff relations & effective communication Males Females 15 9 11 5 19 10 32 46 Investing in Good Health at Work

Self-Help Resources: Drs & Business-Related Issues [%-ages] • Career planning & Males Females skills development 36 53 • Business / financial / investment / pensions 38 46 • Retirement planning 28 49 • Dealing with redundancy & unemployment 34 46 Investing in Good Health at Work

Discussion Points • Who should agree the elements of a comprehensive, quality-assured OHS for OH professionals ? • Should we be helping health professionals to be more self-reliant & if so should we improve our profile & role in Primary Prevention or focus on Secondary Care ? • Could we peer review & agree worthwhile selfhelp resources & tools to use in our clinics & more widely with “the working age population” ? • Are health needs of Drs different & if so can we help them understand better manage them? Investing in Good Health at Work

Avon Partnership Occupational Health Service Questions? www. apohs. nhs. uk Investing in Good Health at Work