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#ProjectA Wellbeing Accelerated Design Event report


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A report of the #ProjectA Wellbeing Collaborative Event held in London on the 5th March 2019.

Published in: Healthcare
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#ProjectA Wellbeing Accelerated Design Event report

  1. 1. 5th March 2018 Twitter hashtag #ProjectA Report of the #ProjectA Wellbeing Collaborative Accelerated Design Event Creating ‘safe spaces’ for ambulance staff
  2. 2. The purpose of this report What this report seeks to do: • Provide a record of the inputs and outputs from the day • Show what happened on the day and the energy in the room • Document the wealth of information and experience that the attendees brought to the day What this report does NOT seek to do: • Make verbatim notes • Analyse, synthesise or prioritise ideas • Develop a decision document or action plan Report compiled by Lynsey Oates and Ian Baines NHS Horizons
  3. 3. Showcase table and wall area Share and show materials from Wellbeing initiatives around the country – learn and share from one another.
  4. 4. Welcome by Jason Killens CEO of Welsh Ambulance Service. Why today is important……… It’s really good to see every service represented here today. Wellbeing is a very important topic. I’d encourage you to share your wellbeing and safe spaces work with one another. Lets take this opportunity to learn about the good practise that is in place across all ambulance services and explore new ideas together. Thank you to NHS Horizons team for planning the event and for all the #ProjectA work. Have a good day everyone.
  5. 5. In the room are people who aren't ambulance staff - these are critical friends, and who are here to help us – embrace them. Helen Bevan Chief Transformation Officer NHS Horizons set the context for the day This is not your usual conference or workshop, it is a specially designed process that enables a depth and quality of output that would usually be unachievable in such a short timeframe...we’ll do three months’ worth of work today.
  6. 6. The activity: On your own, look through the magazines and find two pictures that symbolise for you:How the midwifery profession is now (sometimesalways) •How things could be different in the future People travelled to London from as far afield as Northern Ireland and Scotland to attend the event. Every ambulance service in the UK was represented.
  7. 7. Aims for the day To: • Build proposals for ‘creating a system of safe spaces where staff can discuss emotional/psychological aspects of their experiences and decompress’ • Consider how we link and support (not duplicate) work of the Ambulance Staff Partnership Forum and the existing AACE HROD Ambulance Wellbeing Group • Create a vision for the future • Share existing knowledge and good practice • Identify how we can enable this to happen across the country • Test out the ideas and identify our next steps
  8. 8. Employee Wellbeing Sasha Johnston, South West Ambulance Gill Heuchan, London Ambulance We don’t want to see staff broken, we want to encourage staff to talk about how they feel. Sasha and Gill framed the day by providing some powerful statistics - if all ambulance services achieved the sickness rate of the lowest ambulance service it would mean the equivalent of 1,000 extra people in the service
  9. 9. What unites us? • Attendees were asked to introduce themselves to everyone else at the table • They were then asked to find five things that they had in common and to be prepared to share them with the room
  10. 10. We all deal with trauma We all like Yorkshire Puddings Finding out what unites us We all have dogs
  11. 11. We created a symbol of safe spaces by tying a ribbon around each of the tables. Each table was asked to consider one aspect of being in a ‘safe space’ that was important for ambulance services.
  12. 12. Creating our own safe spaces
  13. 13. Safe spaces - ribbon activity: feedback from the tables 1 – Let’s value our differences 2 – There should be no hierarchies and we are all equal 3 – We need to be able to speak openly about anything 4 – We must give people the time they need 5 – It should be “safe” to leave our safe space at any time 6 - What is said in the circle stays in the circle 7 - Listen, do not judge 8 – Let’s make the most of everyone’s experience
  14. 14. Safe spaces: now and in the future • We asked people to look through magazines and find two pictures - in the context of safe spaces - that symbolised: – How ambulance services are now (sometimes/always) – How things could be different in the future • People were asked to share their pictures with others on the table • The tables then created a “collage” of now and the future for safe spaces #ProjectA
  15. 15. Safe Spaces Now and in the future - teams in action
  16. 16. The collages
  17. 17. The collages
  18. 18. Feedback - Where we are now: Each table fed back three words that described the current state in relation to finding safe spaces for ambulance staff to talk and decompress…. The three words were entered into a word cloud. It is clear that things could be improved.
  19. 19. Feedback - Where we want to be, future: Each table fed back three words that described how they wanted things to be in the future in relation to finding safe spaces for ambulance staff to talk and decompress…. The three words were entered into a word cloud. People want to be engaged, confident and supported.
  20. 20. Three approaches to improving wellbeing #ProjectA Anu Mitra (Imperial College Healthcare NHS Trust) Introduction of Schwartz Rounds Esther Murray Chartered and Registered Health Psychologist Addressing moral injury Fiona Meechan (College of Policing) Compassion at work toolkit
  21. 21. Anu Mitra shared his experience as a resus consultant at St Mary’s Hospital. Anu spoke about the Grenfell Tower tragedy and how the hospital had responded to it. Anu explained about how important it is to understand how harrowing events can impact staff. St Mary’s has introduced Schwartz Rounds to help staff decompress and talk about stressful, emotional and traumatic experiences. These have been a great success with 97% of attendees recommending Schwartz Rounds to other health care workers. Anu Mitra (St. Mary’s Hospital - Imperial College Healthcare NHS Trust) Introduction of Schwartz Rounds “It’s important to look after ourselves so that we can be more effective, compassionate carers for our patients. Well-being, self- compassion, compassion for colleagues, is intimately tied up with compassion for patients”
  22. 22. Fiona spoke about the importance of wellbeing and compassion in the workplace. Fiona described how compassion increases resilience, outcomes, collaborations, trust, effectiveness and job satisfaction. In essence compassion is the key to improved wellbeing and productivity. Fiona explained how small acts can make a big impact. Those who witness compassionate acts also feel better - it’s a contagious effect we pay compassion forward. Fiona Meechan (College of Policing) Compassion at work toolkit “Compassion is a fundamental human value”
  23. 23. Esther presented Moral Injury and how important it is to recognise our need for wellbeing. Moral injury occurs after exposure to traumatic unjust or amoral incidents. Frontline ambulance staff can witness a variety of emotional and difficult situations on a daily basis. Witnessing a number of unsettling events can lead to individuals displaying similar symptoms of PTSD. Esther explained that this is a human response, we are designed to have morals and exposure to horrific events triggers psychological unrest. Esther advised all staff in ambulance services to take time to recognise what constitutes a safe space. It will vary what works for some may not work for others. Flexibility and variety are key. Esther Murray (Queen Mary University of London) Addressing moral injury “Everyone has the capacity to be kind to ourselves - liken it to brushing our teeth - just do it, don’t think about why you are doing it, just do it”
  24. 24. The table feedback from the speakers
  25. 25. The table feedback from the speakers
  26. 26. Feedback from the speakers- teams in action
  27. 27. Approaches to improving wellbeing: Key theme feedback from the tables 1 – What are our questions and issues in relation to what we have just heard? • How do we normalise it? • How do we create the space? • How do you scale it? • How do you get the leadership behind it? 2 -What are the uniting principles we can extract and use in ambulance ‘safe spaces’? • It’s ok to not be ok • Trust • Compassion • Passionate Leaders 3 - What barriers may we have to overcome to enact these principles? • Time • Resources • Culture • Leadership • ‘Here we go again’ 4 - If there was one reflection your table could summarise what would it be? • No shame or blame • Variety • We need to be more compassionate
  28. 28. Market place – 2 minute pitch • Dr Jennifer Wild - PTSD Prevention • Scottish Ambulance Service – RUOK? • South West Ambulance Service – Supervision • East of England Ambulance Service – Digital interventions on health • Yorkshire ambulance service – Schwartz rounds in 111 • Welsh Ambulance Service – Implementation of TRIM • London ambulance service – Peer support network #ProjectA
  29. 29. Market Place A table was hosted by each service that had come forward We asked participants to choose the table they wanted to start with We had 3 rotations around different subjects
  30. 30. Market Place Session
  31. 31. Feedback from the Market Place
  32. 32. Market Place: Key theme feedback from the tables 1 - PTSD Prevention • We need to ask the right questions • We want to take the model forwards • We need to engage student paramedics • We need to broaden, sign post and enable • What are the barriers? - Bullying 2 – Scottish Ambulance Service: RUOK? • Lifesaving commonalities that can be applied across all services. • Any of the first responders fire, police, ambulance can be affected by stress • Signposting internal or external, enabling approach, no formal training- RUOK? • Simple to do, but some barriers - resources, time and money. Also reliant on volunteering CPD events. • Potential to expand, back in ambulance or control room or office, not about a separate section humans can ask RUOK? 3 – South West Ambulance Service: Clinical Supervision • Supervision important H&WB, can be applied to all ambulances, clinical supervision • CS framework applied to many different settings, can discuss what they want to, staff enthusiastic about it, virial methods can work. • Barriers time and demands and understanding what CS is- creating a safe space • Potential for nationwide it’s a framework, place to talk, ground rules and a safeguarding policy.
  33. 33. Market Place: Key theme feedback from the tables 4 – East of England Ambulance Service: Digital Interventions on health • Alertness at work, long shifts things that can make you tired, enablers research communication, people buying in. • Barriers are the lack of research • Potential for this intervention, would it work might not work etc. Interventions that can be realistic 5 - Yorkshire Ambulance Service: Schwartz rounds in 111 • Schwartz rounds comparison between acute and an ambulance sector, peer to peer support. • Open to all staff, need to talk about our problems • Costs money, but have buy in from staff and management, have facilitators in organisation. • Barriers releasing of staff, confidentiality, how we build trust • Potential for this intervention, Schwartz round based facilitators others doing something similar- we do have facilitators at station and we will look at trialling at the station 6 - Welsh Ambulance Service: Implementation of TRIM • Important, evidence based, care about each other, peer led 24/7 service • Embedded in services, enablers, learn from each other, want to know more - positive feedback, resources in place • It has been accepted as senior level • Barriers- time and money • Potential for rolling this out, currently have space at the station encouraging staff, newsletter share experiences and positivity. • We are learning every day
  34. 34. Market Place: Key theme feedback from the tables 7 - London Ambulance Service: Peer Support network • It helps stop little things becoming big things • It’s for staff, evolved from the staff survey • We incorporate trim into peer support model • Focus on networking events and #ProjectA • Barriers: the cost, expertise training and evaluation - how do we quantify - what’s the best model, time, stigma and mandate on mental health first aid. • Potential for peer support approach, first and biggest step if you can get people to care about each other – in society we have stopped, we need to start caring, we have to care • Compassionate leadership: if all ambulance services had the lowest average sickness rate, it would equate to 1000 extra staff a year.
  35. 35. What I have found from today is that there are similar wellbeing issues across the country that we can all tackle. We need to take forward an offer to AACE and put a plan together to support and improve Ambulance staff wellbeing. The Chiefs are committed to this. Thank you all for your contributions. Jason Killens, CEO Sponsor Thinking through next steps
  36. 36. It’s been a great and hugely thought provoking. We need to be mindful of support and remember our staffs’s needs. We will need different resources for different people. At present there is no national work on safe spaces, this is an area that #ProjectA can really develop and work with. We are very keen to support this agenda along with the CEO’s. Anna Parry, AACE Thinking through next steps
  37. 37. Action Planning
  38. 38. Action Planning
  39. 39. Today has been great to be with likeminded people. Our passion should be that we care for each other and that you have time to care for yourself. Compassionate leadership, self-compassion, we owe it to staff to provide the support. Thanks everyone for a great day. Final thoughts John Isaac, Paramedic and Locality Manager Yorkshire Ambulance
  40. 40. Developing the outputs post ADE Jason Killens Chief Executive Welsh Ambulance Service During the falls ADE Jason Killens (one of #ProjectA’s sponsoring CEOs) expressed a desire to move the wellbeing ADE outputs forward across all CEOs. Specifically arising from the ADE will be a number of suggestions for CEOs to consider .These include: • The introduction of a well being pledge that all ambulance services sign up to. • The introduction of a prevention strategy for ambulance services with regard to post traumatic stress disorder (PTSD) – that is embedded in an evidence-based model commissioned through #ProjectA • Providing appropriate on going 1:1 support (One example at the ADE being the RUOK model of the Scottish Ambulance Service). • Setting up a virtual learning group of colleagues to explore potential for the introduction of Schwartz rounds nationally across all ambulance services for winter 2020. All the above have been included in the proposed workplan for #ProjectA in 2019/20. This workplan will be presented to the AACE Council in April