Avon Partnership
Occupational Health Service
SUPPORT FOR THE WELLBEING OF UK
JUNIOR DOCTORS
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•
•
•
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
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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.
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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)
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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
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Completed Studies
• 3 Point Prevalence studies
• 3 Cohort studies
• Response rates > 90%
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Figure 1. Self-rated well-being.
(general: n=53; work-related: n=52)
Percentage of
respondents
11%
2%
43%
37%
general well-being
work related well-being 30%
37%
13%
17%
2%
8%
couldn't be better
pretty good
okay
room for
improvement
not good
0
5
10
15
20
number of respondents
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25
Figure 2. Awareness and use of existing/available resources
Counselling service
Chaplaincy
Printed material
Balint group
not aware
aware, not used
aware and used
Occupational Health
Clinical Tutor
Senior Team
Consultant
0
5
10
15
20
25
30
35
number of respondents
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40
45
Issues Identified
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•
•
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NON-ORGANISATIONAL:
Support
Communication
New self-help resources
ORGANISATIONAL:
Hours, annual leave, relocation
expenses
• Staffing levels
• Job design (IT systems & work patterns)
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Self-assessed well-being
at start and finish of training year
Before
70
percentage of cohort
60
50
40
30
20
10
0
not good
room for
improvement
okay
% F1 drs
pretty good
couldn't be
better
% F2 drs
After
70
percentage of cohort
60
50
40
30
20
10
0
not good
room for
improvement
okay
pretty good
couldn't be
better
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Table 1. Differences between year groups
in expectations at start of training year
Factors expected to threaten WB more by F1s:
• 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)
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Table 2. Differences between year groups
at end of respective training years
Factors enhancing WB more for F2s than
F1s:
• 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 F1s:
• Patients’ suffering and death (p<0.05, Mann-Whitney
U test)
Factors more threatening to WB for F2s:
• Personal safety (p<0.05, Mann-Whitney U test)
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Table 3. Differences between
expectation and experience for F1s
(Wilcoxon signed ranks tests)
Factors enhancing WB
less than expected
Factors threatening WB
less
•
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)
•
Possibility of being sued
(p<0.01)
Table 4. Differences between
expectation and experience for F2s
(Wilcoxon signed ranks tests)
Factors enhancing WB
less than expected
Factors more threatening
to WB than expected
• Being valued by nurse
colleagues (p<0.05)
• 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
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Self-Help resources: What Drs think
(The Top 10) [%-ages]
Males
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•
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Imm, vacc, chemo
for work exposures
Managing personal
Stress
Advice on sleep
hygiene, rest, p/nap
Counselling support
Pregnancy & work
Females
85
85
83
88
75
74
74
62
95
92
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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
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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
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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
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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 and better manage them?
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Avon Partnership
Occupational Health Service
Questions?
www.apohs.nhs.uk
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