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. 2023 Aug 23;13(8):e071826.
doi: 10.1136/bmjopen-2023-071826.

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

Kate Allsopp  1   2 , Filippo Varese  3   2 , Paul French  4   5 , Hannah White  3 , Priscilla Chung  6 , Alysha A Hassan  7 , Sally-Anne Wright  6 , Ellie Young  8 , Alan Barrett  8   9 , Gita Bhutani  6   10 , Katherine McGuirk  11 , Fay Huntley  7   12 , May Sarsam  7 , Hein Ten Cate  6 , Ruth Watson  8   13 , Jenni Willbourn  8 , Daniel Hind  14
Affiliations

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

Kate Allsopp et al. BMJ Open. .

Abstract

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 normalisation process theory 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.

Keywords: COVID-19; healthcare staff; implementation; mental health services; qualitative.

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Conflict of interest statement

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.

Figures

Figure 1
Figure 1
Factors that positively impacted on implementation of the Hubs.
Figure 2
Figure 2
Factors that negatively impacted on implementation of the Hubs. NHS, National Health Service.
See this image and copyright information in PMC

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