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

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

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%

Percentage of respondents 11% 2% 43% 37% 30% 37% 13% 17% 2% 8% Figure 1. Self-rated well-being. 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 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)

Investing in Good Health at Work 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)

Table 3. Differences between expectation and experience for F1s (Wilcoxon signed ranks tests) Factors enhancing WB less than expected Availability of learning opportunities (p<0.01) System of career progression (p<0.01) Being valued by nurses (p<0.05) Being valued by non-clinical staff (p<0.05) Factors threatening WB less Experience of patients’ suffering and death (p<0.01) Physical demands of the work (p<0.01) Emotional demands of the work (p<0.01) 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 Being valued by nurse colleagues (p<0.05) Factors more threatening to WB than expected Availability of learning opportunities (p<0.05)

Investing in Good Health at Work 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] MalesFemales Imm, vacc, chemo8585 for work exposures Managing personal Stress8388 Advice on sleep hygiene, rest, p/nap7562 Counselling support7495 Pregnancy & work7492

Investing in Good Health at Work Self-Help Resources: What Doctors Think (The Top 10) [%-ages] Immun, vacc, chemoMales Females for general health6869 Emotional resilience & coping skills6667 Alcohol & Drugs6265 Cigarette smoking6248 Physio advice/treat.6077

Investing in Good Health at Work Self-Help Resources: What Drs think: Lesser Recognised Tools [%-ages] Religious / other Males Females Spiritual Guidance15 9 / support Complementary ther.1119 Uses of the arts 510 Staff relations & effective communication3246

Investing in Good Health at Work Self-Help Resources: Drs & Business-Related Issues [%-ages] Career planning &Males Females skills development3653 Business / financial / investment / pensions3846 Retirement planning2849 Dealing with redundancy & unemployment3446

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 self- help 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?

Investing in Good Health at Work Questions? Avon Partnership Occupational Health Service