North Yorkshire IAPT service covers the largest county in England with an area of 8,654 square kilometres. Created in April 2010 and provided by Tees Esk and Wear Valley NHS Foundation Trust (TEWV), the service covers the Yorkshire Dales and North Yorkshire Moors as well as significant towns including Scarborough, Harrogate and Northallerton.

The North Yorkshire IAPT service was aware of a growing body of research evidence highlighting concerns over the wellbeing of staff working in mental health settings. That, combined with the high volume, target-driven culture of IAPT, made us want to look at this further. Whilst attention was already being given to key indicators – including staff sickness, retention, staff friends and family questionnaires – we were concerned this did not give enough attention to staff wellbeing.

Within TEWV there are well-established policies and guidelines to managing the health and wellbeing of staff. These include employee support services, counselling, mindfulness retreats and chaplaincy services. Trust-wide, other more informal activities have been encouraged including exercise, mindfulness and group activities.

Within the IAPT service we decided to design and deliver a series of wellbeing continuing professional development (CPD) days for our administrators, trainees, psychological wellbeing practitioners (PWP) and high intensity workers (HIW). These were delivered away from the workplace and used to launch our new focus on wellbeing within the service. Typically, the days included a combination of reflective discussions, physical activity and wellbeing techniques. Participants were invited to write personal pledges for themselves as well as their teams. Space was also created to allow staff to reflect on the connection between their own values and beliefs and those of the trust.

Key actions for the service following the wellbeing launch included:

• establishing wellbeing champions in each team, co-ordinated and supported by the clinical lead,
• the creation of wellbeing boards, regularly updated by the champions and used to encourage, support and promote ongoing wellbeing activities,
• the addition of wellbeing to the agendas of leadership, team, clinical supervision and individual performance management meetings. Typically, these start with a short wellbeing activity,
• the service looks for regular opportunities to acknowledge individual contributions made by staff, including emails, conversations and recognition in the trust-wide newsletter,
• greater emphasis has been placed on workload management tools and techniques to address work-related stress,
• staff are encouraged to book the majority of their leave at the start of the leave period to ensure regular breaks throughout the year,
• team managers have reviewed office furniture and IT equipment, where necessary updating and replacing them.

The implementation of our new wellbeing initiatives started in September 2017. So far, the biggest impact observed within the service has been the level of enthusiasm and priority shown towards managing and maintaining wellbeing by staff. In particular, there is a greater awareness that wellbeing is a shared responsibility and it means different things to different people. Each team has started to identify and implement a number of activities to ensure this new culture is embedded within the service. Many of the ideas are already well known but the process of giving staff permission to undertake them has acted as a real catalyst for change.

Key activities have included weekly mindfulness classes, Yoga sessions, lunchtime walks, undertaking a communal activity; staff also take turns to identify weekly inspirational quotes for wellbeing boards, and organise social events outside work. Staff at all levels attend to and discuss their wellbeing and that of others; this has helped to promote a greater sense of togetherness, connection and shared purpose.

Moving forward, the North Yorkshire IAPT Service has already planned further wellbeing continuing professional development events for the coming year. Our focus will continue on embedding the lessons learnt from staff and ensuring organisational changes become business as usual. The service will continue to support the wide range of initiatives developed by staff. We propose to undertake a staff wellbeing survey and look more specifically at burnout and how we can identify the signs and act to avoid this. The IAPT service will also participate in a North Yorkshire-wide training event sponsored by the adult mental health head of service, designed to promote and support resilience amongst the workforce.