Supporting staff through trauma risk management

Case study: Led by Moya Flaherty & Vicky O’Neil, Northampton General Hospitals NHS Trust

Background to learning

For many staff the COVID-19 pandemic represents the most extraordinary period of their careers.  Staff have worked tirelessly to care for critically ill patients. A wider context of uncertainty – where the understanding of the progression of COVID-19 and effective care has been evolving – has been challenging for staff and many have been redeployed and supported to work outside their usual fields of practice.

Staff may also be anxious about the risks to them and their families, particularly where they have seen colleagues become unwell as a result of COVID-19.

National support has recognised the potential impacts of COVID-19 on well-being.  This case study focuses on how nurses at Northampton General Hospitals (NGH) NHS Trust expanded and enhanced the Trust’s ‘Supporting Our Staff’ (SoS) service to support all colleagues.

Learning and advice to be shared

‘Supporting our Staff’ at NGH is a peer support service to provide psychological support in the context of traumatic events at work. The service is modelled on an evidence-based approach using a trauma risk management (TRiM) methodology. This helps to identify risks for  people who may suffer poor mental heath following traumatic experiences.

At the start of the pandemic, nurses and operating department practitioners led an initiative to quickly upscale this service to provide support to all hospital staff.

Prior to the COVID-19 pandemic the Trust had a small team of TRiM practitioners who provided a formal evidenced based support system in addition to standard occupational health services. Normally, referrals to this service averaged one or two a month. However, as the pandemic took hold, uptake of the service increased and it started to receive an average of one referral per day.

The TRiM model also supports non-clinical staff to spot the signs of risk. So, by design, the team was expanded to include a diverse range of professionals, administration team members and senior staff who lead and contributed to the overall organisational incident response. Through a rapid change cycle, a further 27 practitioners were trained to support the increase in demand for this vital service.

Prior to COVID-19 formal onward referrals from the SoS service for professional psychological support had not been required.  However, during the pandemic, planning enabled increased formal referrals to be made where needed.

These referrals have been facilitated through the employment of a lead psychologist for staff support, and collaboration with a local community health trust which has provided a fast track into their existing services.  Additionally, a psychologist has been deployed to work on-site to facilitate flexible support staff.

Clinical supervision through the team psychologists ensures that SoS practitioners themselves are adequately supported.

Would it be beneficial to retain these changes?

Informal feedback from individuals who have received support from the SoS service has been overwhelmingly positive. A formal feedback questionnaire has been developed and is due to be piloted in October 2020.

We know that healthcare staff may face psychological trauma in their work, especially where they are part of the response to major incidents and trusts have their own processes in place to support staff when they encounter trauma in their work. The COVID-19 pandemic differs from ‘normal’ major incidents in that it has required a sustained incident response over several months.  The Trust has recognised this and has built its capacity to support staff to deal with trauma over a longer period and to avoid poorer mental health outcomes for staff.