Creating a positive work environment greatly influences employees’ attitudes towards their job and coworkers, performance levels and productivity. Some important areas to consider when building a positive wellbeing environment can include:
A healthy working environment creates a positive atmosphere for your staff to thrive and deliver the best patient care says NHS England.
Providing working conditions that enable a positive working environment can increase the functionality of the workplace and increase employees’ satisfaction with their workplace. A growing body of evidence suggests that positive staff experience is associated with care provided to patients (Dawson, 2014).
The World Health Organisation (WHO) stresses the importance of looking after staff’s basic human needs:
“Ensure rest and respite during work or between shifts, eat sufficient and healthy food, engage in physical activity, and stay in contact with family and friends.”
According to the 2020 NHS staff survey, 40% of staff reported that they did not have adequate materials, supplies and equipment to do their work. Improving the functionality of the work place can reduce the risk of accidents and injury and improve patients experience and safety.
Public Health England encourage employers to ensure that the following facilities are adequate to support staff:
Eating facilities – including places to heat food
Drinking facilities – and access to these throughout their work day
Lighting and temperature
Spaces to have confidential conversations
Public Health England suggest that where possible employers should aim to engage staff in workplace design; as staff know the practicalities of their day-to-day role they can provide considerable insight.
This also allows for staff to feel consulted and have a greater sense of control within their work space. They suggest the use of focus groups, short opinion polls or using other innovative ways to gather staff perspectives.
Evidence suggests that access to green space can has a positive impact on mental health. The Space to Breathe study set out to examine the impact of green space on workplace wellbeing within the NHS. The study found that:
Over four-fifths of staff said that would like to spend more time in green space while at work.
Staff who regularly took work breaks in green space had significantly higher levels of wellbeing.
The most common way in which staff spent time in green space was taking a walk in nature during their beak.
Approximately half of staff stated that attractive green space was an important consideration for them when choosing where to work, suggesting it may impact recruitment and retention.
Maintaining safe environments for both patients and staff is essential during the COVID-19 pandemic. The following information from the Health and Safety Executive offers up to date advice for employers on measures that can be taken within the workplace such as conducting risk assessments, hand washing hygiene and supporting vulnerable workers.
What is flexible working?
As we spend approximately 1/3 of our lives at work, it is important that we gain satisfaction from our employment duties and working conditions to maintain good wellbeing. The Covid-19 pandemic has shone a spotlight on how individuals can adapt to different types of working, by allowing staff members to not only discover different modes of working, but also which methods were best suited to their needs.
One such idea which has been suggested to improve wellbeing is through introducing opportunities for flexible working across health and social care settings. Flexible working allows staff members to have more control over how, where and when they work. The NHS People Plan (2020-2021) outlines its support for this idea:
“The NHS will continue to commit to offering more flexible, varied roles and opportunities for different types of flexible working. We believe all our NHS people should be offered the chance to work flexibly, regardless of role, grade, reason, or circumstance. We know it’s not always immediately easy to accommodate individual work preferences, but becoming a more flexible, modern employer in line with other sectors, gives us the opportunity to retain our existing people and attract new talent with to work with us. Flexible working is about more than just retention. It can unlock new opportunities and contribute to people’s mental health, wellbeing and engagement with their role, and we know that in the NHS more engaged staff leads to better patient care.”
Results from the NHS Staff Survey (2021) illustrated how keen staff members are to achieve a work-life balance, however do not necessarily have this implemented through flexible working.
- Just 44% of staff felt that their organisation is committed to helping them balance their work and home life
- Just over half of staff (52.1%) said they achieve a good balance between their work life and their home life
- While 66.7% said that they felt able to approach their immediate manager to talk openly about flexible working, just over half (53.9%) of staff members were satisfied with the opportunities they have for flexible working patterns
Research is ongoing into the impact of flexible working on employee wellbeing, however emerging evidence suggests that positive effects exist for implementation of flexible working for employees, employers and organisations.
- Flexible workers reported having higher job satisfaction, commitment, and productivity compared to those who do not work flexibly
- Flexible working reduces employee absence rates
- A systemic review by Shiri et. al (2022) found that employee-orientated flexible working may have small benefits for mental health, including reducing burnout and emotional exhaustion.
- A study of 26,000 female UK workers reported that the quality of a job (including increased flexibility and autonomy) is positively associated with reduced depressive and anxiety symptoms (Carrino, Meschi & Belloni, 2022; in press). The researchers found the flexibility to arrange working times and the degree of autonomy workers have were two key characteristics of having the largest positive effect on mental wellbeing.
- The UK parliament website have published an article on the impact of flexible and home working arrangements.
- Mind, the UK’s mental health charity, suggest some advantages of flexible working are:
- Being able to have control over working hours, which can help to improve work-life balance
- Having the option to avoid rush-hour crowds and traffic, which could ease financial costs associated with travel and reduce stress
- More freedom in being available to attend medical appointments
- NHS England have also published case studies of flexible working across various healthcare settings, you can read these.
NHS England have published recommendations on how to introduce flexible working into the workplace. These include:
- Toolkit for individuals and line managers
- Advice to revisit your flexible working policy and update it in line with the flexible working definition and principles
- Guidelines for managers around flexible working for nurses by NHS Employers
- Explore how many of your organisation’s roles are currently advertised as flexible
- Encourage staff to join the NHS Flexible Working Network. Aimed at those working in the NHS with an interest or curiosity about flexible working
- Analyse your own data from the staff survey
- See what financial benefits flexible working might have using our flexible working cost calculator
Staff have the legal right to request flexible working after completing 26 weeks or more of employment in a particular work environment. For details on this, please visit www.gov.uk/flexible-working
Working from home can come with both benefits and challenges for staff.
The Royal Society for Public Health (RSPH) conducted a survey which found that overall, more people felt working from home was better for their health and wellbeing (45%), compared to around one third (29%) who thought working from home was worse for their health and wellbeing.
However, people who switched to working from home as a result of Covid-19 had experienced health and wellbeing impacts, with the most common being:
- Feeling less connected to colleagues (67%)
- Taking less exercise (46%)
- Developing musculoskeletal problems (39%)
- Disturbed sleep (37%)
In order to tackle these issues, the RSPH is encouraging employers to make sure that:
- All employees have access to mental health support to help them to cope with increased isolation and anxiety.
- All employees to have access to equipment and a remote assessment to support them with their physical health.
- Organisations to develop a culture which encourages employees to block their work communications outside of work hours.
- 7 simple tips to tackle working from home
- Staff from Mind.org.uk share their top tips
- Empowering disabled staff through flexible working
- Tax relief for employers working from home
Working in busy, fast-paced healthcare settings with many deadlines and clinical targets can often result in staff members feeling increasingly pressured to prioritise work over wellbeing. Working in such environments raises the risk of staff adopting a 'let’s-keep-going' mindset by taking on additional responsibilities and not noticing the impact that this approach has on their emotional and physical health. It may be difficult to set healthy boundaries between our working lives and home lives, leading to them becoming blurred and merged together.
A CIPD survey results illustrate the effects of a blurring of work-life boundaries on health:
- Employees who have experienced at least one characteristic of burn-out attribute it to high work demands, reduced social connections and a lack of boundaries between work-life balance
- Over a quarter of employees (26%) report struggling to relax in their free and personal time due to work
- Nearly half of workers (46%) have worked in recent months despite reporting not feeling well enough physically and/or mentally to carry out their required work duties
- Consistently working routinely outside of your contracted hours - intentionally starting the working day significantly earlier and finishing work later than your contracted hours
- Taking on additional duties in work which exceed the current workload, not allowing tasks to be delegated to others when such opportunities are possible
- Checking work emails during non-contracted hours including on annual leave
- Undertaking work duties on annual leave days or outside of working hours, only scheduling in annual leave when requested to by a manager
- Dropping pleasurable activities/hobbies which you usually enjoy in leisure time
- Reducing socialising and spending less time with loved ones; not attending meet-ups, avoiding taking phone-calls from loved ones, delaying responding to personal messages/emails
- Not prioritising important personal tasks or appointments e.g. putting off scheduling health appointments
The Mental Health Foundation have proposed five key tips on regularly checking managing the home-life balance and boundaries through the following steps:
- Pause. Do you have an opportunity in your day to reflect on your work or personal life? Have you been able to check in on how you’re feeling mentally or physically? How would you describe how you’re currently feeling? Make time for yourself, even for 5 minutes, to check in. This mental space can help you to reflect on your priorities and if your current work-life routine is giving you satisfaction and meaning.
- Pay attention to your feelings. Once you have been able to notice your feelings, thoughts and bodily responses to this situation, what conclusions have you drawn? Are you feeling fulfilled? Upset, happy, angry? Mindfulness is a very useful practice to observe and notice these, you can access mindfulness sessions with Peter Helmer. Once you are aware of your feelings, you can decide which changes you want to put in place.
- Reprioritise. What needs to change? What are the pros and cons of making such changes? How do you want your life to ideally look like? Which areas of your life do you want to spend more or less time on? What is important to you?
- Consider your alternatives. Is there anything within your control at work you can change to meet what is important for you? For instance, are you able to leave work on time so as to spend more time with your friends and family? Is it necessary to check work emails out of hours, so that you can spend that time pursuing a hobby you’ve always loved?
- Make changes. Depending on what changes you wish to make, start implementing these – are you able to discuss your concerns about your work with your manager? Are you able to speak to Occupational Health about the effects work is having on your health? Can you ensure that annual days are spent solely for leisure purposes and not work?
Use our checklists below whilst your at work and before switching off to help create a healthy boundary between work and home life.
There are various reasons as to why we should be incorporating breaks and rest periods into our working patterns and personal lives. Research studies have found a number of benefits associated with taking breaks.
Movement breaks are essential for your physical health. Sitting at one’s desk for prolonged periods of time has been found to increase obesity, Type II Diabetes, heart disease, cancer and premature death. According to the NHS, sitting for long periods of time slows metabolism which negatively affects the body’s ability to regulate blood sugar, blood pressure and break-down fat. Getting up from your chair for a walk, stretch, do some yoga, walk up/down the stairs- even five minutes can make a significant difference.
Breaks can prevent decision fatigue and give you the space to make decisions with a clearer headspace
Breaks help to restore motivation, especially for longer tasks. It can be difficult continue to have sustained attention for long periods of time. Allowing yourself to have short, regular and adequate breaks improves concentration.
Breaks boost productivity and creativity. Allowing yourself a five-minute break can replenish your mental resources and result in higher levels of productivity.
The NHS Physical Activity Guidelines for Adults aged 19-64 recommends that adults should undertake physical activity daily, aiming to do at least 150 minutes of moderate - intensity exercise weekly and reduce time spent sitting or lying down. We can incorporate activity into our breaks through a number of ways:
- Get moving: A brisk five-minute walk, a big stretch, a few minutes of yoga can have a substantial effect on helping you feel less lethargic and more tuned in. The UK Chief Medical Officers’ Physical Activity Guidelines report suggests breaking up long periods of time spent sitting with small, short bursts of activity for 1-2 minutes.
- Connect with nature: If you have the ability to take in some fresh air, get outside even shortly, possibly take a hot drink with you and pause to have a moment to yourself in your busy working day. Kaplan’s Attention Restoration Theory (1989) proposes that spending time or exposing ourselves to nature scenes helps to improve mental fatigue and concentration.
- Change your environment: Leave your work station and give your brain the rest and ability to switch gears.
- Take a few deep breaths: Breathing is a powerful way of relaxing your mind and body. A large body of research supports Diaphragmatic Breathing as a positive means of reducing anxiety, depression and stress (Brown and Gerbarg, 2005; Anju et. al, 2015). Similarly, mindfulness meditation teaches us to use our breath as an anchor to regulate ourselves emotionally. Our mindfulness practitioner Peter Helmer runs free weekly drop-in mindfulness sessions.
We have a dedicated physical health self-resources page you can explore here.
When considering how to structure breaks for shift work, we refer to the Three R’s:
- Don’t feel guilty about taking breaks and encourage others to adopt the same attitude. A culture of skipped breaks only threatens staff and patient safety.
- Remember that health and welfare at work is enshrined in law, as outlined on the UK Government website
- If missed breaks are becoming a pattern, escalate this to your manager.
- Begin your shift well-hydrated and ensure that you keep hydrated
- Dehydration can affect your health and performance, impacting your concentration and cognitive performance triggering fatigue. One NHS study found that 45% of staff were dehydrated at the end of their shift (El-Sharkawy et. al, 2015)
- Always act on signs of dehydrated
- Try to pack your lunch and snacks with healthy food that will help sustain your energy levels throughout long shifts.
- As night shifts have been associated with obesity and poor health outcomes (Sun et. al, 2017), snacking on good nutritious snacks can be especially important.
- All staff should have somewhere to eat in a setting free from contamination