The frontline and beyond — wellbeing support for the NHS team

(the story of Project5, as it happens)

As the COVID-19 crisis emerges, worldwide, healthcare teams are witnessed in their unparalleled ability to maintain a compassionate and humanitarian ethos at the most stressful period in medical history. What’s clear is that this is not business as usual and may require a very human cost, the brunt of which will be taken by our NHS team.

The NHS has long been under pressure to deliver to an increasingly complex and long-term health need, in the context of austerity measures and cycles of change. Through no lack of skill or will, the NHS mental health teams have been struggling to meet the community's mental health needs, and this is predicted to increase beyond service capability. The impact has been a high-stress environment and repeated evidence of staff burnout, recruitment difficulties, and staff shortages. This is not the best place for a health service to be in to respond to a pandemic.

Mental Health teams are being redeployed and there is a genuine need to be concerned for the ‘wellbeing impact’ this situation will have on NHS teams now, during and after this crisis, no matter how long it lasts. A sustainable wellbeing solution is required. When we launched our not for profit project (www.project5.org) in March, we did so to proactively meet the changing wellbeing needs of NHS staff. We had 2 objectives; the first was to offer a service that worked alongside the sterling work of the existing NHS wellbeing plan so that our model simply added extra capacity into the system and the second was to create a sustainable model so we could continue to support the NHS beyond this current crisis.

It was our observation that creating a large scale, centralised, evidence-based and reflective service to meet this need would be a welcomed initiative by the NHS.

Our team of Psychologists designed what would be our ‘dream’ evidence-based multi-tier approach, with a service-evaluation and development arm. In short, a complete service. We then designed the optimal booking system, that would be effortless for both the practitioners and the NHS staff to interact with. A system that would be as simple as clicking the time you want help and then getting that help at that time. After years in the NHS, this truly felt like a game-changer. We then looked at the none-NHS sector wellbeing professionals and considered who could populate this service to support it.

Then we built it and we targeted these sectors to ask for volunteers to deliver the model. The result, something amazing:

Project5 launched at the end of April 2020 with all of this in place:

• 4,500 volunteers from the coaching, Psychology, Psychiatry, Nursing and Counselling (+ more) sectors… now being verified before being added to the system.

• a bespoke digital booking system for NHS staff

• a partnership with the NHS wellbeing Taskforce — who are promoting Project5 to all NHS staff nationally.

• a not-for-profit community interest company structure with a core delivery team of 35 highly skilled volunteers.

• a Clinical Governance Steering Committee (with a panel of senior clinical experts putting a critical eye on the project and setting the standards of delivery)

• supervision for all volunteers with qualified supervisors (6 weekly) and emergency coaching supervision for coaches at request (provided by the Association for Coaching)

• a managerial board including Psychologists, coaches, and NHS quality specialists.

• a consultation committee, to include the perspectives of end-users and stakeholders, including the third sector.

• a Research committee, partnered with Exeter University’s Clinical Psychology Research team — developing the underpinning assessment process.

• onboarding training of all volunteers into evidence-based approaches to supporting NHS staff in varying states of need

• an embedded rapid learning model — collecting data relating to the efficacy of the approach and updating the training of all volunteers (at pace) based on practice-based-evidence

• endorsement from multiple bodies and leading charities

It is estimated that we will be offering around 10 -15,000 sessions per month of evidence-based and high governance support to NHS staff by mid-May! At no cost to NHS Staff! And this number will increase as we continue to onboard credible volunteers.

And this is only the beginning.

The model is designed to learn — to take the evidence of what we think will help staff wellbeing in this crisis — and then to test it by helping them. We will see what works and doesn’t and update the evidence about what works best in this situation. A Plan-Do-Study-Act cycle, on repeat.

This being the hallmark of gold-standard quality improvement in the NHS. The difference between our model and the NHS effort to meet the need is that we have the ability to centralise the entire initiative. A huge delivery team, a single training route, a single data collection route — a single retraining route. We can learn and change rapidly, as the project is purpose-built to do just this. Rather than forcing a model into disparate mental health teams, we created 1 team and 1 method of delivery.

For quality improvement clinicians, like us, this is the dream service design and the likely fastest route to something of real high value for NHS staff.

We see this approach evolving into a support network and approach that is sustainable and really connected to the pulse of need in the NHS team. As it proves itself, we hope to see NHS mental health teams released to support the community and allow our network of highly skilled and specifically trained specialists take up the demand in NHS staff. Working alongside and not in competition.

All NHS staff across the UK and Northern Ireland who come into contact with COVID-19 patients are welcome to ask for support from Project5 irrespective of their roles and responsibilities.

But the ambitious reach of Project5 is beyond this — determined to offer a service that is receptive to all staff working in the NHS who will be facing the pressures and demands placed on them by a system that is straining to support the needs of the UK. To this end — our volunteers will be supervised to ensure that the different cultural background and lifestyles of NHS staff are respected and taken fully into account when they are offering professional support.

Project5.org is led by a team that was trained by the NHS, decades of experience in the NHS and loyal to its core values.

For more information: www.project5.org

To support fundraising: highfiveourcarers.org or share with the hashtag #highfiveourcarers (please)