Salus

Salus – Rising to the Challenge

Salus – Occupational Health - Rising to the challenge

The NHSL Occupational Health & Safety Department sit within the HR Directorate. From March 2020 it significantly redesigned services to support NHSL workforce during the Covid 19 pandemic period. These services are described below and are additional to the established service provision.

Wellbeing Programme:

The anticipated demands that the pandemic would put on the health and social care workforce needed a co-ordinated model of staff support, one that would provide the appropriate support at the right time for colleagues with clear routes of communication and escalation to access specialist interventions when required.

The tiered staff support model enabled a new collaboration across the three services and ensured a variety of mechanisms to seek support via email, phone, social media and face to face. The support could also be adapted to provide for individuals, groups, teams, departments and, following significant events, could be offered to whole sites.

Among the initiatives that were introduced during this time period:

• The Salus Covid-19 Helpline and the Salus Stressline - commenced in order to respond to the increasing number of staff requiring additional mental health support.  Staff from existing case management services with Salus were deployed to support this new service, which was operational 7 days a week from 9am – 7pm and was available to all NHSL staff / HSCP’s / Social Care / Care homes Staff and Third Sector.
• The current sickness absence support service (EASY) team were deployed to support the Helpline, however did retain the service provision for all mental health sickness absence referrals. Calls were made to these identified staff on Day 1, 3 and 10 with signposting and onward referral to specialist and therapeutic services continuing throughout this time.
• Recognition that some staff may wish to seek confidential mental health support out with the organisation, the option remained for staff to contact the independent counselling service arranged by NHSL. This service provides NHSL staff with a confidential counselling service either via self-referral or management referral for a variety of mental health related issues.  A telephone helpline is available in addition to providing psychological first aid and person centred / solution focused counselling. Telephone and face to face normally (Skype at present due to social distancing) with up to 6 sessions if required.  This service is available to all NHSL staff and includes a 24 hour helpline. 
• Staff Care and Rest Centres in each acute site and within the two assessment centre sites. These centres were staffed by 71 colleagues who had been redeployed to the Spiritual Care and Wellbeing department and were then trained in peer support.
• Psychological Services Helplines; Tier 2 for one off Psychological First Aid support, and Tier 3 for more extensive Psychological support of up to six telephone sessions.
• Rest rooms / Wobble rooms / Take 5 rooms were established and supported by psychological first aiders (clinicians and peer supporters) in community and mental health in-patient settings, health centres and community hubs.
• The establishment of a Bronze Command Staff Wellbeing Group (which also acted as a conduit for access to endowments funds for staff wellbeing initiatives)
• The setup of Staff Health and Wellbeing Groups in North & South HSCPs
• Access to helplines for staff from Care Homes
• Access to Staff Care 24/7 Helpline for staff in The State Hospital
• Creation of an online eLearning package by NLC colleagues to support the use of the Staff Wellbeing Collaboration Operational Guide.
• Additional bereavement care training resources addressing the impact when a colleague dies were developed and adopted by NES
• A number of staff side reps attended the peer support training and are now part of the network

Staff Covid-19 Testing :

In March the department reconfigured to establish a 7 day Covid staff testing service. This involved provision of drive through testing for all symptomatic staff and their household members. In addition a mobile facility for home testing for staff too unwell/unable to travel was also introduced in partnership with dental nursing colleagues. By May 2020 the department introduced a fully automated bespoke software programme to manage all testing logistics including booking portal and result return to staff member/manager by SMS text.

Following Scottish Government guidance, the service also took on the routine weekly asymptomatic testing of all Care Home staff in North Lanarkshire and staff from Oncology and Old Age Psychiatry services due to the vulnerability of their patients.

To date circa 4,500 tests have been undertaken. Those returning negative have allowed staff involved return to work saving an estimated 22,000 days that would have been lost to isolation.

Staff Covid-19 Helpline:

As Covid incidence grew, increasing demands were being made of staff regarding provision of safe working practices. In addition frequent issuing of government guidance ensured a fluid and at times confusing period for workers relating to both their patient care and their personal circumstances/requirements out of work. In order to reduce anxiety and provide clarity the department rapidly set up a dedicated one stop Covid Helpline for all staff with concerns/queries. The helpline involved the redeployment of over 14 staff from occupational health nursing and admin providing a 7 day service. This allowed a triage system to be implemented where the call handler could provide advice, however also facilitate rapid access to an Occupational Health Nurse, Physician or HR officer.

Frequent government guidance was converted into pragmatic terms within hours and available to all NHSL staff. Support provided ranged from advice on PPE, Shielding, Risk Assessment Transport, Pregnancy, Isolation, Household Advice, Special Leave, BAME specific, Bank Staffing & complaints. At its peak the service was managing 1,600 calls per day.

To date the Helpline has received in excess of 15,000 calls for advice/action.  Staff have indicated that they have been hugely appreciative of a Helpline specifically to listen to their query and give them advice, information or to signpost to additional support services, at a time of fast paced and frequent changes to guidance. 

Face Fit Testing:

A key element of ensuring safe clinical practice was the fitting of FFP3 masks for staff working in high risk areas. This included critical care, assessment centres, covid wards etc.. As the Health & Safety team is relatively small this involved the identification and training of 40 peer “Face Fit Testers” and close working with NSS experts to ensure all staff remained safe at work.

Due to the prevalence of Covid this work had to be undertaken rapidly to ensure critical areas could be adequately staffed. As such, staff were provided with appropriate masks and face fit tested during April-May. Unfortunately, as provision of mask type was unstable, many staff had to be re-fitted multiple times to various mask types. In a normal non Covid year only 200 staff are fitted.

Following additional government guidance relating to safety within the working environment (2m distancing, sanitisation, and home working ...) The Health & Safety team introduced an environmental audit programme to ensure compliance across NHSL. To date over 80 areas have been audited and additional advice provided

Occupational Health :

All statutory occupational health (OH) provision has remained in place throughout the period. In addition development of specific risk assessments has supported the workforce. Requests for management and self-referrals increased by over 50% in comparison to the same period in the previous year.

All staff testing positive for Covid are followed up 10-14 days following result to ensure wellbeing and ability to return to work. This and our testing data are included within the Scottish government supported SIREN research programme.

In addition the OH team are currently vaccinating for Influenza, including all Lanarkshire Social Care staff, effectively doubling the workforce requiring protection. The department has innovatively altered the Staff Testing Software to provide an electronic portal booking and data collection facility which will be a precursor for Covid vaccinations when available.

Commercial Redeployment

The Occupational Health dept have a dedicated income generating team, providing OH and Return to Work contractual services across Scotland & Northern England. This accounts for approximately 120 staff. During the March – June period these staff were redeployed across NHSL to support covid related activity. This involved staff with relevant clinical backgrounds supporting various departments including Critical Care, Physiotherapy, Mental Health services, HR (recruitment of volunteers & bank staff). Others supported the Wellbeing Programme above working with Psychology and Spiritual services. These additional staff provided a valuable resource for HR to provide support to departments requiring additional input.