Sustainable Working and PIPP

Sustainable Working

Creating successful, satisfying and sustainable careers in Emergency Medicine

Key guidance

• ACP Wellbeing & Sustainable Working (January 2021)
• Supporting the psychological wellbeing of ED staff through Covid and beyond
• Wellness Compendium iBook (December 2020)
• When a Colleague Dies (November 2020)
• EMPOWER: Returning to EM Clinical Practice, Skills Maintenance, Future Professional and Personal Development (October 2019)
• EMPOWER: A Practical Guide to Flexible Working and Good EM Rota Design (October 2019)
• EMPOWER: A Practical Guide for EM Clinical and Non Clinical Managers (April 2019)
• EMPOWER: A guide to engage and retain your established EM staff (September 2018)
• Caring for doctors, caring for patients: How to transform UK healthcare environments to support doctors and medical students to care for patients (GMC, Nov 2019)
• Meeting the challenge of reducing stress and building resilience in the NHS workforce (HEE, Apr 2019)
• Support for doctors (AoMRC 2019)
• Return to Practice Guidance 2017 revision (AoMRC 2017)
• Summary guidance for Clinical Directors and Executive Boards
• Summary guidance for trainees, SAS doctors and Consultants in Emergency Medicine
• Report: Creating successful, satisfying and sustainable careers in Emergency Medicine
• RCEM position statement on sustainable senior doctor working patterns during the COVID-19 pandemic

The College has developed this important strategy to improve the working lives of clinicians working in Emergency Departments in the UK. The guidance documents are specifically aimed to help guide Clinical Directors of Emergency Medicine, clinicians, employers and commissioners of emergency healthcare.

Key elements

• Work patterns: For Emergency Medicine doctors these need to be well structured, sustainable and satisfying. The College has produced suggested solutions for working practices especially for out of hours and night time working by senior medical decision makers through annualised job planning. Recommendations on the ways in which annualised job plans can enhance working patterns are described.
• Models of ED function: These have changed over the years and the approaches that clinicians must consider both working in the ED in different roles, how to describe the specialty and profile it to others is vitally important.
• Flexible careers: Working practices for females and males in Emergency Medicine are changing and the specialty lends itself to allowing better work-life balance and integration as well as enhancing portfolio careers for those choosing to work less than full time.
• Decades of clinical life: The ways in which careers can be developed pro-actively through each decade of a clinical career to maintain satisfaction and longevity are described.
• Team working and leadership: A range of tips on how to optimise your team and leadership skills as well as better develop these skills in members of your team are described.
• Maintaining well being: Creating tailored strategies to maintain well being and embedding them into daily practice are critical to career sustainability. Equally important is the need to recognise early features of chronic stress to prevent possible burnout in colleagues. This is an area that the College will continue to expand on in the future.
• Valuing trainees: Much formal work is ongoing via Health Education England, the GMC and other agencies in this area. In our guidance, a range of top tips from trainees and trainers provides an overview of things that cost little and yet can have a dramatic impact on the future career paths of the young trainee.

What next?

We urge all working in Emergency Departments or responsible for emergency care systems to take the time to read the strategy. Then ensure that:

• You act upon those components that you can directly influence.
• Give the strategy to your Clinical Director (if you are not one) and your team. Decide upon the areas of the strategy that most apply to you and devise a local implementation plan.
• Decide how you can best influence the Executive team and non-Executive team at your Trust/ Hospital Board as well as commissioners to firstly read and then act upon the strategy.
• Devise a timetable to monitor progress.

Anti-bullying

Our members’, and all healthcare professionals’, workplaces should be free from all forms of bullying and harassment. Our Sustainable Working Practice Committee along with other RCEM committees are developing work to tackle bullying in the workplace and in our view the working environment should allow healthcare professionals to work with dignity and respect, without the unacceptable threat of bullying and harassment. Bullying and harassment undermines physical and mental health and can lead to reduced performance and increased sickness absence.

Below are some useful resources from RCEM and other organisations that are there to support you.

RCEM

• RCEM position statement on bullying and harassment (April 2019)
• EMPOWER:A Wellness Compendium for EM (Updated June 2019)

RSCed

• An Alliance Against Bullying, Undermining and Harassment in the NHS (RCSEd, 2019)
• Are you a bully? (RCSed, 2019)

GMC

• Doctors to receive training support to call out unprofessionalism (GMC, 2019)
• Anti-Bullying Alliance resource list

BMA

• Bullying and harassment: how to address it and create a supportive and inclusive culture (BMA, 2019)

Civility saves lives

• Visit the civility saves lives page

National Guardian’s Office

• Visit freedom to speak up page

Wellness resources

Resources

• Improving the mental health of staff in hospital emergency departments (MIND, 2019)
• Taking care of you evaluation (MIND, 2019)
• EMTA Rest and Sleep full resources
• Staying safe this website offers free resources for anyone distressed, thinking about suicide, or worried about someone else.
• ED Spa introduction by Laura Howard – RCEM are proud to be working with Dr Laura Howard on the exciting and innovative new ED Spa. The ED Spa is a safe space, where practitioners can drop their guard and be real about the challenges they face.
• Second victim support – this website seeks to help second victims find evidence based support

Blogs & videos

• Laura Howard and Susie Hewitt blog about the final day of EM50 Celebration Week, the exciting new ED Spa and looking after yourself.
• Watch the specially produced EM50 video about wellness and exercise

Key messages

1. Looking after your body – be active
2. Looking after your mind – keep learning and take notice
3. Connecting with people – invest in relationships and give

The ED Spa works on the principle of 5 elements of well-being:

1. Connect: Take time to invest in meaningful relationships with family, friends, colleagues and communities. Strong, meaningful relationships will encourage and support you.
2. Be Active: Play sport, walk, run, dance, garden, cycle, swim and many more. Find the thing you enjoy that gets you active.
3. Give: Be grateful, be kind, do something nice for a friend or a stranger.
4. Keep learning: Learn a new skill, find a hobby or take on a new challenge.
5. Take notice: Pay attention and be in the moment, notice how you are feeling.

More information on the principles of the ED Spa and how to create one in your own ED ware coming over the next few months. You can also follow or contact the ED Spa on twitter.

Great wellness organisations

• ACEP Wellness Section
• Red Cross Loneliness guidance
• Mind
• NHS Choices
• NHS Fitness Studio
• NHS Choices – Healthy Eating
• Doctor’s Support Network

Psychologically Informed Practice and Policy (PIPP) Project: retention in the emergency care workforce

• PIPP Project: Key Study Recommendations (January  2024)
• Psychologically Informed Practice and Policy (PIPP) Study Executive Summary (October 2022)
• Retention of staff in emergency medicine is at crisis level (PiPP infographic) (October 2022)
• PiPP Project – Retention of Staff (You tube video) (October 2022)