Workforce Engagement and Wellbeing

Our Projects

Supporting staff after error

Second Victim Support website

 ‘Second victim’ is the term used to refer to healthcare workers who are impacted by patient safety incidents. Whilst patients and families will always be the first priority following safety incidents, the wellbeing of the staff involved is often overlooked but can leave them lacking confidence, unable to perform their job, requiring time off, or leaving the profession.


There is existing evidence on the importance and effectiveness of support programmes for such staff and their potential to counter the negative impact outlined above to result in more positive impact for staff and patients alike. Read more here

Developing resilience to adverse events: Training for healthcare professionals

Healthcare professionals who are involved in adverse events can experience depression, anxiety, sleep problems and symptoms of trauma; some have even considered leaving their profession. This project is piloting a training intervention designed to prepare healthcare professionals for these events. Based on an integration of Cognitive Behavioural Therapy principles with research into the factors which confer resilience to failure, the training involves an interactive workshop, case studies and experiential exercises tailored to specific health professional groups, together with a short one to one telephone follow up to support the application of learning. Read more here

An Acceptance and Commitment Therapy-based workplace intervention for improving wellbeing of NHS staff

Poor wellbeing and burnout continue to represent major issues in the NHS. Research shows that poor wellbeing and burnout are associated with patient safety. Acceptance and Commitment Therapy (ACT) is a newer type of Cognitive Behavioural Therapy that has been found promising in improving wellbeing in various UK workplace settings. To our knowledge, no studies have tested the effectiveness of ACT for improving both wellbeing and safe practice in NHS staff. Read more here

Social Emotion and teams

What factors influence junior doctors’ management of risk and uncertainty in A&E?

Research suggests that experience is important in understanding decision making in situations where there is risk and uncertainty. In an emergency care setting, a clinician’s experience has been found to play a role in patient management decisions. Having less clinical experience has been related to increased anxiety about uncertainty, ordering more tests and admitting a higher number of patients and may add to the increasing strain in A&E. This study aims to explore thought processes, feelings, team and environmental influences involved in patient management decisions made by junior doctors during an A&E shift and learn how junior doctors cope with the challenging decisions they have to make.

Read more here

Exploring healthcare professional’s perceptions of how emotional expressions impact team climate in maternity and the team’s ability to deliver safe care (EASI)

Research has found that emotional expressions (anger/happiness) can affect staff wellbeing, but little research has assessed what type of emotional expression (facial movements, body posture or vocal inflections) has the most impact. Similarly, very little research has explored the impact of emotional expressions within an NHS setting and how this may affect patient safety in the long term. Therefore, understanding maternity staff experiences or accounts of witnessing emotional expressions should enable us to better understand their impact on the emotional climate on a maternity ward and how it affects patient safety. This knowledge will then be used to design interventions to maximise its positive impact.

Read more here

Other projects

In the name of safety? Identifying and letting go of low-value practices

In an NHS characterised by acute shortages of time and resources, healthcare staff are required to do more and more ‘in the name of safety’. Safety rules, practices and procedures however, are not always evidence based or good value in terms of the safety benefits they offer.

Read more here

Safe staffing in maternity services

With over 650k births in England each year and an estimated NHS cost of almost £5bn, maternity services represent a major component of health care provision in the UK. Whilst the large majority of births are safe when things do go wrong the consequences in terms of health foregone and long-term medical need and costs can be substantial. The National Maternity Review (2016) estimates that £560 million is spent every year as a result of compensating families for negligence during maternity care – 1 case in every 600 births.

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Enhancing workforce engagement, well-being and patient safety in ambulance services: a mixed-methods exploratory and interventional study using feedback

Ambulance service staff working in an urgent and emergency care setting is an under-researched group at a disproportionately high risk of poorer work-related mental health, well-being and engagement. They experience a uniquely challenging and high level of chronic job-related stressors. Many of the risk factors are linked to the social and organisational aspects of the work environment, including job design. In addition, recent research has identified a desire among paramedics for more and better quality feedback on the cases assigned to them.

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A systematic review and meta-analysis of the association between healthcare staff engagement and patient safety outcomes

Evidence is growing of the links between staff engagement and patient safety as a result of healthcare workforce research in the UK and elsewhere. Previous systematic reviews have focused on related topics such as determining the most effective strategies for engaging healthcare staff, the characteristics of engaged staff, how to enhance staff wellbeing, or the outcomes of staff engagement. There is however no systematic review we are aware of that has determined if and to what extent staff engagement is associated with patient safety outcomes. This is critical because if safety is related to staff engagement, we might improve safety by improving staff engagement. In other words, safety interventions could also be staff engagement interventions.

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Caring in a crisis: Understanding the stressors and uplifts for NHS frontline staff and those supporting them during the COVID-19 crisis
NHS healthcare staff are currently facing unprecedented pressure which has been exacerbated due to the Covid-19 crisis. The stress of this crisis has been amplified by NHS-wide shortages in healthcare staff, where 100,000 jobs stand vacant and this number is rising. This shortage is primarily due to a high number of healthcare staff leaving their jobs, with many citing stress as their main reason for leaving. High stress and sickness levels in healthcare staff impact on patient care, leading to the delivery of poor quality, less safe care. There is a need for research to understand the experiences of NHS frontline healthcare staff during the Covid-19 crisis to inform how the wellbeing and mental health of healthcare staff can be safeguarded as a crisis progresses, and to understand how psychological interventions can be tailored to meet the needs of those who may suffer from psychological distress in the aftermath of a crisis.

Read more here