Issues Faced By A&E Staff In Providing Well-being To Patients: A Study On The NHS Workforce

Impact of A&E staff well-being on NHS

The health care system has been one of the greatest assets for the well-being of the people in the society. Various staff including doctors, nurses, paramedics and managers are involved in the well- being of the emergency departments in the UK. The NHS is one of the largest employers in the world including 1.3 million staffs. Therefore, it becomes difficult for the management to provide well-being services (Cotton 2016). It is understandable since NHS operates for 24 hours a day and 365 days a year. Additionally, the workload is challenging and the NHS staff has to manage that. There is an increase in clinical demand, the patient population which is constantly changing have resulted in 37 percent increase in emergency hospital admissions (Cox, Spiegelhalter and Marangozov 2018).

This research focuses on the issues faced by the staffs of the A&E in providing well-being to patients. The factors affecting the staff performance in the organization have been discussed in the study. The research will use quantitative findings for analyzing the data collected from various sources.

The NHS staffs used to feel the pressure of personal responsibility in the organization. As per the survey, 68% of the NHS staff in England and 70% in Wales have reported not feeling well in their roles and responsibilities (Bagnall et al. 2016). Therefore, this has created a huge problem for the NHS. The mental health of the staffs has been disturbed and suffering from internal depression. The NHS has been reported with several survey reports of their staffs. The performance of NHS in the well being of staff is relatively poor. Sickness absence rates exceed UK public sector by 27% (White 2017). Many factors can be attributed to why the sickness absence rates are higher than the average. NHS work can be emotional, psychologically and physically demanding as opposed to rewarding.

This research will throw light on the factors creating issues in the well-being of the staffs in the NHS. The issues and risks included in the management of staffs in the organization will be discussed.

The primary problem is the issues faced by the A&E staffs in the UK. The impact of the well-being of the staffs in the A&E on the NHS has been described in the research. The mental health problems of the staffs have been a major problem in the A&E.

The aim of the research is to identify the issues in staffs of A&E in the UK.

Factors affecting the staff performance in the organization

The objectives of the research are as follows:

• To identify issues in staffs of A&E in the UK
• To analyze the factors creating issues and risks among staffs of A&E in the UK
• To analyze the impact of the wellbeing of A&E staffs in the NHS
• To recommend strategies for mitigating issues among the staffs

The research questions are as follows:

• What are the issues in staffs of A&E in the UK?
• How are these factors creating issues and risks among staffs of A&E in the UK?
• What is the impact of the wellbeing of A&E staffs in the NHS?
• How to mitigate issues among the staffs?

H0: The impact of the well-being of A&E staffs has been positive in the NHS

H1: There is no impact on the well-being of A&E staffs in the NHS

 Every hospital under NHS has an A&E department. A&E department is also known as an emergency department. A&E department under NHS is responsible for providing 24-hour access for emergency patients. Staff includes nurses, paramedics, reception staff, radiographers, healthcare assistants, porters and medical doctors. Wellbeing, engagement and good staff health are beneficial for hospital and for patients (Jones 2017). This is the major reason why the focus should be on the wellbeing of A&E staff. There are significant benefits which are numerous such as an improved patient experience of care, improved patient safety, reduced costs and personal and professional benefits for NHS staff. This does not stop here since there was a 58 per cent increase in secondary care for the aged (Jennings and Matheson-Monnet 2015). There is a need to look into challenges that are present in the wellbeing of NHS workforce. The first one is ‘Presenteeism’. There is several NHS staff who feels pressure or a sort of responsibility to attend work when they are not in the right physical framework to attend. The reason for stating the above reason is that statistics have proved the above fact (Whiting et al., 2016). 70 percent of NHS staff in Wales and 68 per cent of NHS staff in England has admitted that they have reported to duty despite being unwell that particular day.  

The second point is mental health. Mental health of staff must be in good condition for effective working. More than quarter of staff sickness absence has resulted due to poor mental health. 33 per cent of NHS staff in Wales and 38 per cent NHS staff in England have reported that they have suffered work-related stress. The third point will discuss musculoskeletal disorders. They are staff such as Porters have to engage in physically demanding work. This disorder is major cause injury and illness in the NHS workforce (Ham and Berwick 2017). This has accounted for nearly half of absence for NHS staff. The fourth pint will explain equity and equality. NHS workforce is very diverse in terms of demographic characteristics, working patterns and occupational group. There may be some staff who is employed by third-party contractor. Research has revealed that there is a strong connection between staff health and wellbeing and these factors. There are outsourced staffs, staff working in remote locations and those who are working in night shift experience the lower level of engagement and worse health and wellbeing when compared to other staff members. The fifth point would elaborate obesity and overweight as another reason challenging health and well being of NHS workforce. It was estimated with the help of government officials that 300,000 staff of NHS are obese and 400,000 being overweight. These figures are likely to rise since the levels of overweight and obesity in the general population are on the rise (Board 2017).

Challenges in the well-being of NHS workforce

These will bear significant consequence for both the organization and the staff. It was also established that the working environment is a critical determinant of wellbeing and staff engagement. The next portion will state existing framework to promote wellbeing and health for NHS staff. The first one is promoting mental wellbeing. This is a major cause of sickness absence and must be taken care of. Majority of NHS trusts, specifically 92% of trusts offers some for the form of therapies to staff members. The second point will address long-term sickness absence (Breckon et al. 2016). Majority of the NHS trusts present in England have a policy for long-term absence for sickness. The third point will mention the promotion of healthy weight by NHS. It was shocking to know that only 28 per cent of NHS trusts reported on having a policy that looks after this cause. There must be a comprehensive review of the policy and changes need to be implemented on an urgent basis to tackle the problem (Olive 2017).  

This research will use quantitative findings for a collection of data and information. The research methodology has been a scientific process for identifying the path to complete the research within a deadline. The research will use a positivism philosophy that helps in understanding the existing theories and models related to the topic. The research will use a deductive approach that helps in providing a keen approach towards the aim and objectives of the research by deductive rest of the part (Warwick-Booth, Bagnall and Coan 2016). The descriptive research design will be used in the research that will help in providing a descriptive analysis of the data and information collected from various sources. The use of the descriptive research design helps in maintaining the focus in the research aim and objectives. Data will be collected from primary data collection method. Data will be collected by both quantitative and qualitative method.

An online survey will be conducted in order to collect quantitative data. 10 survey questionnaires will be created using Google forms and uploaded to the website of the A&E. The population for the research will be 100 employees of A&E. However, the sample size for the online survey will be 55 employees. Non-probability and random sampling method will be applied for calculating the sample size of the research. Therefore, there will be 10 close-ended questions will be added to the survey questionnaires and uploaded to the website (Lees, C. and Stubbs 2015). The answers of the participants will be collected as the data and information of the research. Data will be collected from conducting interviews will, three managers of the company. Five open-ended questions will be asked of three managers of the company. The analysis of the data will do by using quantitative data analysis method. Data will be analyzed using tables, graphs and charts. The results and outcomes of the research will be shown on the Likert scale ranging from 1 to 5. The hypothetical analysis will help in finding the correct hypothesis (Iliffe and Bourne 2017).

Existing framework to promote well-being and health of NHS staff

There might be some limitations related to the data collection process. The data collected from the participants might take much time to complete. Participants might provide wrong answers or fill the form haphazardly. This can provide wrong analysis of the data and information. The managers might not be interested in providing answers to the questions of the researcher (Murphy, Harradine and Hewitt, 2018). This might create the problem in the data collection method. The use of the data collection process might be difficult due to the insufficiency of money and budget of the research. The timeline of the research has been another problem. The research will follow the ethical considerations (Murphy, Harradine and Hewitt, 2018). The results and outcomes of the research will not be published before the completion of the research. The Data Protection Act 1998 has been followed in this research that might help in securing the personal information of participants of the survey.

Conclusion

It can be concluded that impact on the well-being of A&E staffs has positively affected the NHS. Many factors can be attributed to why the sickness absence rates are higher than the average. NHS work can be emotional, psychologically and physically demanding as opposed to rewarding. It is understandable since NHS operates for 24 hours a day and 365 days a year. Additionally, the workload is challenging and the NHS staff has to manage that.

It can be recommended that training of the employees in the organization might help in increasing the skills and knowledge of employees. Motivation needs to be provided to the employees that might help in relieving stress. These departments help in an emergency condition of an individual and provide fast services to the patients.

The proposed cost of the entire project that is to be encountered is provided in the following table.

Requirement	Proposed Budget
Access to Online Library	$250
Research Resources	$750
Residence and Consumables	$1500
Conveyance and Transportation	$500
Field Work (Hospital)	$1500
Other Costs	$500
TOTAL	$5000

The risks associated with the research to be conducted can be assessed and mitigation plan can be developed using a risk register as follows.

Risk	Chances of Occurrence	Effect on Research	Mitigation Strategy
A limited idea on the research topic	Medium	Medium	Conduct literature survey and collect primary and secondary data to gather more insight
Lack of scope of on-site research	High	Medium	Contact with hospital authority to gain approval for conducting research on their premises
Catching contagious disease while conducting research in the hospital	Very High	Very High	Take health precautions before performing research actions inside hospital premises
Lack of sufficient data in the hospital	High	Medium	Conduct personal interview or questionnaire interview among the employees of the hospital

Task Name	Duration	Start	Finish
The wellbeing of A&E staff benefits the NHS	93 days	Mon 6/4/18	Wed 10/10/18
Study Initiation	11 days	Mon 6/4/18	Mon 6/18/18
Study Requirements Analysis	2 days	Mon 6/4/18	Tue 6/5/18
Approval of Research Topic from Supervisor	1 day	Wed 6/6/18	Wed 6/6/18
Development of Research Plan Charter / Document	2 days	Thu 6/7/18	Fri 6/8/18
Development of Research Framework	4 days	Mon 6/11/18	Thu 6/14/18
Prepare Draft Research Proposal	2 days	Fri 6/15/18	Mon 6/18/18
Research Planning	21 days	Tue 6/19/18	Tue 7/17/18
Formation of Research Team	2 days	Tue 6/19/18	Wed 6/20/18
Analysis of Research Requirement	1 day	Thu 6/21/18	Thu 6/21/18
Identification of Research Questions	4 days	Fri 6/22/18	Wed 6/27/18
Identify Scope of Research	4 days	Thu 6/28/18	Tue 7/3/18
Estimate Research Timeline	4 days	Wed 7/4/18	Mon 7/9/18
Allocation of Resources and Time for the Research	2 days	Tue 7/10/18	Wed 7/11/18
Initiation of Research	4 days	Thu 7/12/18	Tue 7/17/18
Research Development	26 days	Wed 7/18/18	Wed 8/22/18
Determination of Research Problems	4 days	Wed 7/18/18	Mon 7/23/18
Access to Necessary Media	1 day	Tue 7/24/18	Tue 7/24/18
Access to Online Library	1 day	Tue 7/24/18	Tue 7/24/18
Selection of Literary Sources	2 days	Wed 7/25/18	Thu 7/26/18
Literature Review	4 days	Fri 7/27/18	Wed 8/1/18
Collection of Necessary Data	10 days	Thu 8/2/18	Wed 8/15/18
Collection of Secondary Data	5 days	Thu 8/16/18	Wed 8/22/18
Data Analysis	8 days	Thu 8/23/18	Mon 9/3/18
Analysis of Primary Data	4 days	Thu 8/23/18	Tue 8/28/18
Analysis of Secondary Data	4 days	Wed 8/29/18	Mon 9/3/18
Research Evaluation	13 days	Tue 9/4/18	Thu 9/20/18
Evaluation of Data	6 days	Tue 9/4/18	Tue 9/11/18
Reflection on Research Undertaken	2 days	Wed 9/12/18	Thu 9/13/18
Documentation of Learning Outcomes	2 days	Wed 9/12/18	Thu 9/13/18
Issues Identification and Future Planning	5 days	Fri 9/14/18	Thu 9/20/18
Research Closure	14 days	Fri 9/21/18	Wed 10/10/18
Complete All Activities in Research	1 day	Fri 9/21/18	Fri 9/21/18
Documentation of Entire Research	10 days	Mon 9/24/18	Fri 10/5/18
Validation of the Research and Learning	2 days	Mon 10/8/18	Tue 10/9/18
Team Sign Off	1 day	Wed 10/10/18	Wed 10/10/18

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Iliffe, S. and Bourne, R., 2017. The NHS: not back to Era 1 but forward to Era 3-policy challenges for Labour. Renewal: a Journal of Labour Politics, 25(1), p.76.

Jennings, P. and Matheson-Monnet, C.B., 2015. Multi-agency mentoring pilot intervention for frequent service users of emergency public services experiencing highly intensive moments of crisis: The Isle of Wight Integrated Recovery Programme. J. Crim. Justice. Policy Pract, 3(2).

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Murphy, P., Harradine, D. and Hewitt, M., 2018. Evaluation of Phase 3 of the Kings Mill Hospital discharge project of the’ASSIST’team at Mansfield District Council.

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Olive, P., 2017. First contact: acute stress reactions and experiences of emergency department consultations following an incident of intimate partner violence. Journal of clinical nursing, 26(15-16), pp.2317-2327.

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