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Understanding what we need and where to focus our attention and action

What are the needs that should be met in the workplace to ensure staff health and wellbeing? A group of NHS staff discuss this in this video.

In this step we are going to consider how we think about our workplace needs in the round, what we tend to prioritise, and the implications of this. Read the article below and then watch the video above.

Before designing this course we spent time listening to a variety of NHS staff. We wanted to understand their experience of workplace health and wellbeing, but also what they believed were the key needs and priorities for understanding and action.

What we heard fell into four broad categories, illustrated by the diagram below. And while all were recognised as being important, we also heard that they are not attended to with equal vigour. The NHS is good at reaching for and developing solutions and support aimed at promoting the resilience – or as it was put to us, ‘endurance’ – of individuals. But we heard this often feels insensitive given the reality of excessive workloads, the absence of time and places to rest properly and eat, or the experience of bullying and discrimination.

We chose to present the four categories above as a pyramid-shaped ‘hierarchy’ to reflect as accurately as possible the priorities we heard, and to stimulate discussion. But what do you think?

Diagram illustrating the hierarchy of needs. The diagram depicts a triangle which is horizontally split into four different sections. The base of the triangle and largest section is labelled 'physiological', the next layer up is labelled 'structural', then the next section is 'cultural' and the top and smallest section is labelled 'individual'.

Type of need What this encompasses
Individual This level refers to what we – as individuals – can do for ourselves (self-care), as well as concepts and interventions that are individualised (eg, therapy, training, resilience).
Cultural This level focuses on the social and emotional quality of the workplace, team dynamics and ways of working.
Structural This level refers to institutional and structural forms of inequity and injustice both inside and outside the health system that have an impact on staff health and wellbeing.
Physiological The foundation of our needs, this level is concerned with things like rest, nourishment and security, the impact of workloads and the availability of time-off, sustenance and feelings of physical safety and job/financial stability.

In the video above, a group of staff from across the NHS discuss this diagram and their real-world experience of the needs and interventions it describes.

After you have watched the video use the questions below to join the conversation.

  • Is it helpful to present these categories as a hierarchy?
  • How else could they be expressed?
  • How does your organisation measure up against each layer?
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Leading Well for Staff Health and Wellbeing in the NHS

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