BLOG | Why SFH created a ‘financial hardship fund’ as part of its COVID response

In late June this year, a third of people reported they were enjoying lockdown, 46 per cent were not and 21 per cent had mixed feelings, according to the UK covid-19 social study, which has collected information from 70,000 adults over the past 30 weeks.

Although I am not sure I have met anyone in the 4 per cent who were “very much” enjoying it, it is possible to look back fondly at the early part of this summer. The weather was good, there was a greater sense of community and work had a clear purpose. I know lots of us felt galvanised and energised by covid being a single focus, which was supported by relaxations in financial restrictions and high levels of adrenalin.

More harm than good?

However, life now feels different. The study’s recent findings make grim if unsurprising reading. Depression, anxiety and loneliness levels are all higher than over the summer, with happiness and life satisfaction being lower. Many people are now more worried about finances, employment and access to food.

Thoughts of death or self-harm have increased, along with reports of self-harm and abuse. This is particularly affecting those with long-term physical health conditions and their loneliness levels are higher. People have less confidence that access to essentials will be maintained and in the ability of the health service to cope.

I have not seen a similar study for workers in the NHS but I would imagine the results would be even more worrying. In my experience, the number of colleagues raising concerns about how they feel has increased dramatically in October and November. At Sherwood Forest Hospitals Foundation Trust, I am particularly concerned about four groups of colleagues.

I worry about those who have been caring for covid patients for eight months and are reporting long-term physical and mental health impacts. I worry about our lowest paid colleagues, in particular porters, domestics and housekeepers, who feel they have been overlooked during our covid response. I worry about those who are working from home five days a week and feel isolated, anxious and left out. And I worry about everyone else because whilst we have all been “in it together”, I recognise we have not necessarily all had the same experiences and will not all feel the same.

Our personal and working lives are so interwoven and in this situation, it is impossible to separate them. An idea I read, that works for me, is that we each have a bucket and the bucket represents our ability or capacity to cope with the ups and downs in our life. We all have a different sized bucket and the size is determined by a range of factors including our genetics, our personality and our experiences. Stressful events are the water poured into our bucket.

Money problems? Add a cup of water. Relationship issues? Add a cup. Excessive workload? Add another cup. Not seeing friends or family? Add another cup. Most buckets have capacity for a few stressful events at a time, but when water keeps being poured in, you can get close to the limits of what your bucket can hold. The water in our buckets is not pure, it contains stress hormones, like cortisol and adrenalin and if it is too full for too long, our physical and mental health will gradually get worse.

At this point, it does not take much more stress to raise the water level over the top of the bucket. When this happens, other people think we have overreacted, but they cannot see inside our bucket and everything else we have been dealing with before this moment.

Rest, rehydration and refuelling

The recognition shown to the NHS and key workers this year has been remarkable; however, as we moved into autumn and then winter, we may have lost our way and begun to neglect the most important things in life. If we think about a hierarchy of needs, the most basic level is our physiological needs. For NHS colleagues working long clinical shifts, this translates as rest, rehydration and refuelling. We can all take additional steps to ensure that colleagues are able to do this without feeling guilty. I know we have not cracked this at Sherwood and we have more work to do.

The level above physiological needs is safety needs. At Sherwood, we recognised early on that the economic effects of covid are likely to impact disproportionally on our lowest paid colleagues and their families and we set up a financial hardship fund. This has made a huge difference to a small group of our colleagues when they are at their most vulnerable.

Ideas such as thank you cards, recognition medals and coins and additional annual leave are nice concepts, but consistently delivering the physiological needs are what most of our colleagues require this winter and beyond. We will not be able to provide safe, timely care to patients if we are unable to look after the basics needs of colleagues and also of ourselves.

The NHS is fantastic at caring for patients and there is growing recognition that cultures truly based on inclusion, kindness and compassion make a real difference, but we must also remember to think about ourselves. We are all experiencing a range of emotions and the leaders I admire the most are open and honest about their feelings and share their personal vulnerabilities.

It is perfectly okay and normal to feel scared and hopeful at the same time. Like me, you may not be in the 4 per cent who “very much” enjoyed the first half of the year, but being kind to yourself and thinking about your own welfare and wellbeing are necessary to ensure you can also support others this winter.

We need to continue to find ways to support colleagues to be able to empty their metaphorical buckets. We must remember that to effectively look after others, we also need to be kind to ourselves by role modelling an inclusive culture and a better work-life balance.

Richard Mitchell, Chief Executive, Sherwood Forest Hospitals