Co-design, delivery, and evaluation of wellbeing initiatives for NHS staff: the HOW (Healthier Outcomes at Work) NHS project

Stress and mental health are leading causes of sickness absence in the UK, responsible for over 50% of sickness absence across the country. Healthcare sector workers play a vital role in the life of everyone across the country but have among the highest levels of sickness absence of any sector. The aim of this project, therefore, was to work with UK healthcare workers to co-develop, implement, and evaluate a series of mental health and wellbeing interventions delivered via a smartphone app and associated toolkit. A participatory action research methodology, consisting of individual interviews, focus group discussions, and oversight by an expert action learning group, was used to develop primary (i.e., those associated with the workplace) and secondary (improving individual resilience and coping) stress management interventions. Pre-post-intervention analysis demonstrated improvements in work engagement and working conditions, although significant improvements were only found in mean scoring on demands, control, managerial support, and peer support working condition measures. The project therefore demonstrates that co-produced initiatives which focus on improving either the organisation or resilience of the workforce may be useful in supporting employee health and wellbeing. Future studies should build upon these findings through a full RCT to determine utility of the interventions