Recommendations to support the mental wellbeing of nurses and midwives in the United Kingdom: a Delphi study

Aim: To use Delphi technique to identify and prioritise recommendations for research and practice to improve the mental wellbeing of nurses and midwives in the United Kingdom (UK). Background: Although there is evidence that self-reported mental wellbeing among nurses and midwives in the UK is poor, interventions have not adequately considered the wider context in which they work. The wide range of individual, organisational, occupational, and wider sector-level factors that can influence wellbeing requires the involvement of different stakeholders to identify the most pressing actions required. Design: A three-round Delphi technique conducted in 2019. Methods: In the first round, 16 subject matter experts generated, reviewed, and discussed recommendations from a review of the research evidence with potential to support the mental wellbeing of nurses. A second group with 23 stakeholder representatives then rated and provided feedback on the developed recommendations through two additional rounds. Recommendations that received an ‘essential’ or ‘important’ rating from at least 80% of participants were retained and prioritised. Results: In total, 45 recommendations met the consensus agreement and were retained. More than half (57%) involved action at the organisational level, 27% to public policy and 13% to research. Only one recommendation related to the individual. Collectively, these recommendations highlight the importance of taking direct action to tackle poor mental wellbeing among the workforce and initiating change at the policy and organisational level. Conclusion: Our findings emphasise the need to take a systemic approach to improving the mental health of nurses and midwives in the UK with input from different stakeholders. There is clear consensus that action is needed at the organisation and policy levels, rather than at the individual level as is current practice. Impact: This study provides a framework, alongside a set of practical recommendations, that provides a starting point for different stakeholders to understand, address and support the mental wellbeing of nurses and midwives. Although UK-focused, it has relevance to healthcare workforces internationally