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4 May 2020

Blog by Dr Gita Bhutani

Dr Gita Bhutani,
Associate Director for Psychological Professions, Lancashire & South Cumbria NHS Foundation Trust.


As well as being Associate Director for Psychology Professions at Lancashire and South Cumbria NHS FT, I am on a year’s secondment to Health Education England, setting up Psychological Professions Networks (PPN) across England in addition to the existing three networks (in the North West, South West, South East).

I was travelling to London once a week and it’s quite nice in many ways not to be doing that!

It feels like this is an opportunity to get psychological approaches and interventions out there and to get colleagues involved; there is so much that can help and we are having conversations about how we can really help people, now and later.

Continuing work with clients

I still carry out clinical work one day a week, providing help for people with complex post-traumatic stress disorder. These are people with long term problems, often associated with adverse experiences in childhood. I also support staff who have had traumatic experiences at work. 

Some of the people I see, I can no longer see them face to face as they are shielding at home.  

Some of them do not want to talk about trauma when they are at home as this can bring up memories and thoughts which are harder to manage alone.  I just check in with them at the moment to ensure we make contact.  

I still see three people face to face because of the complexity of their problems and the stage of work we are at which means it’s not helpful to pause the work.  Some of my colleagues are working online with people and have found this works OK for some but there are important things to consider, such as people having a quiet and confidential space to talk, being able to manage distress online as well as the availability of good connections. 

Online meetings

For part of the week, I am working from home, moving around the house trying to share the wifi bandwidth with children, going from one virtual meeting to another – on MS Teams, Zoom, Skype and the phone, then repeat, all day.

I’m finding the online meetings are more focussed which is good; but there are no gaps, no time for comfort breaks and food, they feel relentless! People are now adjusting and we are having check-in calls which are not all about work and that is helping.  I think this is really important in maintaining good relationships with people at work. 

The IT frustrations have been huge.  I already didn’t like Skype but now I detest it! MS Teams is being rolled out and this make some difference.

It would be good to have a more equitable approach to platforms, in terms of access to easy IT support and technology; and updates to computer software. I’ve got what I need but I know that isn’t the case for all staff.  We are keen to offer modified Schwarz Rounds called Team Time which take place virtually and are supportive for teams, allowing them to share concerns.  We’re exploring how to do this as the training was via Zoom but at the moment there are concerns around its use due to security issues.

My inbox has had a clear out; it was full of things that needed doing which I’ve moved into another folder as most of my day is Covid related, mainly providing wellbeing support to staff and maintaining workforce projects.

The other stuff I was doing seemed important a month ago but has now been shelved. Some of it I am happy to put away and some of it I want to do but I just have no headspace.

Wider scope of work

Work has become a very reactive space, which is a turnaround for us because in psychology professions we tend to be needed afterwards to pick up the pieces. Now, people have to be very operationally focussed and we need to make sure we are looking after our staff’s psychological wellbeing.

My scope of work has grown because of the pandemic; I am invited to more meetings and recently was in a meeting where I found that I had been appointed as lead for mental health resilience for the Lancashire and South Cumbria Integrated Care System, focussing mostly on staff but also for the population. This will be a challenge, but it is a good place to be and I am finding that new doors are opening, which is helpful.

There is a focus on what is going to be the effect of the pandemic on psychological wellbeing as not much is known about it. This is an opportunity to think more deeply about how we help people to manage their mental wellbeing. We know that the psychological impact starts to be felt six weeks to three months in, and lasts much longer. We know that suicide attempts have gone up, in our area and nationally, which is why mental health is so high on the agenda.

Our staff have access to a range of apps including Sleepio and Headspace which is part of a national initiative.  Locally, the Integrated Care System are looking at the rollout of an app called Orb which will provide information and support self-care.  This links into local psychological resilience hub development that I’m leading. Ironically, it feels like this is an opportunity to get psychological approaches and interventions out there and to get colleagues involved; there is so much that can help and we are having conversations about how we can really help people, now and later.

Frustrations

I had been frustrated that my work for Health Education England in increasing the Psychological Professions Networks had stalled. But I have recently revisited this because there is now an appetite at the national centre to find out what is happening locally, so I have picked it up again and it is moving forward.

Another frustration is that we don’t have a proper structure as a profession; we don’t fit into other workforce groups and we can be left out in long term plans. That has changed because of the focus on wellbeing during and after the pandemic and I hope that it will continue and we will become more embedded in organisations’ approach to wellbeing.

I hope we continue to have the same opportunities to work alongside HR and occupational health teams and that organisations will invest more in psychology professionals to support the mental wellbeing of staff.

However I fear that the gains we have made will not stick and there will be improvements, but it will be patchy.

What I wish for, is proper infrastructure for our profession with national leadership; we should have a chief psychology officer – just like we have a chief medical officer and a chief pharmacy officer. Then, our psychology professionals will be better placed to support our NHS workforce.

Dr Gita E Bhutani

Associate Director for Psychological Professions
Lancashire & South Cumbria NHS Foundation Trust
Chair of the Psychological Professions Network North West
National Development Lead Psychological Professions Network, HEE
Honorary Research Fellow, University of Liverpool

Story told on 21 April 2020


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