Identifying better practice

As part of the interviews, participants were asked to comment on any examples of best practice from either within their service or elsewhere (see Figure 11).

Reponses to this question were mixed, and views varied in terms of what constituted best practice across (and within) the services. Indeed, over 20% of respondents did not provide an answer to the question, either saying that they could not think of anything that would be ‘gold standard’ or ‘best practice’ or saying they did not think their organisations were there yet in terms of better practice. However, several strategies were highlighted by multiple stakeholders as constituting best practice, indicating that the following may be areas that warrant particular

support: having in-house wellbeing support (whether a team, counsellors, mental health nurse or other wellbeing professionals) was most frequently mentioned, followed by TRiM, Critical Incident Support, peer support, and the use of destigmatising videos (these often constituted a peer or senior figures talking

candidly about their own experience with mental health issues).

Stakeholders also flagged several other strategies as ‘best practice’, although given that these were only mentioned by single individuals, it is unclear whether these opinions are generalisable across the services. Sharing with other services was highlighted as a valuable way of informing better practice, as was having formal wellbeing self-assessment frameworks (like that provided by Oscar Kilo’s Blue Light Framework) – these

Figure 11 - The proportion of interviewees who highlighted different initiatives as best practice (N=33)

0 5 10 15 20 25

Bespoke, embedded wellbeing programme Wellbeing events Good HR policies Good partnerships with charities who have expertise Good wellbeing intranet Proactive wellbeing screening Resilience training Self-assessment framework Sharing best practice with other services Critical incident support Destigmatising videos Good peer support structure TRiM In-house wellbeing support None, or not there yet

frameworks gave services the opportunity to highlight what they are doing well and identify areas for improvement.

Having good signposting to support was seen as important, for example using intranet sites to direct employees to help, as was having good partnerships with charity providers to support workers’ needs.

Good HR policies were also flagged as integral to better practice wellbeing support. In particular, policies that allowed flexible or agile working, alongside considerate leave arrangements that allowed participants to look after their family or act as carers, were seen as being beneficial in terms of wellbeing.

Proactive wellbeing strategies (rather than simply reactive ones) were seen as important by two participants, whether through proactive psychological screening; through organisation- led wellbeing events designed to raise mental health awareness, or through resilience training to help to prevent the development or escalation of mental health issues. One proactive strategy that particularly stood out as better practice was that of one police force who developed a bespoke four-week wellbeing course that was available to all of their staff. The course included a number of evidence-based practices, embedded in a policing context, including: resilience building, wellbeing strategies, and CBT-based techniques. The police force had put nearly 2000 officers and staff through the program, and they designed refresher courses that could be taken after completion to continually ‘top up’ their knowledge.

Variation of provision

Overall, interviews indicated that provision varied enormously across the emergency services. While many mentioned having EAPs (or similar outsourced support) and a framework in place

to offer at least basic support to staff, the quality and quantity of wellbeing provision varied by both region and service. The graphs in the previous section illustrate how varied provision is between services and highlighted how rarely initiatives were talked about consistently both within and between organisations. For example, the percentage of interviewees who mentioned a specific initiative rarely rose above 40%. Whether mentions of initiatives or programmes truly represent what is actually in place, or whether they are more representative of the salience of the different support avenues that are used is unclear. Regardless, this emphasises the variation in provision across (and within) these organisations.

Furthermore, variations in interviewees’ descriptions of what constituted best practice was suggestive of differing wellbeing priorities across the services, as well as indicating variations in the level of wellbeing support that is available. Particularly telling, was the finding that 20% of interviewees were unable to identify examples of better practice, indicating that more work still needs to be done in this domain.

Reflecting the variation seen in the data itself, several interviewees explicitly identified the differences in wellbeing support as an area of concern, noting that they were all at different stages of wellbeing support development across the board; varying both between and within services.

“I know the police are very well into health and wellbeing and particularly mental health and they’ve got a huge amount of resources through Police Care UK and Oscar Kilo. So, I feel that they’re streets ahead of fire and ambulance.” (ID 40, Ambulance)

“There’s a disparate approach across the fire and rescue service, and we’re all at different stages” (ID 27, Fire)

Why this might be the case is unclear, however many had the perception that services varied in terms of their ‘buy in’ to wellbeing initiatives, causing disparity in the offerings available:

“We’re all doing so many different things… some services are using TRiM, some aren’t. Some have got inhouse wellbeing practitioners, some don’t… They have someone who works in HR or an operational manager who has been given wellbeing as a workstream and obviously it’s just a token here your workstream of wellbeing, do what you can, no budget, no dedicated time for it.” (ID 23, Ambulance)

Others highlighted the role geography plays in variation, for example, ‘national’ campaigns have not been wholly inclusive, and the UK’s devolved nations have varied funding structures and mechanisms, which affects the availability of support and services. Indeed, there are concerns that provision is becoming increasingly polarised.

“That [provision] stops at the border. So when we move into England and Wales we have nothing available” (ID 12, Mountain Rescue)

“I can’t speak for services south of the border, but it is quite difficult to pull those schemes together across the emergency services because we’re funded differently and we fund internally differently as well, so it can be difficult.” (ID 29, Ambulance)

Therefore, there is likely to be scope for an initiative which can help to bring together work that is being done in wellbeing, promote better practice initiatives, and support the development of more consistent service offerings across the board.

KEY HIGHLIGHTS

• Stakeholders identified a number of wellbeing activities as ‘best practice’, including in-house wellbeing support, trauma-related strategies and peer support models. However, some stakeholders were unable to identify any examples of ‘best practice’.

4.3 An overview of online resources and