The Recovery Paradox

Dean Royles, President of the Health People Managers Association (HPMA) discusses Coronavirus - Restoration and recovery


Is this the light at the end of a very long tunnel?

The NHS, its staff, managers, and leaders are emerging battled, scared, yet optimistic from the pandemic. Tired, weary and for some demonstrating the all too common symptoms of exhaustion, stress, and anxiety - The NHS has rightly received praise and plaudits for its handling of the pandemic and there are many reasons to be proud; The way the NHS has worked as one team, the care and compassion so clearly demonstrated for patients, their families and to each other and the fantastic roll out of the vaccine.


NHS staff need some well-earned rest and recuperation

As we know all too well, the NHS and its staff and those employees that have given their all, fighting Covid, have not been exempt from the ravishes and personal devastation of the pandemic. Not only have many staff worked tirelessly and selflessly to care for patients over the last 15 months, many have also been personally impacted.

They are not atypical and just like the rest of the population, they have lost friends, colleagues, and relatives to Covid, they have endured isolation and quarantine and have been unable to meet with loved ones. Their children and parents may have been furloughed or lost jobs. It is heart-breaking for all of us, and it is no wonder that the recovery of healthcare staff has been highlighted as a key priority for the NHS as it pulls together its annual service and development plans on what will be a long road to recovery.

A focus on staff health and wellbeing is of course the right thing to do. Just like an army returning from conflict or athletes recovering from a marathon, NHS staff need some well-earned rest and recuperation.

The Backlog

But, and it is a massive but, the NHS now also have an enormous backlog of work, people waiting for diagnostic tests, treatments, operations and therapy, and we desperately want to restore service activity back up to pre-pandemic levels,  so working our way through the backlog is also a priority, but we can’t escape the fact that it is the same staff that need to rest and recover from the challenges of the pandemic that will need to do the work.

It seems an impossible paradox - However, and I know I’m looking for a silver lining here that may not exist, but the beauty of paradoxes is that they are extremely valuable in promoting critical thinking. To somehow square the circle we need to think and do differently.


It seems to me that in helping staff to recover, HR and Workforce teams can learn from other healthcare disciplines as well as introducing some very practical solutions. These practical steps do mean we have to challenge ourselves about the unofficial rules and norms we have historically adopted. We will be able to continue to use the independent sector for additional capacity and we can also allow more staff than normal to have time off over the summer, to allow them to get a proper holiday. 

This means that we will need to make more use of the contingent workforce such as bank and agency.


In the medium term, as more agile working accelerates, this contingent workforce will be an important aspect of our strategies to promote and facilitate increased flexible working.

Insourcing allows teams of clinical staff to use the hospitals, clinics and theatres at times when the hospital is not using the facilities. Typically this occurs over the weekend, Insourcing teams are able to see patients locally, which cuts down their wait and take pressure off the substantive team.

Now, I know many of you will point out that it is often those staff that work in the independent sector, on bank and agency and through insourcing providers are the same staff that work in the NHS and so we need them to recover too.

This is true. However, recovery, as we know from those providing mental health services is more than rest, breaks and holidays, it is often about doing things differently. Recovery is about achieving a sense of normality and for that people need hope, control, and opportunity.


Supporting staff health and wellbeing

We have a responsibility, perhaps even a duty to our organisations to ensure these emotional aspects of work are increasingly evident and to allow staff opportunities to support their own health and wellbeing and, as the old saying goes ‘sometimes a change is as good as a rest’.

Doing things differently and doing different things can feel like a tonic and respite after months of such demanding work. It may seem trite, but these are the ways we can support recovery in addition to the more practical physical solutions – not instead of.

We have to bring hope into the workplace to demonstrate what we can get through and despite the challenges ahead, the future can be better for staff and better for patients - The investment made in health and wellbeing must stay.

We must continue to involve staff in decisions that affect them, now and in the future, this is an important aspect of giving more control and power to staff and to recognise that working in different ways, in different roles, for different employers in different places can stretch and develop us and contribute to recovering service for patients.

Staff recovery that supports service recovery is not a short-term fix but rather an enduring new paradigm that has to be at the heart of organisational and system service strategies and plans.

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