Viewpoint: Protecting the mental health of the NHS workforce during COVID-19

Dr Ian Wood highlights how digital technology, and apps in particular, could help the NHS tackle the mental health issues that will arise as a result of the pandemic.

Dr Ian Wood
Dr Ian Wood

Through the COVID-19 pandemic, NHS staff are working in highly pressured situations, and the changes to practice and demands on our services are greater than ever. We are managing significant risk both personally and professionally, and we are dealing with increased turmoil in decision making for patients.

Existing gaps in the workforce are being exacerbated and the situation and associated stresses are truly unprecedented. All of this serves to intensify the inextricable issues of poor mental health in a workforce stretched to its limit.

Anxiety and insomnia together make up the most common mental health complaints in the UK. This will only increase as the pandemic continues, with many of us on the frontline dealing with immediate worries and stresses that are a direct result of this.

Mental health issues

Worry, stress and anxiety increase the body’s need for restorative sleep, which is a challenge likely being experienced by many healthcare professionals. Daytime consequences of poor sleep include less resilience to daily stresses, and impaired concentration, mood, and capability for self-care. In the longer term, chronic sleep problems have been linked to a higher risk of mental health disorders like anxiety and depression, and other chronic conditions.

It’s hard not to worry about the welfare and sustainability of the workforce under these conditions – both now and in the future. As a GP I am especially concerned about the mental health debt building up, and it is critical that we invest in addressing these issues now.

Historically, addressing poor sleep has been very difficult. The first tool many doctors turn to as a solution for their patients has often been sleeping pills, but NICE guidance holds that these are not an appropriate long-term solution.

There is strong evidence for cognitive behavioural therapy (CBT) but there are still concerns with long waiting times. In the past I’ve felt left with a horrible dilemma, with patients seeking advice from me and having no long-term, accessible solution to offer. The pandemic has only intensified the need for an immediately accessible and effective intervention.

How apps could help

This is where apps could help, and there are a number that are currently freely available to NHS staff during the pandemic.

I have become convinced about the value of apps to help support mental health, which is why I’m now clinical lead for primary care at digital health company Big Health. I first heard about the company when they were piloting one of their apps, Sleepio, in my local area. This is a fully automated, personalised six-week digital sleep improvement programme based on CBT, and it is also one of the digital mental health resources that are currently available for free for NHS staff.

At the time, I quickly realised that the app had the potential to fulfil an urgent need: an accessible evidence-based sleep intervention with long lasting effects. I was keen to lead the implementation of the programme in my own practice, and I stayed in touch with the Big Health team, eventually joining them to assist with further rollout.

The company’s other app, Daylight, offers personalised self-help for worry and anxiety. This is also currently freely available to NHS staff.

As GPs, we have a responsibility to adhere to the highest level of clinical evidence. Sleepio is backed by evidence from 12 published randomised controlled trials and an additional 52 published papers. It has been validated by NICE through the Medtech Innovation Briefing and is included in the British Association of Psychopharmacology guidelines.

This evidence base gives me the confidence to recommend these services to my colleagues and patients, and I hope it will also give NHS staff the confidence to consider trying either programme themselves if they are suffering.

In the last few months, relationships between GPs and patients have shifted, largely due to the changes in the way COVID-19 has forced us to deliver care.

Digital services

Digital services – whether text-based GP messaging platforms, video consultations, or app-based treatment programmes – have allowed us to be more accessible and responsive than ever before.

Undoubtedly, we need to reflect on the people for whom this transition has not been an enabler, but digital innovation has allowed us to continue to do our jobs throughout the pandemic and to offer an effective way of putting patients in control of their own care.

COVID-19 has been a catalyst for the rapid digitisation of the NHS, and while this will be critical in maintaining access to care throughout the pandemic, I believe there will also be longer-term benefits. Digital health technology – once on the margins of healthcare – now plays a critical role in providing solutions where traditional services are unavailable or oversubscribed.

Improving mental wellbeing in both NHS staff and patients has been pushed even higher on the agenda and excitingly, it is one area where digital tools could start to make a real difference.

More details on the wellbeing apps available to NHS staff for free are here.

  • Dr Ian Wood is GP and clinical lead for primary care, at digital health company Big Health

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