NHS Wellbeing - an article for the NHSE bulletin

It often amazes me that the title of this article doesn’t exist as an entity. NHS Wellbeing. It really should be a thing. After all most nouns work as a suffix to ‘NHS’ - NHS supply chain, NHS innovation, NHS Digital, NHS England even. 

With key thought leaders in the press, at The Kings Fund and within our profession all agreed that ‘prevention’ needs to be at the heart of healthcare, little time is devoted to wellbeing in our practices. 

The reasons are obvious.  Dwindling numbers of health care practitioners and huge increases in workload mean that we often forget our own needs as we are forced to think about patients first.  Talking about wellbeing to patients can seem like a luxury when there is so much acute work to cover. Until health coaches or their equivalent are attached to every surgery in the land this will continue to be an issue.  

So what can we do to look after  ourselves a little better in our busy lives and filter it on to our colleagues and patients?  It may all sound a bit fluffy but the science and evidence behind lifestyle is compelling and not always merely down to common sense.  


1. Make time to switch off 


Taking even five minutes a day to indulge yourself to ‘do nothing’ or practise mindfulness can help you recharge. Doing this daily builds a pattern of improving being in a state where our parasympathetic nervous system dominates - the opposite of when we are stressed. Studies have shown an improvement in anxiety and stress reduction. 


2. Eat right 


There is increasing evidence that ultra-processed foods cause illness. Most medics know this but also there are benefits related to the way we eat - eating dinner early, chewing your food and eating whilst seated (not standing) are all important in terms of our insulin responses and digestion. Try not to eat on the go when standing up or ‘al desko’. 


3. Move when you can and get outdoors


No-one would argue against the concept that ‘movement is medicine’ and whilst many of us do Parkrun or perhaps hit the gym it’s possible to do basic strength workouts in a normal day. Take the stairs and not the lift, get outside if you can to get some sun on your skin. 1 in 4 people have a Vitamin D receptor mutation which means they need decent sun exposure or supplementation. 


4. Get an early night


The evidence of chronic and non-communicable disease in shift workers is well known due to shifts in circadian rhythms but even for those of us who mainly work in daylight hours, sleep is a key function. Just one week of disrupted sleep is enough to cause metabolic changes which nudge us towards Type 2 diabetes. If you are able to, get an early night, avoid blue light from screens an hour before bed, avoid or limit alcohol and make sure that your bedroom is dark and quiet. 


5. Connection and community 


Many of my patients share their weight loss successes via one of numerous organisations and support groups. Have they found the cure for metabolic disease or are they secretly plying people with a magic potion?  Of course not - but what they have harnessed incredibly well is the power of community. 


We live in an increasingly frenetic times where the digital world has almost taken over the face to face.  If you can, spend some quality time with your team at work. Perhaps think about team huddles, dedicated space for breaks together, social events and themed months on wellbeing focusing on food, sleep, relaxation or physical activity.
 
And do make sure you “check in” with each other.  The first rule of healthcare should be that the practitioner is in a state of good health.  It is increasingly difficult in the modern world, but it means that more than ever we need to be looking after ourselves and each other.   And who knows, perhaps NHS Wellbeing will indeed one day become a "thing".