At ward/dept level what methods are in place to support staff following the death of a patient? i.e. hot debrief, cold debrief, peer support, follow up with those present/involved

 

Support for Staff Following the Death of a Patient – Ward/Department Level following the death of a patient, it is recognised that staff may experience a range of emotional responses. To support their wellbeing, the following support mechanisms are in place:

 

 

·       Round table discussion.

·       <!--[if gte vml 1]> <![endif]-->Pastoral support - Emotional check-ins: Informal conversations to see how staff are coping, especially after difficult shifts or incidents.

·       Safe spaces to talk: Opportunities for staff to speak confidentially with a trusted colleague, manager, or wellbeing lead.

·       Support after critical events: Compassionate follow-up after patient deaths, safeguarding cases, or distressing experiences.

·       Signposting to further help: Guiding staff toward occupational health, counselling, or peer support networks when needed.

·       De compression session/ Hot Debrief: Immediate, informal debriefing held shortly after the event. This allows staff to express initial thoughts and emotions, clarify clinical decisions, and receive peer reassurance in a safe space.

·       Cold Debrief: A more structured, reflective session held at a later time. This provides an opportunity to review the case in detail, explore learning points, and address any ongoing emotional impact.

·       Peer Support: with senior colleagues and team leads offering informal check-ins and emotional support. Buddy systems or peer mentors may also be available.

·       Follow-Up with those Involved: Staff directly involved in the patient’s care are identified and followed up with individually. This may include one-to-one conversations, wellbeing check-ins, or referrals to occupational health or counselling services if needed.

·       Access to Professional Support Services: Staff can access support through Employee Assistance Programmes (EAP), occupational health, or psychological support services, depending on local provision.

·       Managerial Oversight: Line managers and senior leaders play a key role in recognising distress, initiating support conversations, and ensuring staff feel heard and valued.

·       These approaches aim to foster a compassionate, reflective culture where staff wellbeing is prioritised alongside clinical learning.

 

 

How are the methods above triggered to support staff? Including self-referral or decision from senior  clinical colleagues

·       See above

What follow up is in place and after how long does follow up take place?

·       Any member of staff needing support after a traumatic incident typically begins as soon as possible, it includes structured psychological support, debriefing sessions, and ongoing monitoring. Initial response (within 24–72 hours) Managers, PMAs and pastoral support check in with affected staff promptly to assess immediate needs and offer reassurance.

·       Ongoing Follow-Up – The frequency of follow up is decided between the support network and the individual, depending on the level of support required.

·       Professional mental health support. - Referral to occupational health or counselling services.

·       Monitoring period: Support plans are made to maintain regular contact over the following weeks or months, depending on the severity of the incident and individual needs.

 

 

Are some teams identified as more at risk of psychological stress within your Trust?

·       Yes, certain teams within our Trust are identified as being at higher risk of psychological stress, particularly those in high-pressure, emotionally demanding, or frontline roles.

·       <!--[if gte vml 1]> <![endif]-->High-Risk Teams - Frontline clinical staff such as those in maternity, emergency departments, intensive care units and mental health services are consistently flagged as high-risk due to exposure to trauma, time-critical decisions, and patient distress.

 

 

What support is provided by occupational health?

·       Occupational Health at East Lancashire Health Authority provides proactive, multidisciplinary support focused on staff wellbeing, including health assessments, mental health services, and workplace adjustments.

·       Mental Health & Wellbeing Support.

·       Psychological Support: Access to counselling, stress management resources, and referrals to specialist mental health services.

·       Critical Incident Support: Immediate and follow-up care for staff affected by traumatic events, including debriefing and monitoring.

·       Wellbeing Initiatives: Collaboration with wellbeing teams to promote healthy lifestyles, resilience training, and mindfulness programs.

 

 

Please provide copies of your policies for support given to members of staff following such events.

·       Supporting Staff Following a Patient Safety Incident (PSI)

 

·       Supporting Staff attending Coroners (Being ratified at QSB Nov2026)

 

How do you measure and monitor the effectiveness of these policies?

·       The effectiveness of staff wellbeing policies are measured through a combination of quantitative data, qualitative feedback, and structured evaluation frameworks.

Quantitative Metrics

·       Sickness absence rates: A key indicator, especially for stress-related or mental health absences. A reduction suggests improved wellbeing.

·       Staff turnover and retention: High turnover may signal dissatisfaction or burnout; improvements can reflect successful interventions.

·       Occupational health referrals: Trends in referrals (e.g. for stress, musculoskeletal issues) help identify emerging risks or areas needing attention.

·       Utilisation of support services: Monitoring how often staff access counselling, helplines, or wellbeing hubs provides insight into engagement and need.

·       NHS Staff Survey results: Annual surveys assess staff experience, including stress levels, morale, and perceptions of support. These are benchmarked nationally.

Qualitative Feedback

·       Pulse surveys: Short, frequent surveys that track real-time sentiment and allow rapid response to emerging issues.

·       Exit interviews: Provide feedback on whether wellbeing concerns contributed to staff leaving.

 

 

Do you record how often this support is offered and accepted?

·       Yes, East Lancashire Hospitals NHS Trust does record how often staff support services are accessed, primarily through usage data from Occupational Health, counselling services, and staff surveys.

·       The Trust tracks how many staff are referred to and attend Occupational Health appointments, including for mental health, musculoskeletal issues, and return-to-work assessments.

·       Counselling and wellbeing services: Usage statistics are collected on how many staff access psychological support, including self-referrals and manager referrals.

·       NHS Staff Survey data: The annual survey includes questions about whether staff feel supported and know how to access help. This provides indirect insight into awareness and engagement with support services.

·       Internal reporting: Uptake data is included in reports and quality accounts, which may detail how many staff accessed specific services and whether usage increased or decreased year-on-year.

If a member of staff is absent due to work related stress, do you record triggers and trends related to traumatic events and where are these presented?

·       East Lancashire Hospitals NHS Trust does record triggers and trends related to work- related stress and traumatic events, and these are typically presented through Occupational Health data, staff surveys, and internal wellbeing reports.

·       Occupational health data: The Trust collects and analyses data on referrals, reasons for absence, and presenting issues. This includes identifying common stressors such as workload, exposure to trauma, or interpersonal conflict.

·       Staff Survey Insights: The NHS Staff Survey includes questions on stress, wellbeing, and support. Responses help pinpoint departments or roles experiencing higher stress levels.

·       Health Needs Assessments: These are conducted periodically to gather information on physical and psychological health risks across the workforce. They help identify patterns linked to traumatic incidents or chronic stress.

·       Managerial Reporting: Line managers are encouraged to document and escalate concerns when staff report stress linked to specific events (e.g. patient death, violence, safeguarding cases).

 

 

 

 

What assurance does the Trust senior team have that all departments are supported equally?

·       East Lancashire Hospitals NHS Trust assures equal support across departments through structured governance, inclusive leadership, and regular monitoring of staff wellbeing data.

·       Health and Wellbeing Framework: The Trust aligns with NHS England’s framework, which includes self-assessment tools to evaluate how well departments are supported. This ensures a consistent approach to wellbeing across all areas.

·       Board-Level Reporting: Senior leaders receive regular updates on departmental wellbeing metrics, including stress-related absence, Occupational Health referrals, and staff survey results. These reports help identify disparities and guide targeted interventions.

·       Inclusive Leadership - Equality, Diversity and Inclusion (EDI) Strategy: The Trust is committed to inclusive leadership at all levels, aiming to empower staff from all backgrounds and departments equally.

·       Staff Networks and Champions: These groups represent different departments and demographics, providing feedback to leadership and helping ensure that support is tailored and equitable.

·       NHS Staff Survey Analysis: Results are broken down by department, allowing the senior team to spot trends and address areas with lower satisfaction or higher stress.

·       Internal Dashboards: These track usage of support services, absence rates, and wellbeing engagement across departments, helping ensure no team is overlooked.

·       Annual Reviews and Audits: Policies and support programs are reviewed regularly to ensure they remain relevant and effective for all departments.

7 departments are listed at the beginning of my request, 1 of those may receive traumatic deaths from the other 6 within a working week. How do you ensure mortuary staff are resilient and cared for?

·       Mortuary staff at East Lancashire Hospitals NHS Trust are supported through structured wellbeing protocols, access to psychological services, and tailored resilience strategies to help them cope with repeated exposure to traumatic deaths.

·       Given that mortuary staff may receive traumatic deaths from six other departments weekly, the Trust recognizes their role as uniquely vulnerable. The Human Tissue Authority licensing also mandates high standards of care and professionalism, which includes staff wellbeing oversight.

For more insight into staff support for mortuary staff members please contact – Mortuary Manager - lorraine.richardson@elht.nhs.uk