Work package 3: Stakeholder workshop findings

The purpose of this work package was to facilitate a co-production element in the development of our postvention guidance. This work package responded directly to research objective 4: ‘To identify what helps and/or hinders bereaved colleagues to seek support, to characterise supportive work cultures, and to identify staff preferences for future support’.

Sixty-eight key NHS stakeholders attended an online stakeholder workshop. The purpose of the workshop was to share the findings from our review and grounded theory studies and to invite discussion, questions, feedback and ideas from attendees. As such, this formed the main co-production element of our methods.

Attendees consisted of invited key stakeholders and leaders from across NHS organisations, including well-being and policy leads; senior leaders from Unison, Unite and the Royal College of Nursing (RCN); senior leaders from organisations such as the Nursing and Midwifery Council and other health worker support organisations; senior leaders and policy leads from relevant third-sector organisations; interested academics; research participants, stakeholder group and advisory group members. We also advertised the workshop using our networks and social media platforms inviting any interested parties to attend.

The workshop was chaired by Professor Jill Maben and included presentations, discussion, round table discussions, Q&A opportunities and provision for anonymous contribution. The structure of the workshop was as outlined:

1. Welcome by the Chair.
2. Summary of research findings (Dr Ruth Riley, Dr Hilary Causer and Dr Johanna Spiers).
3. Premier of the film produced with three of our research participants.
4. Q&A session with guest commentators: Kim Sunley (RCN); Alan Lofthouse (Unison); Caroline Waterfield (NHS Employers).
5. Group discussions (Break out rooms with appointed person to note-take and feed-back).
6. Feedback and discussion session.
7. Actions and commitments from our guest commentators.
8. Concluding remarks and next steps (Dr Ruth Riley).
9. Closing (Professor Jill Maben).

Throughout the workshop there was an online facility for all delegates to provide comments and ask questions, either via the meeting chat facility or via an anonymous Padlet platform.

The workshop was recorded with attendees’ consent. The recording, the meeting ‘chat’ comments, the feedback notes and the Padlet comments provided data to inform the further development of the postvention guidance.

In this workshop, delegates were invited to comment upon and critique the key recommendations we had developed from part one of our evidence synthesis. Those recommendations were as follows:

1. Contexts and cultures from which postvention is offered must be supportive and well-resourced.
2. NHS organisations need to be prepared for postvention and to acknowledge suicides.
3. Support must be timely, sustained and proactively offered by a team of empathic leaders.
4. Support must be clearly signposted and include protected time and space for staff.
5. Staff need permission to express emotion, grief and vulnerability.
6. Remembrance and memorialisation should be encouraged, resourced and staff-led.
7. Supporters need postvention training and their own emotional support.
8. All postvention should be evaluated for learning purposes.

Workshop delegates were asked to consider the following questions in smaller groups:

1. Are there any additional postvention recommendations you can suggest or actions you have taken within your workplace following a staff suicide?
2. What recommendations or actions can realistically be implemented within your workplace?
3. What are the barriers and enablers to implementing our recommendations?

They entered their thoughts and experiences relating to each question into Padlet, an online chat board, and fed these responses back to the wider group.

We performed a thematic analysis/organisation of the Padlet data, the meeting chat, and a transcript of the stakeholder workshop to devise a of themes (Table 8).

Based on this analysis, we would summarise the answers to our three questions as follows:

Are there any additional postvention recommendations you can suggest or any actions you have taken within your workplace following a staff suicide?

• Self-care and compassion are important for staff and supporters alike.
• Care needs to be taken over who offers postvention.
• Training, guidance and awareness-raising are needed.
• Preparation is key: a flow chart to enable to swift delivery of support would be helpful.
• There is no one-size-fits-all; everyone will respond to a colleague’s suicide in their own way so support must be individualised.
• Supporters must be visible and proactive; sustained support needs to be offered in safe spaces.
• Prevention and postvention must be linked.

What recommendations or actions can realistically be implemented within your workplace?

• Training for managers and staff.
• Having a plan ready before a suicide, perhaps utilising resources that are already in place.
• Signposting of support to those who need it most.
• Support for supporters, including chaplains.

What are the barriers and enablers to implementing our recommendations?

Barriers

• The lack of funding, time and resources is perceived to be a major barrier to delivering effective postvention support.
• Lack of training and education about suicide.
• Staffing shortages.
• Bullying cultures or those that stigmatise or do not prioritise mental health.
• No support from upper management.

Enablers

• Utilising chaplains/other supporters to support staff.
• Utilising the resources that are already in place.
• Sharing good practice.
• Personalised, open and sustained support for staff.

Next steps

These findings were then synthesised with the findings from our review, grounded theory studies, and thematic analysis (TA) to develop the outline, and inform the content of the postvention guidance. This process is described in the next chapter.