Flourishing on the Frontline

Flourishing at Work

Healthier people. Healthier teams. Better care.

Flourishing at work is not about asking people to do more or simply become more resilient. It is about creating the conditions in which people can do their jobs well, support one another and build sustainable, fulfilling careers in Acute Medicine.

Looking after yourself Supporting each other Managers & leaders Making work better

Looking after yourself

Acute medicine can be physically, cognitively and emotionally demanding. Looking after ourselves is not about perfect routines or adding another task to an already busy day. It is about protecting the things that help us keep functioning well over time.

Make wellbeing realistic. Small, repeatable habits are more useful than an idealised version of self-care that disappears as soon as the unit becomes busy.

Think about the whole shift

There is no formula for a good working day, but there are opportunities before, during and after work to protect energy, connection and recovery.

01

Before the shift

Give yourself the best possible starting point rather than beginning already depleted.

Protect sleep and recovery where shift patterns make that possible.
Arrive with the basics covered — food, hydration and anything you need to get through the shift.
Notice when you are already carrying fatigue, worry or something difficult from outside work.
02

During the shift

High workload can make basic needs feel optional. They are not.

Take breaks when you can — and help create a team culture where colleagues can take theirs.
Ask for help, second opinions or cover rather than carrying every difficult decision alone.
After a difficult event, create space to check in rather than immediately pretending nothing happened.
03

After the shift

Recovery matters, particularly after nights, high-intensity work or emotionally difficult days.

Find a way of marking the transition from work to home rather than carrying the whole shift with you.
Protect recovery after nights and particularly demanding runs of shifts.
If work is repeatedly intruding on sleep, mood, relationships or life outside work, consider seeking support early.
Sometimes looking after yourself means asking for support. If stress, burnout, work problems, bereavement, financial pressure or something else is becoming difficult to manage, the Find Support page brings together practical routes to help.
Find support
Individual wellbeing cannot compensate for poor working conditions.

Rest, breaks and recovery matter, but organisations also have a responsibility to create workloads, staffing, cultures and environments in which people can work safely and sustainably.

Supporting each other

Acute medicine is team work. On difficult days, the people around us can make the difference between feeling isolated and feeling supported. Strong teams notice, check in, share the load and make it safe to ask for help.

Support should be part of how the team works every day. We should not need to wait until a colleague is visibly struggling before asking how they are doing or offering help.

What supportive teams do

Often it is the everyday behaviours within a team that shape whether people feel they belong, can speak openly and know someone will notice when work becomes difficult.

Notice

Pay attention when someone seems quieter, more tired, overwhelmed or unlike themselves. A simple check-in can create an opening for someone who might not ask for help first.

Check in

Ask properly rather than automatically. “How are you doing after that?” can be more useful than a passing “You alright?” when a colleague has had a difficult shift or case.

Share the load

Offer practical help: take a phone call, review a patient, create space for a break or step in when someone is carrying too many competing demands.

Make it safe to speak

People should be able to say “I need help”, challenge a decision, admit uncertainty or raise a concern without humiliation or fear of being judged.

After a particularly difficult shift or event Make space for people to reconnect and check in. Some will want to talk; others may not. If someone needs more than peer support, help them find an appropriate professional or workplace route.
Find support

Belonging matters. Teams flourish when people feel valued, included and able to contribute — regardless of profession, grade, background or role.

The role of leaders

For managers & leaders

Leaders shape more than rotas and operational decisions. They influence whether people feel safe to speak, whether workload is manageable, whether breaks happen, whether concerns lead to action and whether staff feel valued when work is difficult.

Wellbeing is not an optional leadership extra. How work is organised, how people are treated and how leaders respond under pressure all affect whether teams can work safely and sustainably.

What is it like to work in your team?

A useful starting point is not to ask whether staff are resilient enough, but whether the conditions around them help or hinder good work.

01
Can people say they are struggling? Without worrying that it will be interpreted as weakness, poor performance or lack of commitment.
02
Can people challenge safely? Regardless of profession, grade or seniority.
03
Are basic needs protected? Breaks, food, hydration, reasonable workload and recovery should not depend on luck.
04
Does speaking up change anything? Listening matters, but trust depends on visible action and feedback afterwards.

Culture is experienced through behaviour. Policies matter, but staff usually judge the culture of a workplace by what happens on the difficult days.

Six things leaders can influence

Not every pressure can be removed locally, but leaders can still shape how work is organised, how teams respond and whether people feel they have control, support and a voice.

Start with what staff experience. Ask what repeatedly makes a difficult shift harder — and what consistently helps.

Build psychological safety

Make it normal to ask questions, admit uncertainty, seek help and challenge respectfully. Respond constructively when someone raises a concern.

Model the behaviour yourself — including acknowledging when you do not know.

Make workload visible

Repeated overload should not become invisible simply because the team keeps managing to get through it.

Ask where pressure accumulates and what can be stopped, redesigned, redistributed or escalated.

Protect breaks and recovery

A culture where nobody takes a break should not be treated as evidence of commitment or resilience.

Build cover and permission for breaks into the way the team operates.

Preserve autonomy and control

People cope better with demanding work when they have some influence over how it is done and feel their professional judgement matters.

Involve the people doing the work when redesigning it.

Make flexibility possible

Health, caring responsibilities and life circumstances change. Sustainable careers require more than a single model of working.

Ask “how could this work?” before defaulting to “we have never done that”.

Listen — and close the loop

Asking people what is wrong and then doing nothing can increase cynicism rather than trust.

Say what you heard, what will change, what cannot change and why.
Wellbeing conversations should lead somewhere. Ask what is helping, what is getting in the way, whether work or life circumstances have changed and what practical support might make a difference. Do not assume every problem needs to be solved by the individual.
Making work better

Making work better

Some of the things that make work harder are not inevitable. Poor processes, unnecessary duplication, unclear communication and small daily frustrations can drain time and energy. Improvement is one way teams can reshape the work around them.

Start with the friction people experience every day. The best improvement ideas often come from the people doing the work — because they already know where time, energy and goodwill are being lost.
01

Notice the friction

Look for the things that repeatedly make a busy day harder than it needs to be.

Ask: Where do people lose time? What regularly causes frustration, delay, duplication or avoidable cognitive load?
02

Understand the problem

Avoid jumping immediately to a solution. Speak to the people affected and understand why the problem keeps happening.

Ask: What is driving this? Who experiences it? What happens on a good day when the problem is less visible?
03

Test something small

A small, reversible change is often more useful than waiting for the perfect large-scale solution.

Ask: What could we change this week? How will we know whether it helped rather than simply moved the problem elsewhere?
04

Learn and embed

Keep what works, adapt what does not and make successful changes part of normal work.

Ask: Did this make work easier, safer or better? What did staff and patients experience differently?

What might be worth improving?

Not every improvement needs to be a major programme. Small changes to how work is organised can remove repeated friction from the day.

Handover Repeated interruptions, unclear ownership or important information getting lost.
Communication Time lost chasing information, results, referrals or decisions.
Equipment & workspace Searching for basic equipment, computers, phones or suitable spaces to work.
Breaks No clear cover, no shared expectation or breaks disappearing whenever workload rises.
Administrative burden Re-entering the same information or completing processes that add little value.
Patient flow Delays caused by unclear pathways, interfaces or decisions that repeatedly stall.
Not every problem can be improved away locally. Some pressures reflect capacity, workforce, infrastructure or wider system constraints. Teams should not be expected to solve structural problems through goodwill or local workarounds alone.
Moral injury & system change

Wellbeing resources

Practical tools can help individuals, teams and leaders turn wellbeing from an aspiration into something visible in the working day. These are a few useful places to start.

Use what helps. Resources are most useful when they lead to action — better conversations, better working conditions and practical changes to how people experience work.

NHS health & wellbeing resources

NHS Employers

A broad collection covering physical and mental wellbeing, stress, sickness absence, financial wellbeing and healthier workplaces.

Explore health & wellbeing

Back to basics for a healthy working environment

NHS Employers

Practical guidance on basic staff needs including hydration, nutrition, sleep, breaks and appropriate welfare facilities.

View the guidance

Health & wellbeing of shift workers

NHS Staff Council / NHS Employers

Guidance on the health, safety and wellbeing considerations associated with shift work in healthcare environments.

Read shift-work guidance

Safe and effective wellbeing conversations

NHS England

Practical support and learning for managers and others who have conversations with colleagues about health, wellbeing and support.

Explore wellbeing conversations

Post-incident support framework

NHS Employers · 2026

A practical framework for supporting staff after violence, abuse or psychologically difficult workplace incidents.

View post-incident guidance

NHS health & wellbeing framework

NHS Employers / NHS England

An organisational framework setting out practical actions and standards for supporting staff health and wellbeing at work.

Explore the framework
Looking for something more specific? NHS Employers maintains a broader health and wellbeing library covering workplace wellbeing, staff experience, health and safety and practical organisational support.
Browse more resources

A career that can flourish

A sustainable career does not have to look the same at every stage. Our interests, responsibilities, health and ambitions change — and our working lives should be able to evolve with them.

Longevity should not require standing still. Mentorship, supportive relationships, development opportunities and flexibility can help people continue to find purpose and belonging throughout a career in Acute Medicine.

What helps make a career sustainable?

There is no single career template. What matters is having people, opportunities and enough flexibility to adapt when life or work changes.

Find your people

Mentors, peers and trusted colleagues can provide perspective, challenge, encouragement and somewhere to think aloud when decisions feel difficult.

Keep something that gives you purpose

Clinical work may sit alongside teaching, improvement, research, education, leadership or another professional interest. Variety can help sustain curiosity and meaning.

Keep developing

Career development is not only about promotion. Learning something new, taking on a different role or developing expertise can renew confidence and professional identity.

Let the shape of work change

Different career stages may require different hours, responsibilities or balances between clinical and non-clinical work. Adaptation can help people remain in the specialty rather than feeling their only option is to leave it.

Sometimes it helps to see how others have navigated their careers. Explore experiences and perspectives from people across Acute Medicine in Stories, Voices & Inspiration.
Stories & voices

SAM will continue to explore how it can support connection, mentorship and sustainable careers across the Acute Medicine community.

Sometimes the problem is the system

We can look after ourselves, support each other and improve the way we work. But some pressures cannot be solved by individual resilience or local improvement alone.

When clinicians repeatedly find themselves unable to provide the standard of care they believe patients need because of crowding, capacity, workforce or wider system constraints, the consequences can reach beyond ordinary workplace stress.

When better coping is not the answer

The next part of the Wellbeing Hub explores the relationship between working conditions, moral distress and moral injury — and SAM's role in challenging the systems that contribute to them.

Persistent capacity and crowding pressures
Workforce constraints that repeatedly compromise how care is delivered
Working environments that make safe, dignified care harder to provide
Explore moral injury & system change
Flourishing requires both support and change.

Supporting people to cope matters. So does creating workplaces and systems in which coping with unacceptable conditions is not treated as the solution.