What helps people flourish at work?
Individual wellbeing matters, but it is shaped by the people around us and the environment in which we are asked to work.
Looking after ourselves
Rest, recovery, health, connection and the space to sustain ourselves through demanding clinical work.
Supporting each other
Kindness, trust, belonging, psychological safety and teams where people feel able to ask for help.
Creating better conditions
Compassionate leadership, manageable workloads, autonomy and systems that enable people to deliver good care.
Flourishing is shared work. It depends on individuals, teams, leaders and the wider system — not on resilience alone.
Looking after yourself
Acute Medicine can be physically, mentally and emotionally demanding. Looking after yourself isn't about perfect routines or adding more to an already busy day. It's about protecting the things that help you keep going over time.
Think about the whole shift
There is no perfect formula. But there are opportunities before, during and after work to protect energy, connection and recovery.
Before the shift
Give yourself a reasonable starting point, rather than beginning already depleted.
- Protect sleep and recovery where your shift pattern and circumstances allow.
- Cover the basics. Think about food, hydration and what you'll need during the working day.
- Notice how you're arriving. Fatigue, worries or difficulties outside work can affect how you feel during a shift.
During the shift
Busy shifts can make basic needs feel optional. They aren't.
- Take your breaks and help colleagues take theirs. Teams need arrangements that make breaks possible.
- Share difficult decisions. Ask for another opinion, practical help or cover when it is needed.
- Check in after difficult events. Give yourself and colleagues an opportunity to acknowledge what happened.
After the shift
Recovery matters, particularly after nights or emotionally difficult working days.
- Create a transition. Find a realistic way to leave work behind and reconnect with life outside the hospital.
- Make room for recovery after nights, intense shifts and demanding runs of work.
- Recognise when work is affecting the rest of life. Persistent problems with sleep, mood or relationships are reasons to consider support early.
Supporting each other
Acute Medicine is teamwork. On difficult days, the people around us can make the difference between feeling isolated and feeling supported.
Strong teams notice, connect and support one another.
Small actions.
Stronger teams.
Support should be part of how a team works every day. We should not need to wait until someone is visibly struggling before checking in or offering help.
Across the multidisciplinary team, everyday acts of kindness, practical help and being able to speak openly all matter.
What supportive teams do
Often it is the everyday behaviours within a team that shape whether people feel supported and included.
Notice
Pay attention when a colleague seems quieter, more tired, overwhelmed or unlike themselves. A simple check-in may help.
Check in
Ask properly, rather than automatically. A meaningful question after a difficult shift can open a conversation.
Share the load
Offer practical help. Take a phone call, review a patient, provide cover for a break or help with competing demands.
Make it safe to speak
Make it possible to ask for help, admit uncertainty, challenge decisions or raise concerns without humiliation or judgement.
A better check-in
You don't need special training to show someone you have noticed them. Sometimes a simple question is enough to open a conversation.
How are you doing after that shift?
Is there anything I can take off your plate?
Do you want to talk about what happened?
Have you had a break yet?
What would be useful right now?
Listen before trying to fix things. Sometimes the most useful response is to make time, acknowledge what happened and help a colleague work out what they need next.
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 and whether concerns lead to action.
Wellbeing is not an optional leadership extra. How work is organised and how people are treated affects whether teams can work safely and sustainably.
What is it actually 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.
Can people say they're struggling?
Without worrying that it will be interpreted as weakness, poor performance or a lack of commitment.
Can people challenge safely?
Can someone question a decision or raise a concern regardless of profession, grade or seniority?
Are basic needs protected?
Breaks, food, hydration, reasonable workload and opportunities for recovery should not depend on luck.
Does speaking up change anything?
Listening is important, but trust depends on visible action and feedback afterwards.
Culture is experienced through behaviour. Policies matter, but staff often judge a workplace by what happens on its most difficult days.
Six things leaders can influence
Not every pressure can be removed locally. But leaders can shape how work is organised, how concerns are handled and whether teams feel supported, involved and heard.
Build psychological safety
Make it normal to ask questions, admit uncertainty, seek help and challenge respectfully. Respond constructively when someone raises a concern.
Try this: Model the behaviour yourself, including acknowledging when you don't know.
Make workload visible
Repeated overload should not become invisible simply because teams keep managing to get through it.
Try this: Identify where pressure builds and what can be stopped, redesigned, redistributed or escalated.
Protect breaks & recovery
A culture where nobody takes a break should not be treated as evidence of commitment or resilience.
Try this: Build reliable cover and clear expectations for breaks into the way the team works.
Preserve autonomy & control
People need influence over how they work and confidence that their professional judgement matters.
Try this: Involve the people doing the work when changing pathways, processes and team arrangements.
Make flexibility possible
Health, caring responsibilities and life circumstances change. Sustainable careers need more than one model of working.
Try this: Ask "how could this work?" before defaulting to "we've never done that".
Listen & close the loop
Inviting feedback and then doing nothing can increase cynicism rather than build trust.
Try this: Explain what you heard, what will change, what cannot change and why.
Wellbeing conversations should lead somewhere.
Ask what's helping, what's getting in the way and what practical changes might make a difference. Act where you can, escalate what you cannot resolve locally, and let people know what happens next. The next section explores how teams can make 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. Often the best ideas come from the people doing the work — because they know where time, energy and goodwill are being lost.
From everyday frustration to meaningful change
Improvement doesn't always require a major project. Start by understanding the problem, test a manageable change and learn from the result.
Notice the friction
Identify recurring problems that make an already demanding shift more difficult.
What repeatedly wastes time, creates frustration or makes good care harder?
Understand the problem
Talk to everyone affected and explore what causes the problem before deciding on a solution.
Why does it happen, who is affected and what happens on a better day?
Test something small
Try a practical, reversible change before attempting a large-scale redesign.
What could we try, and how will we know whether it actually helped?
Learn and embed
Keep and spread what works, adapt what doesn't and make improvements sustainable.
Did it improve the experience of staff and patients?
Start small, but measure what matters. A useful change should make work easier, safer or better — without simply transferring the burden to another person or team.
What might be worth improving?
Consider the small, repeated problems that make a shift harder than it should be. These are familiar examples from Acute Medicine.
Handover
Interruptions, unclear responsibilities and essential details not reaching the right person.
Communication
Repeatedly chasing results, referrals, clinical decisions or essential information.
Equipment & workspace
Difficulty finding functional equipment, available computers or appropriate spaces.
Breaks
No reliable cover, unclear expectations and breaks disappearing whenever workload increases.
Administrative burden
Duplicate documentation, unnecessary data entry and processes that add little practical value.
Patient flow
Delays where pathways, interfaces or decisions between teams repeatedly become stuck.
Not everything can be improved away.
Local improvement can remove avoidable friction and make working days better. But some problems are rooted in insufficient staffing, capacity, infrastructure or wider system constraints.
Teams should be supported to improve what they can influence, while structural problems are properly escalated and addressed. Goodwill and local workarounds are not substitutes for adequate resources.
Wellbeing resources
Practical tools can help individuals, teams and leaders turn wellbeing from an aspiration into something visible in the working day. These NHS resources are useful places to start.
Healthier shifts
Protecting the basics of working well
Conversations & recovery
Supporting colleagues when it matters
Better workplaces
Organisational action and sustained change
Use what helps
Resources are most useful when they lead to action: better conversations, protected basic needs, improved working conditions and practical changes to the way people experience work.
Looking for something more specific?
NHS Employers maintains a broader library covering health, wellbeing, staff experience and workplace support.
Browse more NHS resourcesA 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.
There is no single career template.
What helps us flourish at one stage of life may be different at another. A sustainable career needs room to grow, adapt and occasionally change direction.
What helps make a career sustainable?
Four things can make a difference as careers and life circumstances evolve.
Find your people
Mentors, peers and trusted colleagues provide perspective, challenge and encouragement. They also offer somewhere to think aloud when difficult decisions arise.
Keep something that gives you purpose
Clinical work may sit alongside teaching, improvement, research, education, leadership or another professional interest. Variety can sustain curiosity and meaning.
Keep developing
Development is not only about promotion. Learning something new, exploring different responsibilities or building expertise can renew confidence and professional identity.
Let the shape of work change
Different career stages may call for different hours, responsibilities or balances between clinical and non-clinical work. Flexibility can help people remain in the specialty.
Every career has a story.
Sometimes it helps to see how others have navigated the challenges, opportunities and changing shape of a career. Explore real experiences and perspectives from across the Acute Medicine community.
Looking ahead: 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.
Supporting people to cope matters. So does creating workplaces and systems in which coping with unacceptable conditions is not treated as the solution.