Moral Distress

Moral Distress

“Moral distress arises when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action” (Jameton, 1984).

Within the health and social care sector, we place huge emphasis on doing our job well and doing the right thing. However, increased pressures sometimes mean this is difficult or impossible to achieve. This can compromise our moral integrity and result in experiences of moral distress. Whilst moral distress can occur at any time, it is more likely to occur during times of crisis, such as during the COVID-19 pandemic. You may experience a range of feelings when in a state of moral distress, including anger, a sense of meaninglessness, guilt and isolation. You may also experience various physical symptoms or notice yourself behaving differently.

Can we help you?

The Healthier Together Support Network (HTSN) can offer advice and support on a range of issues. The challenges affecting your wellbeing may be unrelated to COVID-19; however, you may still benefit from a conversation with our team. The support offered by the HTSN is confidential and separate from mental health and Occupational Health Services.

Useful resources

Moral distress wellbeing explainer

View our short wellbeing explainer videos.



As a result of the COVID-19 pandemic, the pressures and demands placed upon those working in the health and social care sector have increased significantly. Alongside these heightened pressures, lockdown restrictions have meant that many have been unable to engage in activities that often help to reduce stress or promote self-care. For some, this may result in experiencing burnout. Burnout is a state of emotional, physical and mental exhaustion, which is caused by prolonged and excessive stress. It does not just impact our working lives; it can also spill over into our home and social lives.

Below are some common signs of burnout:

FeelingsBehavioursPhysical sensations
Lack of self-confidenceWithdrawing from roles/responsibilitiesFeeling tired/drained a lot of the time
Doubting yourselfWithdrawing from othersFrequent aches and pains
Sense of helplessnessProcrastinationChanges to appetite
Lack of motivationBecoming frustrated with othersChanges to sleep habits
Sense of dissatisfactionDifficulties concentratingFrequently becoming unwell – lowered immunity
Constant negative outlookDrinking or smoking more than usual
Feeling constantly worried

Can we help you?

The Healthier Together Support Network (HTSN) can offer advice and support on a range of issues. The challenges affecting your wellbeing may be unrelated to COVID-19; however, you may still benefit from a conversation with our team. The support offered by the HTSN is confidential and separate from mental health and Occupational Health Services.

Useful resources

Bitesized Books Series 

Burnout: How to avoid it and look after yourself

Apps to support stress and worry

Be part of the Healthier Together story

Health and Care: Your Story poster

Do you have a health and care story to tell? Can your experience help us to reimagine the future of our health and care services?

We often hear people say health and care services are under pressure and can’t continue as they are. What does this actually mean for the future of our local health and care services? How can we evolve our services so they are fit for the future? Is there more we can do as individuals and communities to keep healthy and well?

Please join us for an afternoon of discussions on Thursday 22 November, 2-5pm at The Bristol Pavilion (Gloucestershire County Cricket Club) to:

  • Talk through our vision for the future of health and care in Bristol, North Somerset and South Gloucestershire
  • Understand your experiences and what matters to you
  • Help us to shape some of our priority topics

For further information and to book your place, visit our Eventbrite ticket page.

Or give our Healthier Together Office a call: 0117 342 9282.

£6.5m boost for technology improvements

SmartphoneHealthier Together will receive £6.5million to support digital projects that will help improve the way health and care services are provided in Bristol, North Somerset and South Gloucestershire (BNSSG).

The funding follows Health and Care Secretary, Matt Hancock’s, commitment to investing half a billion pounds to transform the use of technology across the NHS.

Commenting on the news, Deborah El-Sayed Director of Transformation for BNSSG Clinical Commissioning Group, said: “Technology is now an embedded part of our lives and it has revolutionised the way we live. It’s critical that we harness the power of digital and technology to make our health and care services better too. Whether it is focused on supporting clinical staff or digital access for our patients and citizens, technology is a core component of our improvement efforts.

“We are already leading the way with our Connecting Care Programme – a nationally recognised award winning initiative that allows organisations to safely share health and care records. This investment will mean that we can push forward with our ambitions to maximise the benefits of digital solutions across Healthier Together.”

Healthier Together will work with NHS England to understand how the money may be used to support local projects. This could potentially include things such as:

  • Creating digital health records for children, including maternity records to work towards paperless 2020
  • Improvements in our mental health services and the support people receive
  • Consolidate existing infrastructure and create a single flexible solution, across our services, estates, geographical boundaries and organisations.

Don’t miss the party! Help us celebrate the NHS’s 70th birthday

Health and care organisations in Bristol, North Somerset and South Gloucestershire are encouraging people across the area to join in the celebrations as the NHS turns 70 on 5 July.

Julia Ross, Chief Executive of Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group and one of the Healthier Together leaders, said: “The NHS has come a long way since its launch in 1948. Medical advances and improvements to health have been phenomenal in that time, which is credit to our hard-working and passionate staff.

“The birthday celebrations are a perfect time to recognise how lucky we are as a nation to have a health service that provides high-quality support and treatment which is free at the point of access.

“Looking ahead, we need to consider how we all work together to ensure the future of our NHS and other public services for generations to come. That’s why the work of Healthier Together – our local Sustainability and Transformation Partnership is so vitally important.”

To mark this special occasion, a number of local activities are taking place, including:

- Southmead Hospital Charity will be hosting a “Big 7Tea” tea party on Thursday 5 July in the Brunel building. Staff, patients and visitors are invited to join for a cuppa and cake for a suggested donation between 10am and 2pm. With live piano music covering the seven decades, people will be encouraged to chat about their memories and take part in craft activities.

- Over the past month, North Bristol NHS Trust has been sharing daily patient and staff stories and facts of their experiences through the decades, such as the first ever IT worker who started in the 1980s, pioneering brain research using robots in the 1940s, and multiple generations of families working in different roles.

- Southmead Hospital will be hosting a memorabilia display in its Brunel building between 2 and 6 July showcasing historical photos, uniforms and kit from Southmead and Frenchay hospitals.

- Bristol University are going to light up the Wills Memorial Building on 5 July with blue light as part of the #LightUpBlue social media campaign.

NHS 70 #LightUpBlue

- Hospitals in Bristol are in the final week of a #WhyILoveTheNHS social media campaign. They are encouraging members of the public and staff to share the reasons why they love the NHS on Twitter, Facebook and Instagram.

- Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group has created an NHS 70 video, which will be shown for the first time at their AGM on 3 July. Anyone can sign up for tickets to the AGM through Eventbrite.

- There is still time for children to enter the BNSSG-wide art competition, which closes on 5 July.

- Bristol Archives will be holding a small display (running until September) featuring documents and images exploring the development of medical care in the city, from early institutions funded by donations and philanthropy, to the transfer of services to the National Health Service in the 1940s.

NHS70 - a photo from the Bristol Archives collection
A nurse administers a polio vaccine at Bristol’s Central Health Clinic in the 1950s (Bristol Archives 40826/PUB/80)

- Sirona care & health holds an annual awards ceremony to recognise outstanding work and achievements of its staff. This year it will feature two categories to mark the 70th birthday of the NHS. The awards will be launched on 5 July and anyone can make a nomination:

- University Hospitals Bristol NHS Foundation Trust is planning tea parties for staff and volunteers, a film showing and giving away free books to celebrate the 70th birthday of the NHS. Staff, patients and visitors will have the opportunity to tell us why they love the NHS on comment boards which will be popping up around the Trust next week. You can keep up to date with UH Bristol’s NHS70 activities via the following link:

There are lots of ways to wish the NHS a happy birthday and show appreciation for one of the nation’s most loved institutions. From giving blood, to making an online pledge to use NHS services wisely – take a look at for other ideas and inspiration.

Healthier Together Conference materials now available

Presentations and posters are now available to download following our first Healthier Together Conference, which took place in Bristol on 21 June 2018.

All materials can be viewed online or downloaded from our Document Hub. Alternatively, follow the handy direct links below.


Making the vision happen – Robert Woolley, Dr Mark Pietroni, Julia Ross

Health and Care of the Future: A visualisation not a vision – Professor Sir Muir Gray




Urgent Care

Primary Care Transformation


Mental Health


Integrated Community Localities

Healthy Weston

Acute Care Collaboration

Please note, these materials capture a moment in time and our work will continue to evolve over the coming weeks and months.

You can find out more about the conference by reading our recent post: Defining moment for health and social care in our area.

Welcome to our new Healthier Together website


We are delighted to launch our new Healthier Together website today.

Please take a moment to look around – you will find information on what Healthier Together is all about, our leaders and frequently asked questions.

We will be launching a regular e-newsletter soon – you can sign up to the mailing list now.

This website is a work in progress and we will be adding a lot more content over the coming weeks. If you’ve any feedback on the website or you have a question, please send us an email or give us a call.

Healthier Together conference



Are you already involved in Healthier Together programmes of work? Or do you have an appetite to know more and do more to support our partnership approach to improving health and care? If the answer is yes we'd like you to come along to our first Healthier Together Conference on the 21 June 2018!

The event will be an opportunity to showcase progress so far, discuss five year plans and to enlist people to get more involved in shaping the future.

You may be a clinician, manager, local councillor, social worker, non-executive, volunteer or patient representative. We are particularly keen that attendees have enthusiasm for partnership working and a willingness to be part of at least one of the priority areas.

Our priority areas are:

  • Mental health
  • Maternity
  • Urgent care
  • Healthy Weston
  • Integrated community localities
  • Acute care collaboration
  • Primary care transformation
  • Prevention
  • Workforce
  • Digital transformation

If you’d like further information or to sign up to the event please get in touch with the Healthier Together office here.