Long Covid

Long COVID


What is Long COVID?

Our understanding of COVID-19 has significantly evolved since the start of the pandemic. It is thought that the majority of patients infected with the virus will experience resolution of their symptoms within four weeks.  Unfortunately, statistics indicate that 13-21% of people with COVID-19 will go on to develop ‘long COVID’ (Office of National Statistics, 2021) where they have symptoms lasting longer than four weeks. Long COVID refers to the enduring symptoms that can be experienced following the acute phase of a COVID-19 infection. Depending how long symptoms persist, long COVID can also be referred to as:

  • Ongoing symptomatic COVID-19 (4-12 weeks post-infection)
  • Post-COVID-19 syndrome (12 weeks or more post-infection, where the symptoms cannot be explained by another condition)

Research findings suggest that there may be a number of different factors that lead to people experiencing long COVID, and that causes could relate to post-viral fatigue, immunology, viral persistence, organ impairment, blood clots, neurological impacts, biological sex, and psychological factors (NIHR, 2021). As such, treatment and support need to be patient centred and take into accounts these differences. While we know that access to support services has been variable, the recommendation is that support is holistic and multi-disciplinary. There is currently no available research or evaluation of treatment for people with long COVID. This means that treatment interventions have been developed from expert consensus and evidence from other conditions with similar symptoms.

Signs and symptoms

Long COVID includes a wide range of symptoms. Some people might experience a single enduring or progressing symptom, and others may have symptoms that relapse, sometimes referred to as the ‘Corona coaster’.  Many people recover within 12 weeks, but symptoms can affect people in different ways and at different times, and some people experience ongoing impacts. 

The list of symptoms associated with long COVID is increasing, and some symptoms remain poorly understood. There is also large variation in estimations of prevalence of long COVID due to different measurements being used and resulting difficulties in comparing studies (NIHR, 2021).

The most commonly reported symptoms according to NICE are:

  • Respiratory symptoms: breathlessness, coughing
  • Cardiovascular symptoms (heart and circulation): tight chest, chest pain, palpitations
  • General symptoms: fatigue, fever, pain
  • Neurological symptoms: Cognitive impairment (‘brain fog’, loss of concentration, or memory issues), headache, sleep disturbance, peripheral neuropathy symptoms (pins and needles, and numbness), dizziness, delirium (in older people)
  • Gastrointestinal symptoms (digestive system): abdominal pain, nausea, diarrhoea, anorexia and reduced appetite (in older people)
  • Musculoskeletal symptoms: joint pain, muscle pain 
  • Psychological difficulties: symptoms of depression, symptoms of anxiety
  • Ear, nose and throat symptoms: tinnitus (ringing in the ears), earache, sore throat, dizziness, loss of taste and/or smell 
  • Dermatological symptoms: skin rashes

The likelihood of experiencing long COVID is not thought to relate to the severity of symptoms in the acute phase, including whether or not you were hospitalised. However, it does appear to be more prevalent in women and young people (NIHR, 2021). According to a report from the Office of National Statistics (ONS), compared to other professions, the prevalence of self-reported long COVID is highest amongst health and social care staff (ONS, 2021).

More information about signs and symptoms that develop during or following COVID-19 can be found on the Your COVID Recovery website: www.yourcovidrecovery.nhs.uk/what-is-covid-19/how-can-covid-affect-you/ 

Impacts

Long COVID can have physical, psychological and social impacts, and for some people it can have a considerable bearing on their quality of life. In a recent study, 71% of survey respondents said Long COVID was impacting family life, and 80% said it was affecting their ability to work (NIHR, 2021). The higher prevalence of long COVID in the health and social care staff may have particular implications for workforce pressures, placing increasing demands on teams, and increasing the risk of staff being vulnerable to stress, burnout and moral injury.

Psychological considerations

If you have experienced symptoms of long COVID, you may have found you have had to change how you live your life on a daily basis. This can be a difficult adjustment, perhaps involving feelings of uncertainty, isolation, and loss. There may be feelings of fear about illness, a range of emotions in relation to thinking about your own mortality, or traumatic memories of being severely unwell. These thoughts and feelings can be understandably distressing, and may contribute to difficulties in managing day-to-day activities, work, and home life. 

Some people may notice feelings of guilt around needing time off to recover, particularly if your team is under a lot of pressure; working in caring roles can also bring up conflicting emotions around taking time to look after ourselves when we are so used to putting our energy into caring for others. Returning to work after a period of absence can feel daunting, and perhaps bring up additional anxieties when going back to a place of work where you contracted COVID. You might have concerns about being able to cope with the demands of your role, which can be intensified if you are feeling a pressure to return to work before you feel well enough. 

Support offered by our service

If you are struggling after a COVID-19 infection and have experienced any long-COVID symptoms, you may benefit from some specific support. The first step is to talk to your GP, who can support any necessary investigations and arrange a referral to the Long-COVID Single Point of Access for an assessment. Depending on the outcome of this assessment, you may be advised to access the Long COVID group that we run within the Healthier Together Support Network. Please see our website for information about the group programme coming soon, or contact the HTSN on 0117 342 4740.

Further information and support

NHS Your COVID Recovery website: www.yourcovidrecovery.nhs.uk/what-is-covid-19/how-can-covid-affect-you/

Manging post viral fatigue: https://www.nlg.nhs.uk/content/uploads/2021/01/IFP-1277.pdf 

Booklet for people who have signs and symptoms that continue or develop after acute COVID-19: https://www.sign.ac.uk/media/1825/sign-long-covid-patient-booklet-v2.pdf 

References

ONS (Office for National Statistics), 2021). Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 1 July 2021: Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK – Office for National Statistics (ons.gov.uk)

NICE (National Institute for Health and Care Excellence), 2020. COVID-19 rapid guideline: managing the long-term effects of COVID-19: Overview | COVID-19 rapid guideline: managing the long-term effects of COVID-19 | Guidance | NICE

NIHR (National Institute for Health Research), 2021. Living with Covid19 – Second review: NIHR Evidence – Living with Covid19 – Second review – Informative and accessible health and care research

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Support to Stop Smoking

Support to stop smoking


If you choose to quit smoking, you will be able to access a local stop smoking service provided by the NHS which is free and delivered by friendly trained advisors who will support you with accessible information and advice on proven methods and affordable treatments to help you quit.

When you stop smoking, you give your lungs the chance to repair and you will be able to breathe easier. There are lots of other benefits too and they start almost immediately. Stopping smoking is one of the best things you can do for your health.

Can we help you?


The Healthier Together Support Network can offer advice and support on a range of issues or refer you to local and national specialist services. We offer a completely confidential service, and are separate from your employer’s own mental health and occupational health services.

There is a range of free support options available to people who wish to quit smoking – we highlight some useful resources below.

Useful resources


Support for NHS and non-NHS colleagues and members of the public

NHS Stop Smoking Services

Information on the benefits of quitting smoking and to make your quit attempt a success is available from your nearest NHS Stop Smoking Service. Your GP can refer you, or you can phone your local service to make an appointment with an adviser.

Call the free Smokefree National Helpline on 0300 123 1044.
Website: https://www.nhs.uk/live-well/quit-smoking

NHS Quite Smoking App

Use the NHS Quit Smoking App to help you quit smoking and start breathing easier. The app allows you to:

  • Track your progress
  • See how much you’re saving
  • Get daily support

If you can make it to 28 days smoke-free, you’re 5 times more likely to quit for good.

Better Health

Visit the Better Health website to access the NHS Quit Smoking app, personal quit plan, information on stop smoking aids, and smoke free tips.
Website: https://www.nhs.uk/better-health/quit-smoking/


Physical Activity

Physical Activity


Physical activity can be defined as any bodily movement produced by skeletal muscles that require energy expenditure. Physical activity includes all forms of activity such as everyday walking or cycling, work-related activity, active recreation (such as working out in a gym), dancing, gardening, playing active games and organised competitive sport.

Can we help you?


The Healthier Together Support Network can offer advice and support on a range of issues or refer you to local and national specialist services. We offer a completely confidential service, and are separate from your employer’s own mental health and occupational health services.

There are a range of free support options available to people wishing to increase their physical activity – we highlight some useful resources below.

Useful resources


Support for NHS Colleagues

Doing our Bit:

#DoingOurBit is a FREE online platform for NHS colleagues -containing a collection of fitness videos and advice on hydration and practical bite-sized tips for managing the menopause:
Website: www.fit4thefight.org/nhs-welcome

The Invictus Games

The Invictus Games Foundation has collaborated with the NHS to provide guidance on how to support the physical, mental, and social wellbeing during the Covid19 pandemic. This includes a series of podcasts that reflect on a variety of themes designed to help inspire and support.
Website: www.england.nhs.uk/supporting-our-nhs-people/support-now/physical-health-and-wellbeing

Workstation Workout – Avon Occupational Health – Physio Direct Service

Desk based at work or home? Ensure you get out of the office/home for a walk in your breaks and try workstation exercises to prevent of relieve muscular discomfort. Try this exercise circuit designed by physiotherapists to get you moving.
Website: https://youtu.be/qVWggWXfFQw

Support for NHS and non-NHS colleagues and members of the public

Physical activity guidelines for adults

Adults should do some type of physical activity every day. Exercise just once or twice a week can reduce the risk of heart disease or stroke. Find out the recommended government guidelines and ideas for incorpotat8ing physical activity into your daily routine.
Website: https://www.nhs.uk/live-well/exercise

Better Health

The NHS Better Health website offers a range of tools, tips and special offers to help us to move more every day. Features include:

  • Couch to 5K running programme for absolute beginners.
  • Active 10 app – records every minute of walking you do (anonymously).
  • Home work out videos.

Website: www.nhs.uk/better-health/get-active

Living Streets

Walking is free, flexible and fun, and proven to have a huge impact on your wellbeing. We’ve put together 20 tips to help you fit 20 minutes of walking into your day.
Website: www.livingstreets.org.uk/what-you-can-do/nwm-tips

Walking Routes

Walking is simple, free, and one of the easiest ways to get more active and become healthier. Check out the local information and maps across the locality.

Bristol: https://visitbristol.co.uk/things-to-do/sports-and-adventure/walking
North Somerset: https://www.visitsomerset.co.uk/things-to-do/activities/walking/
South Gloucestershire: https://oneyou.southglos.gov.uk/for-your-body/move-more/walking


Healthy Weight

Healthy Weight


Maintaining a healthy weight is important for overall health and wellbeing and for reducing the risk of developing health conditions such as heart disease, high blood pressure, type 2 diabetes, breathing issues and certain cancers.

How much a person should weigh is dependent on many individual factors. Measures such as the Body Mass Index (BMI) is very popular but should only be used as a reference. Adopting health focused self-care through regular physical activity, eating a balanced diet and getting sufficient sleep are positive steps to achieve and maintain a healthy weight.

Can we help you?


The Healthier Together Support Network can offer advice and support on a range of issues or refer you to local and national specialist services. We offer a completely confidential service, and are separate from your employer’s own mental health and occupational health services.

There is a range of free support options available to people seeking professional weight management support – we highlight some useful free resources below.

Useful resources


Support for NHS Colleagues

Digital weight management programme for NHS staff

This programme provides online access to a 12-week weight management programme, personally tailored to support the journey to a healthier lifestyle. As a digital programme, it can be used anywhere, allowing you to complete the programme in your own time, at a pace that works for you.
Colleagues are eligible to register for this programme if:

  • You are a member of staff working in the NHS (working in any role, including bank staff and staff on temporary contracts) with a valid NHS email address.
  • You are over 18 years of age.
  • You have a BMI of 30 or greater (this is lowered to 27.5 or greater for people from Black, Asian, and Minority Ethnic groups, as these groups are at an increased risk of conditions such as Type 2 diabetes at a lower BMI).

As this programme develops, the intention is to extend eligibility to anyone with a BMI of 25 or greater (or 23 or greater for people from Black, Asian and Minority Ethnic groups) in the near future.

Self-referral Website: https://staff.wmp.nhs.uk/

 

Support for NHS colleagues, non-NHS colleagues and members of the public

NHS weight loss – 12 week diet and exercise plan

This plan is available to everyone and features:

  • Safe and sustainable weight loss tools
  • Advice on healthy food choices
  • Exercise plans – record physical activity and progress

Website: https://www.nhs.uk/live-well/healthy-weight/start-the-nhs-weight-loss-plan

Better Health

To help to support people to make healthier choices, the NHS Better Health campaign provides a suite of free apps and tools that support adults to make better food choices and become more active. It features:

  • Free NHS Weight Loss Plan to support healthy eating habits and physical activity
  • Easy Meals App, Food Scanner App and Drink Free Days App
  • Physical Activity tools
  • BMI Calculator

Website: https://www.nhs.uk/live-well/healthy-weight/start-the-nhs-weight-loss-plan

NHS Digital Weight Management Programme

The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health. It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access.

Website: https://www.england.nhs.uk/digital-weight-management


Menopause Guidance

Menopause


Menopause, sometimes referred to as ‘the change’, is when a woman’s ovaries no longer function or produce hormones. The menopause has different stages – typically, these are:

Perimenopause – this is the onset of earliest menopausal symptoms until twelve months after the last menstrual period.

Menopause – is a retrospective diagnosis – a look back in time. It is described as the permanent stoppage of menstruation (periods) for twelve months.

According to the Faculty of Occupational Medicine (FOM), nearly 8 out of 10 of menopausal women are in work. That’s potentially 3.5 million women experiencing key menopause symptoms in the course of their daily duties. Transgender, non-binary and intersex colleagues may also experience menopausal symptoms and require equal support.

Can we help you?


The Healthier Together Support Network can offer advice and support on a range of issues or refer you to local and national specialist services. We offer a completely confidential service, and are separate from your employer’s own mental health and occupational health services.

There is a range of free support options available to people experiencing menopause – we highlight some useful resources below.

Useful resources


Support for NHS Colleagues and managers

Guidance on menopause at work

The menopause at work guidance includes principles that will help:

  • Organisations support the workforce
  • Line managers support their staff
  • Employees look after themselves

Website: https://www.nhsemployers.org/publications/guidance-menopause-work

Menopause in the workplace

Information on how menopause can affect people at work, and practical guidance for employers on how to improve workplace environments for them.
Website: https://www.nhsemployers.org/articles/menopause-and-workplace

Support for NHS and non-NHS colleagues and members of the public

Menopause (NHS website)

Overview – typical age to experience menopause, etc.
Symptoms – hot flushes, night sweats, vaginal dryness, difficulty sleeping, low mood or anxiety, etc.
Treatment – when to see a GP, hormone replacement therapy (HRT), etc.
Website: https://www.nhs.uk/conditions/menopause/

Balance app

Brought to you by renowned menopause specialist, Dr Louise Newson and the thousands of people who’ve shared their perimenopause and menopause insights, the free balance app allows you to track your symptoms, access personalised expert content, download a Health Report©, share stories in the community and lots more.
Website: https://www.balance-menopause.com/balance-app


Money advice

Financial wellbeing


Money worries can be a major cause of stress and lost sleep which can impact daily life. There are a number of FREE and impartial financial wellbeing services backed by government that can provide you with information, guidance and tools to assist with budgeting and saving, debt management and pension’s advice.

Can we help you?


The Healthier Together Support Network can offer advice and support on a range of issues or refer you to local and national specialist services. We offer a completely confidential service, and are separate from your employer’s own mental health and occupational health services.

There is a range of free support options available to people experiencing money worries – we highlight some useful resources below.

Useful resources


Support for NHS Colleagues

Money Advice Service

NHS colleagues can call a dedicated support line provided by the Money Advice Service, for free and impartial money advice Monday to Friday, 8am to 6pm: 0800 448 0826.
NHS WhatsApp: add +44 7701 342 744 to your WhatsApp to send the Money Advice Service’s national support team a message for help with sorting out debts, credit questions and pensions guidance.
Webchat: Chat to one of the Money Helper Advice Service team via their online portal.
Website: https://www.moneyhelper.org.uk

NHS Pension Scheme Ready Reckoner

Use the NHS Pension Scheme Annual Allowance Tax Ready Reckoner on the NHS Employers website to assess your annual allowance liability. The ready reckoner provides members of the NHS Pension Scheme with:

  • a broad insight into their annual allowance position
  • an indication as to whether the tapered annual allowance may apply to their circumstances
  • an estimated breakdown of the total annual cost of scheme membership
  • an estimate as to how much their annual NHS Pension is projected to increase by over the next year.

Website: Click here

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Looking out for others

Looking out for others


This is the time of year lots of new recruits join us – how can you help them manage?

Starting a new job can be an exciting time as it brings with it new experiences, opportunities and relationships. It is common to feel anxious, nervous, and unsure when adjusting to a new role, work environment, team and workplace culture. Beginning a new role in health and social care services during the Covid-19 pandemic brings with it additional challenges due to the work pressures on teams, remote working, and concerns around contracting and spreading the virus. Each person will adapt to and feel settled in a new role in his or her own time. Researchers have found on average it takes people 66 days to establish a new habit (Lally et al., 2010). Understandably, the bigger the change the longer it will take the person to feel settled.

 

Positively, there are many steps that managers and team members can take to support their new recruits.

 

Managers can:

  • Have a significant impact on onboarding new staff effectively. Onboarding involves acclimating staff to a new environment, teaching them how to perform tasks effectively, educating them about the organization’s mission and values, teaching them how to access resources, and determining how they can contribute to the organisation’s success (Baker and DiPiro, 2019). Research has shown that effective onboarding can result in new employees getting up to speed faster, being more efficiently able to contribute to achieving desired goals and improved retention rates (Lynch Buckner-Hayden, 2010). The first three months of being employed by a new organization have been identified as a critical time period for new staff to become efficient and develop confidence in their roles and develop a connection to the organization (Weinstock, 2015).
  • Formally introduce new staff members and clearly communicate their role to the team and the key stakeholders in the organization.
  • Be mindful to allocate new staff member’s shifts (within the first couple of weeks/months) when other more experienced team members will be working. This will allow for shadowing opportunities but will also make it easier for new recruits to ask for support when they need it.
  • Support new staff by scheduling regular catch-ups with them until they feel settled in their new role.
  • Link new staff in with a mentor and/or ‘buddy’ support, such as frequently touching-base and more formal one-to-ones with a team member.
  • Assist in an effective orientation by creating a written Orientation Guide for new starters with key up to date information about the service, processes and contact details of key people/services for them to be aware of in their new role.
  • Make new staff aware of health and wellbeing resources available to them within/outside the organization.

 

Team Members can:

  • Be mindful that their new colleague will likely be feeling uncertain and unsettled in the early days of commencing their role.
  • Help by making time to get to know new recruits and sharing with him/her their roles and responsibilities within the team.
  • Aim to be supportive, enthusiastic and available if asked to be a ‘buddy’ to a new recruit.
  • Make time to offer new staff informal support and regularly check in with them.
  • Offer them opportunities to engage in peer support activities/sessions, e.g., peer supervision, case discussions, journal clubs.
  • Invite them to attend daily team huddles which can be used for feedback/discussion and support.

 

Support available from the Healthier Together Support Network

1:1 Assessment and therapy sessions with a Clinical Psychologist

Leadership Consultations 

Webinars

Workshops

Training

References 

Baker, B., & DiPiro, J. T. (2019). Evaluation of a Structured Onboarding Process and Tool for Faculty Members in a School of Pharmacy. American journal of pharmaceutical education, 83(6), 7100.

Lally, P., van Jaarsveld, C.H.M., Potts, H.W.W. and Wardle, J. 2010. How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology, 40: 998–1009.  

Lynch K, Buckner-Hayden G. Reducing the new employee learning curve to improve productivity. J Health Risk Manag. 2010; 29:22–28.

Weinstock D. Hiring new staff? Aim for success by onboarding. J Medical Practice Mgmt. 2015;31:96–98

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Preparing for winter

Preparing for winter


For health and care staff winter often poses significant challenges. Increased rates of viral illness and staff absences often make the perfect storm. This year the impact is predicted to be much greater, so what can we do to look after our psychological wellbeing?

For most of us, the Covid-19 pandemic has been a challenging time and some of us may already be feeling exhausted or stretched to our limits, wondering how we will manage the potential for extra stress. Being aware of potential challenges and how we are feeling about them can be a helpful first step.

We may be feeling concerned about the numbers of people that will be in need of our services; anxiety about backlogs that have built up in this time or concern about how the people who use our services will fare over this period. The vaccine programme has been successful in reducing serious illness however; we may also justifiably feel worried about ourselves or our colleagues getting sick (perhaps again) and feel under pressure to cover extra hours when staff shortages commonly arise. The possibility to feel that we just cannot meet the demands of work can be a risk for feelings of ‘burnout’ or moral distress (bnssghealthiertogether.org.uk/help-for-me/#wellbeing-explainers). That is, feeling that we either have very little left to give to others, or intense feelings of guilt when we don’t have enough resources for all those who need more support. Both of these can be very common responses to working in a challenging environment under difficult circumstances.

Outside of work, at a time when daylight hours are at their shortest it can be more challenging to spend time outdoors and enjoy activities that may be important to wellbeing. Shift work may also bring extra challenges in this regard. While Christmas is usually a time for celebration, it can also bring financial worries, difficulties in relationships and in families and, especially this year, may be a time when some of us could feel isolated from friends or family we can’t see due to ongoing travel restrictions or working through the festive period.

With all of this in mind, what helps to boost our resilience when faced with complex challenges?

Being aware of uncertaintyThink about how uncertainty affects you, now and in the past. Try to notice if you are avoiding thinking about important issues, or perhaps worrying a lot and not feeling in control of anything

Think about what has helped you to cope with uncertainty before

Do you need to add in some extra routine or structure into your week or your working day? Perhaps some planning for how you will ‘cope ahead’?

Consider using some of the mindfulness resources below – whether you are new to this or not developing our mindful awareness of thoughts, feelings and behaviour can help to combat added stress and support self-care and self-compassion skills

Identifying added pressures or stressesAs healthcare workers we can have a tendency to look after others before ourselves and can feel internal pressure to ‘go beyond’ duty and good practice to help colleagues and patients

Be aware of signs of unhealthy stress levels or exhaustion: irritability, concentration difficulties, low mood, new unexplained body symptoms (aches, pains, palpitations, stress response symptoms), anxiety, forgetfulness, insomnia/fatigue, disconnecting from others, feeling emotionally up-and-down, turning to excess alcohol or drugs to wind down/keep going.

If you notice this happening ask yourself:

  • Can I care for my clients if I’m this tired/stressed/not caring for myself?
  • What are reasonable limits on what I can do?
  • Who can I reach out to for help and support?

Prioritise tasks both in and out of work – at times of high demand what really needs to be done? Ditch or postpone the non-essential tasks and plan in at least one extra space per week for self-care, winding-down or distraction

Watch our Wellbeing Explainer on managing conflicting demands (bnssghealthiertogether.org.uk/help-for-me/#wellbeing-explainers)

Maintaining valued activities and relationshipsWhen we give time and focus to the things that are important to us (in work and life) we tend to feel life is moving in the right direction and added stresses are more manageable, or reduced.

When stressed, it can be easy to stop doing things or seeing people that are important to our overall sense of who we are – both in and outside of work – and this can increase stress, anxiety, low mood and feelings of burnout.

As above, if you notice you aren’t finding time for activities and loved ones that give you a sense of who you are and what fulfils you in life try to make space for these again or (if at your most time-stretched) schedule these for another time soon and create space for them.

Holistic healthBe aware of what your body needs to support a healthy mind.

When under pressure sleep can be challenging (whether feeling over- or under-tired). To help, try to continue to eat well, take breaks where you can (and prioritise these) and try to combine with small bursts of light or moderate exercise.

Most people do not get enough vitamin D during winter and this can be a problem for some, think about discussing this with your GP or practice nurse if this may apply to you.

Feeling aloneFeeling that you are alone with stresses or worries often makes us feel much worse about them. It can be tempting to see everyone else around us as ‘perfectly coping’ but this is very rarely the case.

Feeling understood and just ‘getting things off our chest’ can be helpful to avoid feeling isolated. Think about who, amongst your colleagues, managers, supervisors or mentors it might be helpful to share how you are feeling with.

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.

For leaders and managers of people it may be helpful to look at the resources provided by the Healthier Together Support Network (HTSN) and some of the suggestions below. Looking after teams through: compassion both towards ourselves and our colleagues; fostering team cohesion and creating a space for emotional and psychological safety are key to maintaining our own and others’ wellbeing at work. You may wish to consider joining one of the group programmes we run or learning more about common staff wellbeing themes. Take a look at our pages on ‘Common‘ Themes’ and our Wellbeing Explainer and Webinar pages.

Useful resources


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Information for veterans and their families

Information for veterans and their families


  • Veterans and their families in England can access the specialist NHS Op Courage services
  • Anyone in the UK or overseas can contact the Veterans’ Gateway helpline on 0808 802 1212, or visit the website for advice and signposting to further support, including for families and the bereaved.
  • Staff can contact the Samaritans helpline on this dedicated number for NHS staff:  0800 069 6222.
  • There are also a number of military charities which offer advice and support, all of which are members of The Contact Group, a collaboration of organisations working together to improve mental health support to the UK armed forces community:

COMBAT STRESS

Walking with the wounded

Help for Heroes – Hidden Wounds Service

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Low Mood

Low Mood


It is normal for our mood to fluctuate and change in response to things that happen in our lives. For many, the Covid-19 pandemic has brought about significant levels of change and uncertainty. It has also caused a lot of us to lose things that previously gave us purpose and meaning. During periods of such difficulty, we may find that our mood feels lower. A period of low mood may last for a very short time, or it may last longer. It may be that this is the first time you have felt low, or it may be that you have experienced periods of low mood in the past. 

Below are some common signs of low mood:

FeelingsBehavioursPhysical Sensations
SadnessDifficulties concentratingFeeling more tired than usual 
Anxiety and/or panic Withdrawal from activities you enjoyChange to sleeping habits
Anger Difficulties thinking clearly or making decisions Change to eating habits 
Frustration Self-harming Loss of libido 
A sense of hopelessnessHaving thoughts of ending your life
Lacking enjoyment in things you previously enjoyed doing

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