How To Use Best Organisational Psychology Practices To Build Wellness Programmes With Kristina Middleton

Let’s start off with how you got into organisational psychology, what it is as and how it links to behaviour and culture change. 

My bachelor's degree was in Chinese medicine, so I always knew that I wanted to do something with people that helps. I was working for Kingston University at the time, and I came across the master's programme in Organisational Psychology, which was the first time I saw everything I was interested in bundled together in a single programme, and I immediately knew this is what I wanted to do. After my master’s, I got into my first wellbeing role so I could transfer the knowledge immediately. 

Organisational psychology as a discipline is broad. It encompasses things like training, assessments at work, health and wellbeing, leadership development and change management. I think what unites them all is how do we feel in the organisation and what does it actually mean? What impacts does it bring to the organisation itself? So it's not just about us as individuals, but it's very much in a business context. 

I believe you work with the NHS in a wellbeing context. Talk about that work and the impact you’ve seen through organisational psychology. 

It’s interesting because I worked in higher education in my first wellbeing role, so I could compare two very different environments. I think, since I started working in this field, wellbeing as a discipline evolved. When I first started out, it was very much focused on how we improve mental, physical, financial, and social wellbeing of individuals. A lot of our work was around creating activities for people to engage with, having some mental health training, having yoga classes and things like that.

I think that still exists, and I think people appreciate it. But when I moved to the NHS, I quickly realised that it's just not going to cut it anymore, just because the environment is different. The way I felt when I started in the NHS, was if I was continuing to do what I did before, it's a bit like playing violin on the Titanic. Because burnout rates are really high, people's workloads are intense. The nature of the job is traumatic at times, and just telling people to develop individual resilience, exercise and eat well isn’t enough. 

I had to change my thinking pretty quickly, and over time some NHS-specific research came out of Birkbeck University, saying that wellbeing in the NHS is a systems issue. What is helpful as well in the NHS is that there is a health and wellbeing framework, which is holistic, so you can assess where you are with things like leadership, being data-driven, and having systems in place within the organisation.

I started thinking more and more about how to improve the overall experience, because it's the job itself and the experience in the workplace that affected people's wellbeing the most. So rather than putting more interventions targeting individuals, how do we improve that overall experience so the job isn't as damaging for individual wellbeing? And that's a much harder and much longer process, but also much more effective.

So while we still do interventions targeted at individuals, recently we adopted a programme which uses a continuous improvement methodology, and we work with teams. We go to teams and we ask, "What matters to you at work? What do you need to happen? What improvement ideas do you have?" and facilitate those conversations and support managers with implementing those little actions that make the workplace just that little bit better for people.

We do it on a cycle basis, so we would go to the same team several times  because we can’t expect groundbreaking changes from the  first conversation.  Things start improving gradually and we want people to feel like they're able to influence change. This has been the most impactful thing we have done for our people, and it's been reflected in our staff survey results.

The teams that participated, and the teams where managers embraced it and started improving things, saw improvements of around  20% in their staff survey results. People reported feeling heard, being able to influence change in their teams, better working relationships and improved job satisfaction.

That’s one of the first initiatives that's enabled us to link what we do with organisational metrics. We are a company of over 17,000 staff, so when we do individual interventions there's no way we could meaningfully say, "Oh, that intervention for 200 people improved something for the organisation," because there are so many variables that it just kind of gets lost. So those targeted interventions really help us connect what we do with  the data and measure outcomes in a tangible way.

We also have a project now specifically targeting night shift workers, called Project Night Owl. Again, it's a targeted group of people. We can collect data specifically for them, and they're the ones that experience a higher impact on their health. Socially they're isolated, and the same support resources are not always available to them, so they may feel organisational support is targeted to the day-time workforce and not to them. 

We are doing a number of things for them. For example, individual support, health checks to spot health risks early, training for them and their managers, an app where they can put their individual shift cycles in, and it tells them how to transition between shifts effectively. For example, when to drink or not drink  caffeine, when to expose themselves to light or when to dim the lights.

But the most exciting thing for me that we're doing is we're changing the lighting. We're working with professor Steve Lockley from Surrey University who is the expert in this and who has done a lot of research in emergency services demonstrating the link between lighting and reduction in serious medical error rates. In line with this research, we are changing the lighting to a slightly bluer coloured  light. It increases alertness levels, so it works with our circadian rhythms and tells our brain to stay alert.

We are implementing it as a part of our Green Plan initiative to switch to LED lighting, so we are able to do both - make our lighting more cost-efficient and support our people’s alertness levels at work. 

That’s interesting to me because it’s influencing the environment and we expect to see a difference in medical error rates and sickness absence, but we are not asking our people to do anything differently. This enables us to deliver impact at scale and puts responsibility to act on the organisation, not the individual. .

Let’s take an example of a wellbeing programme e.g. Mental Health First Aid. Why do you think it would be hard for training like this to bridge into behaviour change?

With Mental Health First Aid, it's difficult to collect the data on the behaviour change after a programme. This is the case for a lot of learning and development programmes in that it’s hard to identify the behavior change afterwards.

Anecdotally, we hear that people are using it, but people are not consistently providing us with data. So we ask them every month: "Can you tell us, have you spoken to anyone?", and we receive some responses, but I believe that the official numbers are hugely underreported.. Because  when we speak to people just by running into them in the corridor, they're like, "Oh yeah, I've supported three  colleagues this month and I referred them to the counselling team”" But these people do not officially report when we ask them for data. 

So part of the gap is that the data is not very good. But there are some other things as well. Even the basic training we do on wellbeing and resilience is usually largely telling people  the things they already know. I started focusing a lot more on behaviour change and behaviour change models to encourage more reflection on why we don’t do the things we know we should do for our wellbeing and how do we remove the barriers to healthy behaviours. 

I think a lot of the time it's the context in which we live and work. We can take time to go on training, come out with the best intentions, but then go back to the same context we came from. So we could tell people to do the right things, but if the environment that they're going back to isn't supportive of that, then it's easy to default to their original behaviours. So we need to make changes to the environment as well to make the training transfer more effective. 

That’s a common pattern that I'm seeing from a lot of people who’ve been interviewed for the Training Impact Gap Project.

I'm interested in the idea of wellbeing washing, where you might say from a cultural level that internally nothing is changing, but externally it's saying, "Yeah, we're doing all this," as a tick-box exercise.

Maybe people don't necessarily understand that they're doing it. They might have the best of intentions, but it's not helping anyone. What are your thoughts on wellbeing washing and how can organisations be more aware of not doing it?

That comes with the territory that wellbeing at work is a relatively new phenomenon, so we're all learning. People do think that they are doing the right thing by putting all those things on, and we've been doing it for a long time as well, where we would put all those things on and that offer on the surface looks excellent. But maybe 20 people out of 17,000 would take it up.

The best way I found to think about it is always considering the impact. I heard someone say on LinkedIn that if you want to treat your wellbeing as a PR thing, then just be upfront about it. It's fine to say, "Oh, we've got all those perks," and it attracts people to the organisation.

But if you want to have a meaningful offering that improves employee wellbeing, it's about how are you measuring the impact? How are you making sure that all those things get to people, people can use them, and people want to use them? Have you consulted with staff before putting things out?

Shifting the focus from having a good employee offer to asking what are we trying to achieve and what impact do we want to see helped me personally think about that at a different level and make it more meaningful.

On the subject of impact, quantitative and qualitative data are important from showing and measuring what has been achieved. I think it’s important to strike a balance between stats and telling stories that show behaviour change. 

What’s your perspective on this balance for securing funding for programmes?

Thinking this way helped with securing funding for the Night Owl project. There was a lot of quantitative data, which was excellent. I went  around the wards at six in the morning to speak to the night shift workers, and it really did come through how isolated they feel and how they don't feel a part of the wider organisation because nothing is there for them. Everything is happening during the day.

And it shaped our thinking now. We were planning a launch event for the night shift project. Our default steps for a launch project would be to book a room, invite speakers and talk about it, but then we had to pause and think, "But who are we doing it for?" We either have to be clear that we're doing it for senior leaders during the day when everybody's available, or we're doing it for night shift workers, in which case we have to completely rethink how we're doing events because they probably can't attend anything in person due to minimal staffing. So what does the event even look like?

Those qualitative stories help, and they're the most powerful as well. You can write the best quantitative reports, but if you insert a nice quote that illustrates the experience, it changes things. When we had been thinking about the cost of living crisis, the one thing that stuck with me is that somebody shared that they didn't have money to get into work towards the end of the month. They didn't have the bus fare.

That was something that made me think we need to offer something to people to help them through that.That was also a useful story to persuade the execs that we need a stronger financial wellbeing offer.

AI is huge in every space and in your role are you using it in any interesting ways or do you feel it’s having a negative impact? 

I don't think there's anything groundbreaking. I’ve used AI recently to help me think and plan, but we're in an interesting space with AI because sometimes you look at something people produce and you know immediately it's AI, and you give it less value.

We’re still finding our way in terms of how to work effectively with it. I've seen bad things produced with AI that look pretty but on closer inspection were not great. In terms of detriment, it can quickly damage somebody's credibility.

There’s a real opportunity for task automation. My colleague created some wonderful spreadsheets with AI, and those kinds of things that would take days now take minutes. So in that way, it's really useful.

A common thread that comes up in these interviews is that L&D tend to be lumped in with wider teams like HR and are siloed in being able to make decisions within organisations.

From your experience, how do you think communication can be improved between departments to strive for culture change?

I sit in the Organisational Development and Culture team, and L&D is under our umbrella, along with EDI. So we should be working a lot closer together, but there are still a lot of opportunities for us to do better. Having spaces to come together, like standing meetings in the diary either for planning or even without a super set agenda, where people can bring each other into projects early, is something that helps collaboration. 

Another important element of collaboration is to bring collaborators at the beginning of the project so the ideas can be shaped together, not towards the end when there is little scope for change.  

In my work, I’ve established a steering group for wellbeing with people who are interested in shaping the wellbeing offer. I was keen to make it as representative and diverse as possible - from porters to cleaners to consultants and researchers. Everyone comes in and says what wellbeing means to them. We've co-designed the bones of the wellbeing strategy together, and that's where the employee experience piece really came through, that wellbeing is not seen by people in isolation, it's the whole experience.

In terms of culture change, it's so important that everyone is aligned. A lot of the time something gets decided at the top level, like, "This is what we're doing for culture change," but it just doesn't get through the lower levels of the organisation and people on the ground see the promises but don’t notice any differenceSo for me it's always thinking, “okay, we’ve developed this wonderful strategy, now what's going to change? How is it going to translate to all levels?”. I like to start at the end and work backwards sometimes.

For example, how do we want our people to feel? Can we go and ask what needs to happen for them to feel that way and develop an action plan that connects the organisation’s strategic vision to that person who works fon the front line? 

In terms of creating a more holistic employee experience programme, let's say somebody asks you for best practices. What would you suggest to get started on a simple level and then start to build up towards bigger goals?

On a basic level,  thinking from the perspective of an individual employee is what I like to do. One of the projects I led on was around stress, and it was asking what is that process for somebody to start feeling stressed, or even before they start feeling stressed, what steps do they need to go through? What we've identified through interviews and talking to the teams involved is that different people will go through different routes.

To me, that sounds like there's no clarity. And when you are stressed, one thing you want is clarity on what support is available and where to access it.  Corporate companies and consumer-facing companies always think about user experience, and I think we need to think in that same way because our people are our customers. So if I was to give a single piece of advice, I’d say listen to your users and act on what you hear, remove barriers, simplify processes and bring in new things when your users need them. 

How do you keep learning and evolving? Any particular modalities or mechanisms that help you learn and get better at what you do?

A lot of my learning happens through my PhD, which I do outside of my work, which is a deep expertise but on a pretty narrow topic. I try to network and interact with people either through events or LinkedIn, and look outside of the organisation at what best practice is.

I am also a big fan of  coaching, just having someone to sit and reflect on things with and someone challenging your thinking is helpful. Also a good book is a great way to learn, although with all the reading I have to do for my PhD, I don’t remember the last time I finished a book, although I started a few and they pile up on my night stand waiting for their time to be finished.