Re: Remote Working in Medicine: The Good, The Bad, and the Barriers

Agreement: 
I Agree
Body: 

Dear Editor,

In response to this paper, we would like to express how exhilarating it is to read a well-balanced, yet positive article.

This is similar in NHS Wales, where remote working is a dream come true for many. But as argued, it comes with barriers. But, barriers TEC Cymru are attempting to remove by working with Welsh Government and NHS Wales.

In 2021, we conducted an All-Wales study looking at the pros and cons of remote working. The aim was to explore the experience of remote working and develop a co-designed, future-proof remote working model for Wales.

See study & infographic on our website (1-4).

Initial recommendations for this model were captured via 999 surveys and focus groups, and revised via a robust peer-review process. Recommendations were based on the preferred method of a ‘blended approach’ which offers dynamic working opportunities, and should be available as an option to all employees that want it.

Recommendation 1:
In appropriate circumstances, the choice of remote working should be at the discretion of the health boards, trusts and managers, supported by professional bodies, occupational health and employee unions. While managerial discretion is a factor, the decision to work remotely ultimately should be based upon individual employee circumstances and the nature of their job role.

Recommendation 2:
The offer of appropriate equipment for remote working to support an ergonomic setup, should be made available to all, but is not mandatory.

Recommendation 3:
Improve IT infrastructure. To include, prioritising improvements to technologies/team work whilst remote working e.g., shared electronic note systems. This will reduce having to double-note (electronic and paper) or retrieve files in-person. There should also be a focus on integrating platforms to streamline the work process rather than operating across numerous systems.

Recommendation 4:
The offer of professional development assessments should be considered on an ad hoc basis, suited to employee needs. This can provide an opportunity for managers to update employees on team developments and define expectations whilst working remotely e.g., expectations for responding to emails ‘out of hours’ and taking breaks. This aims to prevent employees from feeling overburdened, guilty or burnt out. This can also be an opportunity for the discussion of employee progress, whilst placing no pressure upon employees to share difficulties if they do not wish.

Recommendation 5:
Different individuals want different things from working relationships. Whilst some employees may want to maintain strictly professional working relationships within working hours, others may want more personal connections with colleagues. All colleagues need to feel that they are equally supported/appreciated in their professional roles, such as receiving feedback, praise or constructive criticism.

Recommendation 6:
Whilst some employees may be suited to remote working, others may find this a challenge. Thus, employee mental health and emotional wellbeing should be a priority. Resources to support wellbeing on an individual basis should be available (e.g., self-help guides), while also considering the need for support from managers.

Recommendation 7:
A need to tackle the loneliness and social exclusion that can occur whilst remote working. Regular meetings and the offer of talking lunches or work-based social media group chats can support this.

In conclusion, remote working at the time of the above study, was a new concept for many , and therefore ongoing evaluation and revision of recommendations is needed.

An example of this, is a joint study TEC Cymru are now doing with an NHS England trust, pilot testing 100% remote working with full-time Consultant Psychiatrists. This will evaluate the application process, plus a 1-year in-depth study of the virtual roles. If this proves successful, this would significantly improve future NHS recruitment and retainment.

https://digitalhealth.wales/tec-cymru
https://digitalhealth.wales/sites/default/files/2021-09/20210917%20TEC%2…
https://digitalhealth.wales/sites/default/files/2021-12/20211213%20WFH%2…
https://digitalhealth.wales/sites/default/files/2021-09/Welsh%20Home%20W…

No competing Interests: 
Yes
The following competing Interests: 
Electronic Publication Date: 
Tuesday, November 8, 2022 – 14:26
Workflow State: 
Released
Full Title: 

Re: Remote Working in Medicine: The Good, The Bad, and the Barriers

Check this box if you would like your letter to appear anonymously:: 
Last Name: 
Johns
First name and middle initial: 
Gemma
Address: 
Technology Enabled Care Cymru, Mamhilad House, NP4 0YP
Occupation: 
Head of Research
Other Authors: 
Bethan Whistance, Sara Khalil, Mike Ogonovsky & Professor Alka Ahuja
BMJ: Additional Article Info: 
Rapid response
Twitter: 
@teccymru

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