This thesis consists of three chapters, the first chapter is a systematic literature review investigating staff’s experiences of burnout during the covid-19 pandemic. Thematic-meta-synthesis was used to analyse the available data, which was extracted from 11 selected papers during which seven themes were identified: ‘our hands were tied’, ‘you put yourself last’, ‘hey we’re all here, where are you?’, ‘we weren’t prepared (for the unpreparable)’, ‘our voices were quashed’. Finally, the seventh theme ‘I found that really hard’ described how the challenges of working through the pandemic impacted staff, overarching all the prior 6 themes. The findings highlighted several cultural aspects of working in the NHS which negatively impacted on staff’s wellbeing during the covid-19 pandemic.
Chapter two investigates staff’s perspectives on their ability to speak up during multidisciplinary team (MDT) meetings. Semi-structured interviews were conducted with 11 team members of a Child and Adolescent Mental Health Service, analysed using thematic analysis. Four themes were identified: ‘Control Vs Collaboration’, ‘Expectation Vs Reality’, ‘Conflicting Vs Motivational responsibilities’ and ‘Connection’. The findings highlighted how staff’s experience of being in positions of threat and working under hierarchical structures impacted their ability to speak up within MDT meetings. The findings also suggest that a change in culture from a hierarchically based team culture to a leadership-based team culture may enable staff feeling able to speak more freely in MDT meetings. The third chapter explores the implications of findings from the previous two chapters and their contributions to existing theory and or clinical practice. It also includes a reflective section providing personal reflections on the process of completing the research.