Acute inpatient mental health services operate under systemic pressures that limit staff capacity for reflective, relational work. Reflective practice groups (RPGs) are widely recommended, yet the experiences of healthcare assistants (HCAs) – who deliver much of the day-to-day relational care – remain underexplored. This paper aims to examine HCAs’ experiences of ward-based RPGs on two male acute inpatient wards and how organisational conditions shaped opportunities to attend and participate.
Seven HCAs who had attended at least one RPG in the previous six months participated in semi-structured interviews. Data were analysed using Framework Analysis. Routine operational records of RPG delivery (attendance and cancellations) across a 57-week period were also reviewed descriptively to contextualise qualitative insights.
HCAs experienced RPGs as a rare, protected space offering emotional decompression, reduced isolation and more empathic understandings of patients. Participants described subtle changes in practice, including reduced reactive responding and greater consistency. Engagement was influenced by confidence, psychological safety and mixed views on leadership presence. RPG delivery was operationally fragile: across 57 weeks, only around one-third of scheduled sessions occurred, with cancellations largely linked to staffing shortages and ward acuity.
This evaluation provides a focused examination of HCAs’ experiences of RPGs in acute inpatient settings. Findings highlight RPGs as a valued but vulnerable resource that helps restore reflective capacity under operational pressures, underscoring the need for organisational conditions that protect reflective time.
