Counselling for NHS Staff: Your Options and Their Limits

7 November 2026

If you work in the NHS, you spend your days looking after other people. When it is your turn to need support, it can be hard to know where to start, and harder still to ask. Most trusts offer something, and there are national services too. Each one helps some people well and leaves gaps for others.

I have worked in the NHS myself, as a high intensity therapist with Let's Talk Wellbeing, which provided NHS talking therapies in Nottingham, and in perinatal mental health services. I have also worked with NHS staff as clients, and the things they bring include burnout and incidents at work. This guide sets out the main routes to support, what each one is good for, and the questions worth asking before you choose.

Support through your trust

Most NHS trusts have more than one kind of staff support, and it is worth finding out what yours offers.

Employee assistance programmes (EAPs). These are run by outside companies such as Health Assured or Vivup and paid for by your trust. They usually offer a 24-hour phone line and a short course of counselling. At Nottingham University Hospitals, for example, the EAP offers structured telephone counselling of up to six sessions per issue (NUH).
Staff counselling or psychology services. Some trusts have their own team, often linked to occupational health, offering short-term counselling and sometimes trauma therapy.
Occupational health. Its main job is to advise you and your manager about your health and your work. It can refer you on for support, but it is not a counselling service in itself. Is occupational health confidential? explains what your manager will and won't see.
Wellbeing teams and peer support. Many trusts run wellbeing hubs, rest spaces, peer supporters and reflective practice sessions such as Schwartz Rounds.

These services are free, quick to reach and confidential, and for many people a few sessions are enough. They are a good place to start.

Where support through work falls short

The reasons NHS staff look outside work for support tend to be much the same.

It can feel too close to home. Even when a service is completely confidential, it may be run from the building you work in, by people who share your canteen. Some staff worry about being seen walking in, or about sitting opposite someone they have worked alongside.

The number of sessions is limited. Six sessions can be plenty for a recent problem. They are often not enough for something that has built up over years, or for a traumatic incident that keeps coming back.

The support may be general. Short-term services are designed for common problems such as stress and low mood. If what you are carrying is a trauma, a death that stays with you, or guilt after something went wrong, you may need someone who works with trauma specifically.

What you can get depends on where you work. Dedicated staff mental health and wellbeing hubs were set up across England in 2021. Most of their national funding was cut in March 2023, and 18 of the original 40 had closed by March 2024 (BPS). Some areas still have one, and many don't.

National services you can use

NHS Practitioner Health is a free, confidential NHS service, originally set up for doctors and dentists. Its website now says that any member of staff working in the NHS in England who feels unable to get confidential care through local routes can contact it (Practitioner Health). It is independent of your employer, which matters to many people. It does not usually take on people who are already being treated by a secondary care mental health service, and it is not designed for complex or long-term conditions.

NHS Talking Therapies is open to anyone in England, and you can refer yourself without seeing your GP. Some staff are wary of using it in their own area, because they may know the team, or may work alongside it. You are entitled to ask about that before you start.

Profession-specific support exists too. Doctors can use the BMA's free counselling line, and nurses can get advice from their union. If you are a doctor, counselling for doctors looks at the options in more detail.

Questions to ask any service before you start

Whichever route you choose, it is reasonable to ask a few questions first. Any good service will be glad to answer them.

Who runs it? Is it your trust, an outside company paid by your trust, a national NHS service or an independent practitioner?
Where are sessions held? On your own site, somewhere else, by phone or by video?
How many sessions can I have? And what happens if I need more?
What is written down, and who can see it? Ask whether anything goes to your manager, occupational health or HR, and in what circumstances.
Who will I see? Ask about their qualifications, their professional body, and whether they have experience of working with healthcare staff.

The answers will tell you a lot about whether a service fits what you need. If anything is unclear, ask again.

When private counselling might suit you better

Private counselling isn't the right choice for everyone, and cost is a real factor. Where it can help is when:

you want someone with no connection to your trust, your team or your area
you need more sessions than a short-term service can offer
you want a therapist who works with trauma, for example using EMDR
you would rather choose the person you see, rather than be allocated someone

Online sessions widen the choice further, because you can see someone well away from where you work. How online sessions work explains what that involves.

Confidentiality and your registration

Many NHS staff hold back from getting help because they worry about their registration. It is worth knowing what the regulators actually say.

The GMC says it only needs to know about a doctor's health condition if it poses a risk to patients (GMC). The NMC asks nurses and midwives to declare at revalidation that their health allows them to practise safely, and the RCN points out that this does not mean having no health condition at all (RCN).

In my own work, I don't share anything with your employer, occupational health, the GMC or the NMC without your agreement, unless there is a serious risk to you or someone else. That is the same in person and online.

What brings NHS staff to counselling

The reasons vary, but some come up again and again.

Burnout. Exhaustion, feeling detached from patients and work you used to care about, and doubting whether you are any good at it. Burnout in the NHS looks at the signs and what helps, and there is a separate guide to burnout in nursing.
Incidents at work. A patient's death, a resuscitation that stays with you, or an incident where something went wrong. Some staff feel guilt or self-doubt long afterwards, whether or not anyone else sees it that way. Second victim syndrome explains this experience.
Moral injury. The distress of not being able to give the care you know a patient needs, because of staffing, beds or time. What is moral injury? explains it in an emergency services setting, and much of it applies to healthcare.
Trauma. Repeated exposure to distressing events can lead to symptoms of PTSD, such as flashbacks, nightmares and feeling constantly on edge.

Frequently asked questions

Do NHS staff get free counselling?

Most trusts offer free short-term counselling through an employee assistance programme or a staff counselling service. NHS Talking Therapies is free to anyone in England, and Practitioner Health is free for those who can use it.

Will my manager find out?

Self-referral to an EAP or staff counselling service is normally confidential. If your manager refers you to occupational health, they will usually receive a report about your fitness for work, which occupational health should discuss with you first.

Can I have EMDR as an NHS employee?

Some trust staff psychology services offer EMDR, but many don't. You can also see a private EMDR practitioner. EMDR therapy explains how it works.

Is it a sign of weakness to need support?

No. Working in healthcare means being around pain, loss and pressure every day. Needing support is a normal response to that, not a failing.

Talking to someone

I'm a BACP registered counsellor offering person centred counselling and EMDR therapy in Nottingham and online. If you would like to ask whether I might be the right fit, you can get in touch before committing to anything.

Sources

More about person centred counselling