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Staff survey shows progress and spells out where more effort is required

The 2018 NHS staff survey is out and draws a mixed picture. More than 300 NHS organisations took part in the survey, including all 230 Trusts in England, and 497,117 staff responded.


Among the key changes in the 2018 results compared with 2017 are improved staff satisfaction with pay levels (+5.1%), how they are recognised for good work (+3.1%) and how their organisation values their work (+3.7%). More staff are reporting errors, near misses or incidents that could have hurt patients (+2.8%) and there is a 4% increase in the number who feel their organisation treats staff who are involved in such an event fairly. 


However, in spite of emphasis on health and wellbeing in recent years, these indicators are down with a fall in the number of staff who feel their organisation definitely takes positive action on health and wellbeing (-3.2%) and an increase in those experiencing musculoskeletal problems as a result of work activities (+1.8%). 39.8% of staff also reported feeling unwell as a result of work-related stress in the last 12 months. This is the worst result for this measure in the last five years. 


Other areas that have been a focus for improvement for the NHS in recent years include equality, diversity and inclusion, and bullying/harassment. It is clear that the NHS is right to focus on these areas and it is equally clear that even more needs to be done as efforts to-date are not translating into positive progress. 


The provision of equal opportunities has been on a downward trend since 2014 and in these latest figures has fallen again by 0.8% to 83.4%. Support for staff with a disability or long-term condition has also been on a steady decline since 2016 and in 2018 stands at just 72.9%. Discrimination, on the other hand, has been steadily worsening since 2015 and this trend is continuing with an increase of 0.3% to 6.9% of staff reporting experiencing discrimination from service users, patients or members of the public. Numbers reporting discrimination from managers or colleagues remains the same as in 2017 at 8.1%.


Bullying and harassment is also continuing to grow, with slight increases to staff experiencing at least one incident of bullying, harassment or abuse from patients/service users, their relatives or other members of the public (+0.2%), from managers (+0.4%) and from other colleagues (+1%). At national level the reporting of bullying, harassment and physical violence when they are witnessed has gone down (-0.5%), as has reporting of physical violence (-1.5%).


Staff retention is another important area for the NHS which is facing growing vacancies and skills shortages. It would seem that the NHS is actually doing quite well on staff retention with 48.9% of staff saying they were not considering leaving their current job. Of those that said they were thinking of leaving, the majority would look for a job at a different NHS organisation (16.4%) or another job within their existing organisation (13.7%). Some want to take a career break (9.2%) and others want to move to a job outside healthcare (7.5%). Only 4.3% said they want to stay in healthcare but not with the NHS.


The biggest failure highlighted in the survey is around non-mandatory training, learning or development, which is now at its lowest level in four years, with only 70.9% of staff reporting having received any. This continues the year-on-year decline since 2016.


Staff are also less satisfied with the quality of care they give to patients/service users (-2%) although there is a slight increase (+0.4%) in those who said they are able to deliver the level of care they aspire to.


Responding to the survey results, Saffron Cordery, Deputy Chief Executive of NHS Providers, says: In spite of the pressures they face NHS staff remain positive and dedicated to the NHS.

“It is welcome that the recent Agenda for Change reforms have improved staff satisfaction with pay. Relationships with managers have improved and more respondents have recommended their organisation as a good place to work.


“But it is clear that rota gaps and staff shortages are piling pressure onto existing staff. More staff are reporting that their health and wellbeing has been impacted by work-related stress while satisfaction with the quality of work and care they can provide has fallen. It is disappointing to see that more staff are experiencing instances of bullying or harassment by colleagues. 


“We can only address workforce challenges by urgently tackling the growing number of vacancies within trusts and ensuring people want to stay within the NHS. To do this, we must ensure that staff feel valued, are supported and have equal opportunities to develop their careers.”


Download the full survey here.