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Editorial Tuesday 23 February 2016: The NHS staff survey in detail

The latest version of the NHS staff survey shows a welcome improvement in the 'overall engagement' score.

"Over half of all staff (58%) report that they often or always look forward in going to work, with 74% of staff feeling enthusiastic about their job"

Jolly good. It also finds that, at headline levels, "seventy-three percent of staff agreed or strongly agreed that there are frequent opportunities for them to show initiative in their role and 75% reported that they are able to make suggestions to improve the work of their team or department. A slightly lower proportion, 56%, said they are able to make improvements happen in their area of work.

"Seventy-three percent of staff agreed or strongly agreed that care of patients/service users is their organisation’s top priority, and 59% said they would recommend their organisation as a place to work. When asked whether, if a friend or relative needed treatment, they would be happy with the standard of care provided by their organisation, 69% of staff agreed or strongly agreed."

Some positive signals here, and a few worrying ones.

Firstly, only just over half of those surveyed report they can make improvements happen in their area of work. That sounds like a very disempowered workforce.

Deeper in the detail, we find that "forty-two percent of staff agreed that their role makes a difference to patients/service users, with the largest proportion of staff (49%) saying they neither agreed nor disagreed that this was the case.

"Similarly, only 39% of staff agreed that they felt satisfied with the quality of care they provide to patients – although a further 45% said that they ‘neither agreed nor disagreed’ with the statement.

"Even fewer staff (34%) reported feeling able to deliver the patient care they aspire to, but again a substantial proportion (38%) said that they ‘neither agreed nor disagreed’ with the statement, while 4% indicated that it was not applicable to them".

Ahem. Not so good.

Less good still is the resource issue responses: "only 55% of staff felt that they had adequate supplies or equipment to do their job effectively. Similarly, there were concerns about the numbers of staff available.

"Only 31% of staff agreed that “there are enough staff at [their] organisation for [them] to do [their] job properly”, almost half of all staff (48%) disagreed or strongly disagreed with this statement.

"Related to this, many staff do not feel they are able to meet all the conflicting demands on their time at work: only 43% agreed that they were able to manage these demands, whilst nearly one in three (31%) disagreed".

On training, we find that "of those staff who had had recent training, less than a quarter (24%) agreed that it had enabled them to perform in their role more effectively and a similar proportion (28%) felt that the training allowed them to provide a better service to patients or service users".


Not quite as bad as staff, engagement, though: this sucks: "whilst over four-fifths (82%) report that they know who the senior managers are at their organisation, only just over a third (38%) agreed that communication between senior management and staff was effective.

"Even fewer staff (32%) felt that senior management tried to involve staff in important decisions, and only 30% reported that senior managers acted on the feedback given by staff".

The chances of the current change agenda succeeding without bringing the workforce with them? Nil, at best.

Secondly, there has been a big, whacking change to the question about happiness to receive care from your organisation. It has been recalibrated with the Friends And Family test question: this is not as sharp as the original, which asked about 'you or a member of your family'.

Human factors: a long way to go
Third, to err may be human, but it's still not part of the quality and safety agenda as it should be: "When asked whether their organisation treated staff involved in near misses, errors and incidents fairly, less than a quarter of all staff (24%) reported this was the case and 37% said that they did not agree.

"Only 29% agreed that their organisation encouraged staff to report these incidents – although only 11% disagreed.

"When incidents were reported, only 23% of staff felt that action was taken to prevent the error happening again. In addition, only 19% of staff reported that feedback was given by organisation to their staff about any changes that had been made in response to the reported error or incident".