Steven Weeks, policy manager at NHS Employers, reflects on the 2020 NHS Staff Survey, the results of which were published on Thursday 11 March 2021.
The NHS Staff Survey 2020 showed staff in the service under severe pressure but still positive about working for the NHS. The overall indicators in the survey were broadly stable, which is a great achievement in the circumstances. There was an improvement on the health and wellbeing measure with the remaining indicators stable and a fall on the team working score. The improvement in the health and wellbeing score reflected the range of support that has been provided from national and local initiatives.
The staff engagement score holding stable is a also a tribute to the innovative adaptation of staff engagement methods during COVID-19. There are, however, many challenges within the data as well. The team working score and immediate manager scores were adversely affected by the disruptive impact of COVID-19. Bullying and harassment and violence levels remain far too high. Already high stress levels rose even further. Those working on CPVI wards felt far less positive. The most glaring and concerning figures though are those demonstrating the deep-seated discrimination experienced by BME staff and disabled staff. Progress on WRES and WDES measures has been very limited.
Staff engagement and advocacy
It was positive to see that the staff engagement score held up at seven (on a ten-point scale). The overall score combines the scores for the nine individual questions within the survey. These measure different dimensions of engagement and there were different trends in each of the elements. There are measures of job satisfaction (where the NHS has traditionally scored highly, but there was small fall this year), and of staff involvement (which also fell slightly). The overall score was boosted by an increase in advocacy, ie staff willingness to recommend the NHS as a place to work, which rose from 63 per cent to 66 per cent.
The questions on how staff view their jobs are likely to reflect the pressures of the pandemic. Overall, job enthusiasm fell from 75 per cent to 73 per cent. There was also a small decrease in those who look forward to going to work (0.8 percentage point decrease to 58.7 per cent in 2020). However, these are still remarkably high and reflect the commitment of staff to their jobs and the sense of pride they feel in the NHS during the pandemic.
Opportunities for involvement and to make improvement
There may also have been a fall in opportunities to be involved in the pandemic. There were reductions in the proportions of staff who felt able to make suggestions to improve the work of their team or department (1.0 percentage point decrease to 73.0 per cent in 2020); make improvements happen in their area of work (0.7 percentage point decrease to 55.2 per cent in 2020); and frequently show initiative within their role (0.8 percentage point decrease to 72.1 per cent in 2020). These scores remain high but with scope for improvement. A sizeable minority of trusts made progress in this area with innovative ideas despite the context. NHS Employers has highlighted examples in case studies and at recent events. We will be seeking to understand and spread insights into supporting greater involvement as organisations move forward.
The scores for perception of senior managers remained low, although there was an improvement in view on communication with staff, perhaps due to the impact of greater visible leadership in many organisations and virtual feedback forums in others. It is a concern that figures on all these measures were lower for staff working on COVID-19 wards and on most measures for BME staff.
NHS Employers will be sharing ideas and learning from organisations that made progress during the pandemic, including those that made innovative use of technology and adapted existing surveys, using everything from tea trolleys to 'corridor conversations,' working with equality networks and partnership working with staff side organisations.
As we approach the anniversary, we hope to bring some learning out of the terrible crisis. We hope that the spirit of trust, staff involvement and appreciation of staff that was shown in most of the NHS in the early spring and summer and sustained in most areas in autumn can be taken forward as we move to a sustainable recovery.