Steven's view: NHS Staff Survey 2018

Steven Weeks

Steven Weeks, policy manager at NHS Employers, has written this blog following the publication of the 2018 NHS Staff Survey results with a focus on the staff engagement scores.

Staff engagement was one of the areas of the 2018 NHS Staff Survey where the overall indicator remained broadly stable (at seven out of ten). On top of this, there were improvements in key individual dimensions of the overall score. In my view, sustaining staff engagement is a considerable achievement in the current context of the NHS and the pressures on staff.

The staff engagement score is calculated from individual questions covering three dimensions of engagement (motivation, involvement and advocacy). The main improvement was in advocacy, with the percentage of staff willing to recommend their employer as a place to work rising from 59.6 to 61.5 per cent and improvements in willingness to recommend care in the NHS. Motivation levels remained high with 74.3 per cent of staff reporting that they are enthusiastic about their jobs (up from 73.5 per cent in 2017). The measures for involvement remained broadly stable compared to 2017; 74.3 per cent said they are able to make suggestions to improve the work of their team or department while 55.9 per cent said they were able to make these changes happen.

These figures suggest that staff engagement has held up despite growing pressures on the service and show that staff have positive commitment to their role and employment. However, it is clear that the progress that was made in the period 2013-17 has become difficult to maintain. It is also clear that there is scope to improve levels of staff involvement, with a sizeable gap between staff feeling they can put forward ideas for improvement as compared with feeling their ideas can be implemented.

Although overall figures remained stable, there was a considerable degree of movement with 39 organisations making a significant improvement in their NHS Staff Survey scores. This was an increase on 2017 and included a number that have had long-term staff engagement challenges. The number of organisations which saw a decline in their scores fell to 18 compared to 22 in 2017, and a number of case studies from improvers have been published on the NHS Employers website.

However, while staff engagement showed stability, other areas were not so rosy. Overall results for the 2018 NHS Staff Survey indicate a service under severe strain - health and wellbeing scores in particular highlighting pressures on staff.

We are planning to add more examples of trusts that have improved staff engagement, and these will be added over coming months. If you have examples you would like to share, please get in touch via

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