The NHS Staff Survey provides a wealth of data which trusts can use to help shape their local approach to people management. Data from the survey can:
- help identify shifts in staff experience which, in the long term, will impact on patient care
- provide information on the key workforce issues such as staff engagement, health and wellbeing and equality
- identify the issues in an organisational culture
- give insight into staff views on the role of line managers, raising concerns and staffing levels.
It should be assessed alongside other data such as the Staff Friends and Family Test (Staff FFT), locally designed surveys and workforce information from Electronic Staff Records.
The survey enables trusts to compare their year on year improvement on any of the indicators, whether these are key findings such as the overall level of staff engagement or individual questions such as the questions around staffing levels. The annual level of increase should be compared with the average trend to see if the organisation is out performing the wider trend. Comparison can also be made with other organisations although it is best to compare with organisations of a similar type.
Areas for analysis
The main areas of staff experience which are assessed in the survey are:
- staff engagement
- health and wellbeing
- people management and organisational culture
- patient care
- ongoing action
- responding to the survey
- data sources.
The survey can provide a guide to levels of staff satisfaction, motivation, involvement and willingness to recommend the organisation (known as advocacy). Satisfaction and motivation are complex and the survey provides details on the underlying issues. For example, the survey gives data on how staff feel about the way the organisation treats them (the question about whether staff feel valued) and their enthusiasm towards their job. The extent to which staff feel valued by their organisation does appear to vary between employers, whereas other indicators of motivation appear more linked to occupation.
The survey has a range of questions about the level of staff involvement. This tends to vary a lot between organisations and although it has improved in recent years it is quite low on some measures. The involvement indicators give a good measure of the impact on engagement initiatives.
The willingness to recommend the trust as a place to work is an important overall proxy for staff experience and is variable between organisations. It can be compared with the similar question in the Staff FFT and may be a factor that impacts on recruitment and retention.
Health and wellbeing
The survey provides data on individual health and wellbeing status such as feelings of stress, data on attendance (especially attendance when unwell which should be seen alongside absence data) and training in health and safety. In addition it shows whether staff have confidence in the health and wellbeing support available from their line manager and whether they feel the organisation is taking action to promote health and wellbeing. This will be increasingly relevant in the light of the focus on action on health and wellbeing in the NHS Five Year Forward View. It also provides the only data source on self-reported levels of violence, bullying and harassment. This data can be compared with the number of reported cases to give an indication of actual scale and trends.
The survey provides invaluable information on equality issues. It gives staff a chance to give their view on whether the organisation provides equality of opportunity which is a useful test of effectiveness. In addition because all questions can be broken down by demographic characteristics the differences in experience between different groups of staff can be seen. On the NHS Staff Survey website there is table comparing overall answers on perception of fairness between Black and Minority Ethnic (BME) staff and non BME staff.
People management and organisational culture
The survey has a range of questions which are indicators of overall people management. On appraisal and training related questions the survey provides a good measure of effectiveness.
The survey gives a wide range of information on the work of line managers. This could be used to develop development support for line managers to ensure that they are able to carry out their role most effectively.
Organisational culture has come to be seen as a key factor in effective performance. The survey gives data on how senior managers are perceived and how it deals with errors and incidents. It also looks at whether staff are aware of and feel confident in raising concerns.
The question on adequacy of staffing levels should be correlated with other staffing data to assess impact of staffing changes and with data from patients to identify areas of concern. A number of trusts have begun to assess staff and patient data on a regular basis to identify and resolve issues at an early stage.
Overall staff experience has been shown to affect patient care. The survey has a number of patient care related questions which, taken together with other information, provide a good proxy for staff on views on quality of care. The questions on whether staff believe staff care is the top priority of their organisation, whether they feel able to deliver the care they aspire to and whether patient feedback is used for improvement, are useful indicators. The overall barometer question is whether staff would recommend their organisation as a place to be treated. This can be compared with the similar question in the Staff FFT and with data from patient FFT.
- Leicestershire Partnership NHS Trust integrate the use of survey data as part of ongoing work rather than doing a one off response.
- Leeds Teaching Hospitals Trust analysed data from its national survey alongside data from its own extensive discussions with staff to identify priority areas.
- Wrightington, Wigan and Leigh NHS Foundation Trust has developed a diagnostic survey tool to gain more understanding of staff views.
Boards need to be made aware of key issues raised in the survey and how they are being addressed. In particular what the survey data says about issues such as quality of care and staffing levels should be of interest to board members. The survey data is now used by the Care Quality Commission and Monitor as part of their ongoing monitoring.
Responding to the survey
It's important that staff know that management have responded to the issues identified in the survey as this helps address the perception that nothing is done with the survey results which can lower future response rates. Many trusts produce you said, we did communications which demonstrates issues are being addressed. It is also important to show where issues are not acted on you said, we didn't do and clearly explaining why.
Ideally the survey should be one part of an ongoing system of getting feedback from staff. Where possible it should provide the basis for partnership working with staff on issues like bullying and harassment.