NHS Staff Survey 2018


NHS England released the results of the 2018 NHS Staff Survey on Tuesday 26 February 2019. The feedback in the annual survey suggests that the NHS is still struggling to provide care against increasing demand, but staff are reporting improvements.

Over 497,000 NHS staff took part in the survey with a response rate of 45.7 per cent and just under 10,000 more people shared their views compared to the 2017 survey.

The main change in the format of this year’s survey is a reduced number of summary indicators and instead the questions have been presented in the form of ten main themes:

  • equality, diversity & inclusion
  • health and wellbeing
  • immediate managers (which includes providing support and feedback)
  • morale (a new area for 2018)
  • quality of appraisals
  • quality of care
  • safe environment - bullying and harassment
  • safe environment - violence
  • safety culture 
  • staff engagement.


The results of the 2018 NHS Staff Survey still show a service struggling to provide care against increasing demands.  However, staff have reported improvements in a number of areas when compared to 2017, including staff motivation and pay, job satisfaction, recognition and feeling valued.

Although some aspects of the survey have improved, we are aware that staff are reporting feeling stressed. Staff have reported that we have more to do to support their health and wellbeing and to create an environment free from discrimination and bullying.

A new question measuring morale reported a score of 6.1 (out of 10).  These scores are different depending on the type of trust staff work in, ranging from 5.6 for staff at ambulance trusts to 6.2 for those at combined mental health/learning disability and community trusts.

Work currently underway to implement the workforce aspects of the NHS Long Term Plan will focus on these areas so that the positive experience of some staff becomes the positive experience of all. 


Of the ten themes in the survey, five have seen improvements, these are; immediate managers, quality of appraisals, safety culture, safe environment - violence and staff engagement, which have seen their highest theme scores of the last five years.  Questions are now all scored out of 10.

  • The safety culture theme score has increased from 6.64 in 2017 to 6.69 in 2018.
  • The safe environment from violence score has increased from 9.40 to 9.44 in 2018. 
  • The staff engagement theme score has increased from 6.96 to 7.00 in 2018. 
  • Line manager support increased to 6.83 and quality of appraisals to 5.46, which have seen a year on year increase for the last four years.
  • There was also a sustained improvement for safety culture to 6.69. 

There are four theme scores that show a deterioration compared to 2017. These are equality, diversity and inclusion, health and wellbeing, quality of care and safe environment from bullying and harassment.

  • The health and wellbeing score has decreased from 5.99 in 2017 to 5.90 in 2018. This includes increases in the proportion of staff who have experienced musculoskeletal (MSK) problems as a result of work activities (28 per cent in 2018) and those who have felt unwell as a result of work-related stress (40 per cent) in the last 12 months. 
  • The proportion of staff who are satisfied with the quality of care they can give (81 per cent) as well as the proportion of staff who feel their role makes a difference to patients (89 per cent) both decreased in 2018, to the lowest values of the last four years.
  • 19 per cent of staff report personally having experienced harassment, bullying or abuse at work from other colleagues in the previous twelve months, a 1.1 per cent point increase from 2017, and 13 per cent of staff report experiencing this from managers (an increase of 0.3 percent points from 2017). 
  • Staff experience of equality, diversity and inclusion also decreased further to 9.01 and bullying and harassment to 7.98.  
Further information and more detailed analysis can be found on the NHS staff survey website.

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