NHS Staff Survey 2019 - progress and challenges

Meeting for finance

The results for the 2019 NHS Staff Survey highlight continuing pressures on NHS staff, but also progress on key issues.

  • Five of the eleven key themes improved, these include immediate managers, morale, quality of appraisal, quality of care and safety culture. 
  • There has been positive progress in the area of people management such as the role of the line manager and the experience of appraisal, but no improvement on other indicators.
  • There was no change to the overall score for health and wellbeing.
  • The staff engagement score held stable.
  • Scores for bullying and harassment and violence did not improve.

Key themes

The overall key theme scores highlight an improvement in some individual questions, for example:

  • The percentage of staff who would recommend the organisation as a place to work rose to 63 per cent (up by 1.7 per cent from 2018). 
  • There was also an increase in staff feeling valued by their organisation, this rose to 48 per cent (up by 1.9 per cent) and 74 per cent of staff feel enthusiastic about their jobs.
  • There was a noticeable shift in the percentage of staff satisfied with their level of pay which increased to 38 per cent (up by 1.7 per cent). 
  • The percentage of staff saying they feel valued by their organisation also rose by 1.9 per cent to 48 per cent.

The survey results are reported across eleven key themes which group questions in the following areas:

Line managers

Most of the questions in relation to line managers improved. 71 per cent of staff said they were satisfied with the overall level of support from their line manager and there was a particular improvement in staff feeling supported on health and wellbeing. (1.3 percentage points increase from 2018 to 69.7 per cent in 2019).

Staff engagement

The overall score for staff engagement did not improve, although there was a small improvement in both the motivation element and the advocacy dimensions of engagement. The motivation score improved due to increase in staff reporting they are enthusiastic about their jobs. The advocacy element improved due to the increase in staff being willing to recommend the NHS as a place to work. The involvement questions within the staff engagement score did not improve and overall the score remained stable.

Health and wellbeing

The overall score for health and wellbeing did not improve but there were improvements in the question that relates to organisational action on health and wellbeing. 29.3 per cent of staff reported positive action on health and wellbeing by their employer (up from 28.6 per cent in 2018).

The measures of individual staff experience on health and wellbeing by contrast did not improve, with 40.3 per cent of staff reporting feeling unwell as a result of work-related stress, up by 0.5 per cent since 2018. The other health and wellbeing indicators remained broadly stable. 

Freedom to speak up

All of the questions in this area improved, contributing to the overall improvement in the key theme for safety culture. 60 per cent reported that they would feel confident that their organisation would address their concerns (1.3 percentage point increase from 2018).


There is a complex picture in relation to equalities. The overall key theme indicator has remained the same. There has been some progress on indicators used as part of the WRES and WDES but the disparity in experience between different staff groups remains significant. Staff confidence that organisations provide equal opportunities has improved overall and the disparity in experience on this indicator has also improved.


The staff survey includes a question on whether staff have considered leaving the organisation, although this is not considered a direct predictor of whether staff will leave it can be a barometer of staff feeling. The question was introduced in 2018 and this is first year for which there is trend data. Overall the percentage of staff considering leaving the organisation fell slightly but remained sizeable at 21 per cent.

Further information

The full results of the 2019 NHS Staff Survey are published on the NHS Staff Survey website along with briefings from the national staff survey centre on overall themes, benchmarking reports and five yearly trends.

A more detailed analysis on key aspects of the survey such as staff engagement and health and wellbeing will be added to this website over the next week.


Why Register?

Great reasons to register with NHS Employers

  • A personalised website
    Manage your profile and select topics of interest to you
  • Access your dashboard
    Bookmark useful content to help you quickly find what you're looking for
  • Get involved
    Contribute to our Talking Points discussions, comment on and rate our webpages
  • Keep up to date
    Receive the latest newsletters and media summaries

Log In