We want to make the NHS a better place to work, and be transparent about improvements and failings, says Dean Royles
It’s that time of year when trusts take stock of the results of the NHS staff survey. It’s important they do because the learning it can give is immense.
We also owe it to patients to engage with the findings. Well managed and supported staff deliver better care, especially where staff and managers collaborate.
With over 200,000 responses, it is the world’s largest survey of staff opinions, and provides points for reflection. Given it’s the year after the Francis report was published, the results are significant. It lets us think about where we are going and where we can improve. We can all ask ourselves - managers and staff - “What will I do to ensure I enjoy work more this year?”
The results matter - we want to make the NHS a better place to work and be transparent about improvements and failings. In addition, having engaged and motivated employees and managers (yes, managers are employees too, most of them clinicians with a case load) leads to better care.
“The ultimate aim is to provide an environment where patients are protected and staff can raise concerns”
What do the results tell us? It’s pleasing to see more staff are having appraisals, communication is better and job satisfaction scores have risen. The standout result for me was that nine out of 10 staff say their work makes a difference to patients.
I certainly get a sense when I visit organisations of a renewed focus of working with and valuing staff. This is positive and more than a response to Francis.
However, some indicators stand out starkly, such as bullying and harassment, staffing levels, raising concerns and health and wellbeing.
I struggle to come to terms with the number of staff on the receiving end of violence or abuse from patients and the public. This year, almost 30% of staff experienced bullying, abuse or harassment, a finding that will shock any right-minded person. While I appreciate stress and anxiety among patients and families can be high, there is no justification for violence or abuse of any kind against those whose purpose is to provide care.
The Friends and Family Test is intended to shine a spotlight on patients’ experience - what about the view from the coalface? It is telling that 69% of staff have confidence in care quality, which is heading in the right way, but there is room for improvement. The introduction of a staff Friends and Family Test in the spring will inform this.
Most staff - 89% - know how to raise concerns but 14% have little or no confidence that concerns will be taken seriously. While 90% of staff who saw potentially harmful incidents reported them, too many staff feel unsupported, so blow the whistle. If someone has to blow the whistle, something has gone wrong. Problems are exacerbated when staff raise concerns and are victimised for doing so.
The ultimate aim is to provide an environment where patients are protected and staff can raise concerns. We are not there yet, but change is afoot to embed the right kind of culture. We need the whole system − regulators, government, commissioners and scrutineers − to set the right tone too.
With over a million NHS workers, we are never going to get it right all the time. But, with better results in 21 out of the 28 categories, we are seeing year on year improvements.
I’d like to end on a word that featured throughout the Francis report − compassion. Next month, the Care Maker programme is focusing on compassion in practice. NHS Employers is involved in events with the chief nursing officer at NHS England. Compassion is an area where an individual can make a huge difference to patients and their experience of care. Sceptical? Then take five minutes to view this video of the Hello My Name is… campaign. Get the tissues out….
Dean Royles is director of NHS Employers