Many nurses and midwives say they often think about leaving their job, with a significant proportion considering quitting healthcare altogether, shows the latest staff survey results.
The NHS Staff Survey 2018, which for the first time asked staff if they were thinking of moving on, shows 30.5% of registered nurses and midwives said they often thought about leaving their organisation.
“The government and NHS England must listen and redouble efforts to keep staff in post”
The majority said they would probably continue working in the health service. However, nearly 9% said they would seek a role outside the NHS, while a significant proportion – 11.6% – revealed they would probably look for a job outside healthcare.
More than a quarter – 26.5% – who were thinking of leaving said they would like to find another job within their current organisation, while 31.3% said they would seek employment with another NHS employer.
A significant proportion – 15% – said they would quit as soon as they found another job. More than a fifth – 20.9% said they would probably look for a job at a new organisation within the next 12 months.
The 2018 staff survey is the biggest to date, gathering responses from 490,000 NHS workers including nurses, midwives and healthcare assistants.
Results show some positive trends, including when it came to staff feeling valued by their organisation and being recognised for good work, with an ongoing improvement in the quality of appraisals.
“Today’s results underline the need to change and improve the culture of the NHS”
Meanwhile, an increasing number of staff seem to be reasonably happy with the amount they are paid. The 2018 results show more than a third of nurses and midwives – 33.6% – were either satisfied or very satisfied with their wage packet, up from 27.5% in 2017.
However, this is below satisfaction levels in 2015 when 35.7% of nurses and midwives reported being okay with the amount they earned.
The survey shows ongoing problems, including concerns about staffing levels and workload and issues like violence and bullying.
Less than a third – 28.3% – of nurses and midwives reported there were enough staff in their organisation for them to do their jobs properly, although this is up from 27% the previous year and has been climbing steadily since 2014.
Only around two in five – 41% – of nurses and midwives said they were able to meet all the conflicting demands on their time at work but again this was up from 39.6% in 2017.
Just 15% of nurses and midwives said they never or rarely experienced “unrealistic time pressures”.
The majority – 78.8% – said they satisfied with the quality of care they gave patients – a slight increase on the previous year but down from 80.8% in 2016.
Nearly a quarter – 23.6% – of nurses and midwives said they had experienced at least one incidence of physical violence by patients or relatives in the past year, while 39.5% said they had experienced at least one incident of bullying, harassment or abuse.
Nearly 15% said they experienced bullying, abuse or harassment by managers, while more than one in five – 21.9% – said they had been bullied, harassed or abused by colleagues with the proportion rising each year since 2015.
The survey findings suggest an overall decline in staff health and wellbeing, with just 28.6% saying their organisation took positive action, down from 31.8% in 2017.
Just over a quarter – 25.9% – of nurses and midwives said their organisation definitely took positive steps to improve staff wellbeing down from 28.6% in 2017.
Meanwhile, the 2018 survey results show an increasing proportion of nurses and midwives say they have been made ill by work-related stress.
In all, 43.5% of registered nurses and midwives say they had felt unwell in the past 12 months due to stress caused by work. This is up from 42.6% the previous year and 40.9% in 2016.
sara gorton for index
Staff were also asked to rate their morale for the first time on a 10-point scale. The average score for nurses and midwives was six.
The union Unison said the pressures on staff meant it was understandable that some simply wanted to get out.
“With so few staff, it’s no wonder the pressures of working in the NHS are making so many health workers ill,” said Unison’s head of health Sara Gorton
“The combination of rising stress levels along with bullying and bad behaviour from managers and colleagues shows the pressure is really getting to staff,” she said. “It’s a testament to them that they keep going, but the government can’t expect this to continue.”
Dame Donna Kinnair, acting chief executive and general secretary of the Royal College of Nursing, said: “When close to a third of staff are thinking of going, the government and NHS England must listen and redouble efforts to keep staff in post as well finding thousands of new recruits.
“Half of all staff have raised low staffing levels as an issue, more are saying they are working unpaid overtime to keep the service running and increasing numbers report seeing errors that could harm patients,” she said.
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Source: Kate Stanworth
“These are all indicative of a health service with a cavernous gap between the number of staff it has, and what it actually needs to meet demand,” she added.
Suzie Bailey, director of leadership and organisational Development at the influential King’s Fund think-tank, said the survey highlighted the scale of the “workforce crisis”.
“The service needs to do everything it can to retain staff, so it is deeply worrying that stress levels have hit a 5-year high,” she said.
“It is simply unacceptable that so many NHS staff face abuse and discrimination from their colleagues at work,” she said. “Action is needed at every level of the health service to create environments where staff can do their very best work.”
However, she said it was “good news” that more employees reported feeling valued and recognised for their efforts.
Neil Churchill, director of patient experience at NHS England, said it was important trusts were doing all they could to support staff “who regularly go the extra mile for their patients”.
“Whilst there are a number of positives in this year’s survey, it is also clear that local employers can do more to improve and we would expect all trusts to listen to the results from their staff survey and take appropriate action,” he said.
Interim proposals from the NHS Workforce Implementation Plan, which forms part of the new NHS Long Term Plan, are due to be published in April.
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Baroness Dido Harding, who is chair of NHS Improvement and leading on the implementation plan, said: “Today’s results underline the need to change and improve the culture of the NHS to make sure every member of staff is supported to develop and thrive.
“A key part of the workforce implementation plan is looking at how we can make the NHS the best place to work for current and future staff and to improve our leadership capabilities at team, organisation and system levels,” she said.
Saffron Cordery, deputy chief executive of NHS Providers, said: “In spite of the pressures they face NHS staff remain positive and dedicated to the NHS.
“It is welcome that the recent Agenda for Change reforms have improved staff satisfaction with pay,” she said. “Relationships with managers have improved and more respondents have recommended their organisation as a good place to work.
“But it is clear that rota gaps and staff shortages are piling pressure onto existing staff,” she said. “More staff are reporting that their health and wellbeing has been impacted by work-related stress while satisfaction with the quality of work and care they can provide has fallen.”
She added: “We can only address workforce challenges by urgently tackling the growing number of vacancies within trusts and ensuring people want to stay within the NHS.”
- 2017: NHS staff survey shows rise in stress levels, staffing concerns and attacks
- 2016: Rise in NHS staff survey scores ‘perhaps surprising’
- 2015: More staff working extra hours, reveals annual NHS survey
- 2014: Third of NHS staff do not feel secure about raising care concerns
- 2013: Third of NHS staff have seen patient safety ‘near miss’
- 2012: Less than two thirds of NHS workforce would recommend their trust
- 2011: NHS staff feel excluded amid growing job security fears
- 2009: NHS staff complain of lack of support in survey