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Only a third of NHSE staff think it has a ‘clear vision’

Published on: 16 Oct 2024

A survey showing only a third of NHS England staff believe it has a “clear vision” for the future has been described as ”not as challenging as could be expected” by the organisation. 

It is NHSE’s first full staff survey since its major restructuring and merger with Health Education England and NHS Digital, which has seen around 7,000 posts cut, and widespread irritation with how how the changes were handled.

The summary report from the 2024 staff survey, obtained by HSJ, highlights particular problems with morale, and failures to develop staff.  

Among NHSE’s worst scores were whether staff felt it had a “clear vision for the future” (33 per cent agreed), while only 26 per cent “feel like I am part of my organisation’s vision for the future”, and just 36 per cent agreed the organisation would address staff concerns if they spoke up.

However, an NHSE executive team presentation report on the results (below), also released to HSJ under the Freedom of Information Act, said: “This year’s results should be considered against the backdrop of ongoing organisational change, which can significantly impact staff engagement levels and decreased morale. 

“Independent feedback from our survey providers indicates that the results are not as challenging as could be expected, given the scale and complexity of NHSE’s change programme.”

NHSE’s overall “morale” score was 5.7 – lower than the whole NHS (5.9) and than staff in comparable NHS management/admin roles (6.2).

On the “we are always learning” category – which measures appraisals and support for development – it scored just 4.6, lower than 5.6 for all NHS staff and 5.3 for comparable NHS staff.

NHSE performed better than the NHS as a whole, and than management/admin staff elsewhere, on “recognition and reward”, and “we work flexibly” – despite tensions this year over home working. The survey was carried out in January.

Strategy problems

At the level of NHSE’s 16 different directorates those with biggest problems were strategy (including communications), vaccination and screening, and operations – all of these scored among the bottom five in seven of the eight areas measured, including on “morale” (see chart and table below). The workforce, training and education directorate, which had major problems several years ago, was slightly better (among the bottom five in six measures). 

The best-performing teams were several NHSE regions. The Midlands scored top in seven areas; followed by the East of England, North West, North East and Yorkshire, London. 

Both the Strategy directorate and the South East region received very poor scores in 2022, suggesting deep-seated problems among both teams. The workforce directorate also continues to struggle. 

The survey also revealed a discrepancy in how staff felt NHSE acted on career progression and promotion.

While 47 per cent of white staff said NHSE did, only 31 per cent of staff with an ethnic minority background felt the same. This was 39 per cent for disabled staff, compared to 45 per cent who did not have a disability.

Nearly one in six (15 per cent) said they had experienced bullying and harassment from colleagues within the past 12 months, and one in eight (12 per cent) from managers. The figures for the wider NHS were 17.7 per cent and 9.9 per cent respectively. 

No respondents at all said they had experienced physical violence, from either colleagues or managers, within the past 12 months, nor been the target of unwanted behaviour of a sexual nature.

NHSE said in a statement: ”This is the first staff survey [across all staff since the merger] and we know there has needed to be a period of adjustment as staff were surveyed during the major organisational change programme.

“We have already begun to implement a number of programmes that address feedback from staff. This includes piloting an accelerated development programme with colleagues from underrepresented groups, improving understanding of and engagement with our organisation’s vision and values and ensuring colleagues feel confident to share any concerns they may have but we know there is still more work to do to improve experience of working for the organisation.”

NHSE’s May executive team report said, in relation to “vision and values”, it was planning “orientation sessions for all colleagues” and launching its operating framework and business plan. It also highlighted plans for management and leadership development, including an accelerated programme for underrepresented groups.