Two out of five NHS staff would not recommend their organisation as a place to work

The 2021 survey results, published today, showed regression across a broad range of questions, including in areas such as motivation, morale, workload pressures and staff health.

The survey was conducted between September and December last year, with more than 1.3 million employees being invited to take part. The preceding 12-month period included the wave of covid in winter 2020-21, which was the most severe for the NHS, ongoing lower level pressures throughout 2021 and the omicron variant pushing admissions up again during December 2021.

One of the biggest drop-offs in survey scores related to the question asking whether there were enough staff in their organisation for respondents to do their job properly.

Only 27.2 per cent of those surveyed said staffing was adequate, a fall of 11 percentage points from the previous year (38.4 per cent).

Only 59.4 per cent of staff said they would recommend their organisation as a place to work. This represented a seven percentage point decline from the previous year (66.8 per cent). The rating had steadily improved since 2017 when it was at 59.7 per cent.

While a decline was seen across all sectors, the steepest drop was found among ambulance trusts.

In 2020, 57.4 per cent of ambulance trust staff said they would recommend their organisation as a place to work but this fell to 43.5 per cent in 2021. The decline was less marked among mental health/learning disability and community trusts.

Ambulance trusts performing worse compared to other sectors appeared to be a recurring theme across the survey. 

The divergence was seen, for example, in the number of staff who were happy with the standard of care being provided by their organisation, those satisfied with the recognition they receive for their work and those who have gone to work despite not feeling well enough to perform their duties.

The survey also found just over 52.5 per cent of NHS staff said they looked forward to going to work, down six percentage points from 2020 (58.8 per cent).

A decrease was seen across most occupational groups, but again it was most significantly found among frontline roles and those working in the ambulance sector.

There was also a decline in the number of staff who felt they could meet all the conflicting demands on their time at work and who believed they had adequate materials, supplies and equipment to do their work.

There was an increase in those who felt they were under unrealistic time pressures.

Some improvements

However, there were some improvements to be found in the results.

Although only 62 per cent of staff felt they could speak up about anything that concerned them in their organisation, 74.9 per cent felt secure about raising concerns regarding unsafe clinical practice.

This rating has continued to improve in previous years, and is now nearly five percentage points higher than it was in 2017.

However, only 59.4 per cent of staff said they were confident their organisation would address their concerns.

The survey did note that, despite a national decline, confidence had continued to rise among mental health/learning disability and community trusts, and were now “well above” 2017 levels.

Em Wilkinson-Brice, NHS England’s acting chief people officer, said: “The NHS is nothing without the commitment and dedication of its staff and that has never been clearer than over the last two years as they have cared for over 660,000 covid patients, rolled out the world-leading NHS covid vaccination programme, all while dealing with record levels of pressure in other parts of the health service.

“Yet staff have stepped up and looked after one another in the face of these pressures, with more people benefitting from extra support from their trust and line manager than in previous years.”

UPDATED, 13.32: This story has been updated to include a comment from Em Wilkinson-Brice and about covid pressures