Sunday, 14 April 2024
Sunday, 14 April 2024

Growing proportion of staff are unhappy with the standard of NHS care

LESS than two-thirds of staff in the NHS would be happy with the standard of care in their organisation if a friend or relative needed treatment, according to the national NHS staff survey 2022, published recently. The proportion who would recommend their organisation as a place to work is also declining, and almost one in three staff ‘often think about leaving’.  

Results from the survey, which was coordinated by the independent charity Picker on behalf of NHS England, include responses from more than 600,000 NHS staff working across more than 200 organisations. They provide rich insight into the experiences of staff from all occupational backgrounds in secondary and tertiary care: from consultants to care assistants, and from porters to paramedics. Questions in the survey cover all aspects of work experiences, particularly focussing on those described by the NHS People Promise

One of the most concerning findings was a drop in the proportion of staff who agreed that “if a friend or relative needed treatment, I would be happy with the standard of care provided by [my] organisation”. Nationally, less than two-thirds of staff (63%) agreed with this statement – a drop of 5% points since 2021, and of 11% points since 2020. More than one in eight staff members (13%) said that they ‘disagree’ or ‘strongly disagree’ with the statement – including almost a fifth of all staff in ambulance trusts (19%).   

Compared to the previous survey, conducted in 2021, staff reported fairly consistent and in some cases slightly improved experiences around many specific areas of their work. For example, 69% of staff feel valued by their teams (an increase of less than one percentage point since 2021) and 69% say they have opportunities to improve their knowledge and skills (up 2% points from 2021). But despite this, morale and engagement have declined since before the pandemic. Staff remain markedly less likely to say that they are enthusiastic about their jobs than in 2019 (67% vs 75%; an 8% point decline over three years), and the proportion who “often think about leaving” their jobs has risen to a new high of 32% (up from 28% in 2019; a 4% point increase). More than one in six (17%) say they will leave their organisation as soon as they can find another job.  

The 2022 survey was conducted during September, October, and November 2022: a tumultuous period for the NHS that saw unions including the Royal College of Nursing balloting members on strike action over pay and staff shortages. The survey’s results align to this context: there was a sharp drop in the proportion of staff who said that they were ‘satisfied’ or ‘very satisfied’ with their level of pay, from 33% in 2021 to 26% in 2022. Some of the lowest overall levels of pay satisfaction were found amongst nursing and healthcare assistants (13%) and registered nurses and midwives (19%), but the year-on-year decline was steepest amongst medical and dental staff, whose level of pay satisfaction fell from 50% to 37%. 

The survey also identified significant variations in the experiences of staff from different occupational groups and in different organisation types. As in previous years, staff working in ambulance trusts tended to report poorer experiences across a range of areas: for example, only 42% of ambulance trust staff would recommend their organisation as a place to work, compared to a national average of 57%. In hospital trusts (excluding specialist providers), nurses and especially midwives reported poorer experiences on average: for example, 58% of midwives said that they ‘often’ or ‘always’ ‘feel burnt out because of [their] work’, compared to an average of 35%.  

Commenting on the findings, Chris Graham, Chief Executive at Picker, said:

“Today’s results give cause for alarm regarding the quality of care in the NHS. Although many will be unsurprised by the declines in staff pay satisfaction and morale given the wider context of industrial action, the steep drop in the proportion of staff who are happy with the standard of care their organisation offers is deeply concerning. Staff who work in the NHS every day have first-hand knowledge of standards, and their testimony should be taken very seriously.    

“All good employers recognise the importance of staff feedback, and we know that NHS organisations will take a keen interest in their results. We are calling on NHS organisations to use today’s worrying results as a rallying call and as an opportunity to create a dialogue with staff about how their experiences and the standards of patient care can be improved. Evidence shows that improvements in staff experiences are associated with better care, so employers should work with their people to understand how work arrangements can be developed to ensure that colleagues are valued, respected, and supported to provide person-centred care.” 


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