Survey of NHS staff shows signs of improving satisfaction

The latest NHS Staff Survey shows signs of improving satisfaction among NHS staff, but too many are still feeling undervalued, stressed as well as facing record levels of discrimination from the public.

Compared to the previous survey in 2022, staff are markedly more likely to say that they would recommend their organisation as a place to work; that they would be happy with the standard of care provided if a friend or relative needed treatment; and that they have the right support and resources to do their jobs.

Over half (55%) also reported they look forward to coming to work – the highest number since 2020. There are also improvements in the wellbeing of NHS workers, who are experiencing less burnout than before. However, results for many key measures of staff experience remain below pre-Covid levels.

The survey, which includes responses from more than 700,000 NHS staff working across more than 200 organisations, was conducted during September, October, and November 2023. This was several months after freshly agreed pay deals were implemented for most staff groups – but at a time when junior doctors and consultants remained in dispute.

Overall, satisfaction with pay improved by 5.6% points compared to 2022 – but remains low at 31.2%. However, the proportion of medical and dental staff who were satisfied with their pay fell by 4.5% points to 32.0% – continuing a steep decline from a high of 56.9% in 2020.

Many NHS staff experienced unwanted sexual behavior

The survey also included a new question asking staff whether they had “been the target of unwanted behaviour of a sexual nature in the workplace”, either from patients and the public or from colleagues. Overall, 8.7% of staff reported being the target of unwanted sexual behaviour from patients and the public.

This figure was much higher for staff in roles that are frequently patient-facing (11.5%), and there was significant variation between different staff groups. The highest rates were reported by ambulance technicians (36.1%) and paramedics (32.2%).

One in 12 NHS staff that responded to the poll also said they faced discrimination while treating patients at work – the highest percentage since the question was first asked in 2019.

Dr Navina Evans, Chief Workforce, Training and Education Officer said: “It is very distressing that more than 58,000 NHS staff reported experiencing unwanted sexual behaviour from the public last year and such conduct should not be tolerated in the NHS.

“That is why the NHS launched its first ever Sexual safety charter last year which provides clear commitments to improve reporting on unacceptable behaviour, as well as appointing more than 300 domestic abuse and sexual violence leads who will review and improve trust policies for reporting of sexual harassment.

“While there is still more to do, it is good news that less than 12 months on from the publication of the NHS Long Term Workforce Plan staff are happier at work than last year thanks to initiatives such as flexible working hours, clinical support squads to help menopausal women at work, and human resources stay advocates.”

Improvements in learning and growing

The survey also shows NHS staff reported improvements in opportunities for learning and growing in their roles. After declines on most of these questions in 2021 and 2022, results are now equal to or higher than they were before the pandemic in 2019. For example, 46.7% of staff said that they are “able to meet all the conflicting demands on their time at work”; a 3.7% improvement from 2022, and 0.7% higher than in 2019.

There was an even bigger improvement in the proportion who said that there are enough staff in their organisation for them to do their job properly – up 6.0% points from 26.4% in 2022 to 32.4% in 2023. The concern remains that only a minority of staff agreed with these statements – but the improvements are substantial and demonstrate good progress in an area that has long been challenging.

The King’s Fund said that while there are some positive improvements across various indicators, there is still work to do to make health and care a more attractive career. Sarah Woolnough, Chief Executive, said: “As we head towards a general election, any government wanting to stabilise the NHS workforce must take action, including delivering and building on the NHS Long Term Workforce Plan. This will involve actions such as expanding the flexible working offer, ringfencing funding for staff wellbeing hubs, and supporting the development of high-quality compassionate and inclusive leaders in health and care.

“Recruiting enough NHS staff is only one part of the workforce challenge. Just as important is retaining staff, and today’s survey results include some cause for concern. The results show that two in five staff report feeling unwell due to work-related stress. Concerningly, the results regularly show that young staff aged between 21-30-years-old are generally the most dissatisfied in their role, with this year no exception – 29% are considering a new job in the next 12 months.”

Ruth Thorlby, Assistant Director of Policy at the Health Foundation, added: “Today’s results show some glimmers of hope in the levels of stress and exhaustion experienced by NHS staff after a difficult few years, but suggest that staff morale is still in a precarious state in the face of persistent pressures.

“Only around 1 in 3 staff feel that there are enough staff to do their jobs properly, an improvement compared to last year, but the proportion of staff reporting being unwell due to work related stress is still higher than before the pandemic. Worryingly, discrimination from managers, colleagues and the public remains a problem. Measures to ensure staff feel safe and supported must be a priority.

“Nearly 30% of NHS staff report that they often think about leaving their organisation; this underlines how important it is for the NHS to improve staff retention if it is to realise its goals set out in the long-term workforce plan. And any improvements in NHS staff morale need to be accompanied by improvements in the experience of those who work in social care, still in desperate need of its own workforce plan.”