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Time to turn our attention to the frontline?

The findings of the recent NHS staff survey should send a warning to leaders that their greatest asset is in danger of being neglected, says Shirley Cramer, CEO of the Institute of Healthcare Management (IHM).

NHS staff, in the main, work extremely hard, often going beyond the call of duty, and are truly dedicated to the NHS and delivering care to patients. These are the words of Lord Carter of Coles, in his recent report on operational productivity and performance in English NHS acute hospitals. His words are echoed time and time again in reviews of the NHS, whether they are looking at how to improve patient care, to increase efficiency, or to create a bold new culture of transparency and accountability. 

These are hard times for the NHS and the headline grabbers tend to be around financial, leadership and care deficits, rather than the celebratory stories – of which there are many – of people working together to forge new and successful partnerships to deliver new models of care and meet the changing needs of our population, or reports on the largely uncomplaining nurses whose 12-hour shifts on understaffed wards often turn into many more by the time the handovers and administration are completed. 

For many, if not most people working for the NHS, the work itself is the factor that determines their satisfaction, regardless of money, prestige, or control. Few people escape illness and health scares and everyone has witnessed family and friends who have had periods of care in the hands of GPs, doctors, nurses and allied professionals. Whether meticulously cleaning to safeguard patients, producing nutritious food, treating or caring for the ill, the payback is self-evident. You know it could be you or yours and what you do can really make a difference. 

How sad then to see the result of the latest NHS staff survey. Let’s start with the good news story: a high level of engagement. Nearly three-quarters (74%) are enthusiastic about their job. This compares favourably with the 2013 Gallup Poll, which gathered information from 230,000 full-time and part-time workers in 142 countries and reported that only 13% of workers felt engaged by their jobs. 

The importance of feeling valued 

However, less cheering is the fact that 41% of the 1.4 million people employed by the NHS would not recommend their trust as a place to work, over half (57%) say they are unable to meet the conflicting demands on them at work, and 13% report being bullied by their managers. Alarmingly, only 42% feel their work is valued by their organisations. 

The 2013 report by Sir Robert Francis on the failings at Mid-Staffordshire NHS FT urged a new – or renewed – focus on patients. Patient-centred care is the mantra of today’s NHS, but disillusionment or presenteeism among staff must surely threaten the standards of patient care as much – or even more – than financial constraints. 

This is one of the greatest challenges facing managers today. How can staff throughout health and care services be made to feel more valued? Clearly this won’t happen by chance; it will come about by design. And it isn’t rocket science. 

Weighty tomes have been written on the subject, highlighting the rewards reaped by those who invest in their staff. Communication is, as ever, key. Share the vision of the future and link it to everything employees do. Build and encourage interpersonal relationships through fostering a collaborative atmosphere. Involve staff and draw on their expertise to ensure they feel an integral part of the team. Praise, recognise, criticise constructively and invest in training. 

It isn’t unreasonable to expect to feel valued by the organisation you work for. If more than half of NHS staff don’t, there is a serious problem and it needs to be addressed as a matter of urgency.

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