2023 NHS Staff Survey Report and Plan

Meeting: Public Meeting

Date: 8 May 2024

Report Title: 2023 NHS Staff Survey Report and Plan

Agenda Item: PUB24/05/5.1

Author: Lauren Singleton, Deputy Director of Culture and Leadership

Lead Director: Dr Hein Scheffer, Director of Strategy, Culture and Education

Purpose: Information noting

Assurance: Reasonable

Link to Strategic Objective:

• Be an exceptional place to work, volunteer and learn

Link to Strategic Risk:

• SR3: Failure to embed a culture focused on staff safety and wellbeing
• SR7: Failure to ensure a well governed and accountable Trust

Equality Impact Assessment: No negative impact identified

Previously considered by: SCE Group, ELT and People Committee.

Purpose: The purpose of this paper is to provide the Trust Board with an overview of the NHS staff survey results for both staff and Bank staff. The results are to be discussed, noting achievements, ongoing challenges, and the impact of the various cultural initiatives, including Fit for the Future. The weight of this paper focuses on the results for staff (as opposed to Bank staff) based on the fact that more data is available to compare, discuss and note achievements for this section of the workforce. In future years, we will be able to compare Bank staff results.

Recommendation: The Trust Board is asked to review the 2023 NHS Staff Survey results summary and note the achievements and challenges in comparison to the data from 2022. The data, as collated by the nominated contractor Picker Management, was officially released on 07 March 2024.

A summary slide deck has been provided and attached to encourage debate and discussion on the survey outputs. There is also an additional summary slide deck providing a high-level overview of the Bank staff survey data, which is a new addition for 2023-24.

ELT have previously approved Option 2. at the end of this paper, which is now being implemented throughout the Trust, with results being reviewed in June 2024.

Introduction/Background

The NHS Staff Survey is conducted annually. All eligible NHS organisations in England are required to participate in the survey. Picker, the survey contractor, worked with seven Ambulance Trusts on the NHS Staff Survey 2023. Each organisation receives a report which shows the results in comparison to the average of similar organisations, as well as the organisation results from 2022. Whilst Bank staff have been included this year for the first time, their response data reported separately; this means all data referenced in this paper is reporting on like for like in terms of the results generated from the staff respondents.

Staff Survey

A total of 100 questions were asked in the 2023 survey; of these, 97 can be compared to 2022 and 71 showed positive scores in relation to the 2022 data. EEAST achieved a 52% completion rate: a fraction higher than the average of other Ambulance Trusts at 51% but lower than EEAST’s 2022 response rate of 60%.

The 2023 NHS staff survey results show positive results for EEAST. Out of the seven comparable Ambulance Trusts, EEAST was the top organisation in terms of showing the most positive change in responses between 2023 and 2023 data; an accolade now held for two years in a row. A breakdown of the changes in response between the 2023 and 2022 data can be shown in Figure 1. below, with 71 questions showing a better response than the previous year. The previous year’s comparison is also shown for context.

Figure 1

Whilst this shift-change in response is a positive indication of progress, it is important to consider the context in which the answers are provided. Despite the change in responses, EEAST was still bottom of the league table in comparison to the other seven Ambulance Trusts. This is due, as shown in Figure 2., to 73 of our questions rated significantly worse than the ambulance sector average (improved from 85 in 2022). In effect, this means we continue to make progress compared to last year, but still lag marginally behind other Ambulance Trusts in three quarter of the questions.

Figure 2

For ease of review, the accompanying summary slide decks for staff and also for Bank staff have been attached as Appendices, to provide a high-level summary of the data.

Engaging with staff – an agreed approach in 2024

Within the summary document, a proposed approach (later approved by ELT) is outlined for how we can improve the level of engagement relating to staff survey results (slide 13). In 2023, we introduced a more prescriptive approach in asking all directorates/sector to create a staff survey action plan. This work was predominantly led by the HRBP team who were tasked to implement and support this creation. In total, we collated 16 directorate/sector action plans for the 2023-24 year, with mixed levels of engagement and quality. More work is needed in 2024-25 to ensure all directorates/sectors have a comprehensive action plan in place.

Following ELT approval, we are now also introducing ‘listening into action’ events for all sectors/directorates. To implement this, we have asked all Heads of Service to run virtual/face-to-face sessions with their teams to inform them of the results (relevant to their area of work) and then co-create solutions that will shape their action plan. The idea is that, once these are created, we can regularly ask for updates via the accountability forums.

Key Issues/Risks

The NHS staff survey results are generally a good news story, highlighting some positive progress in the right direction for the Trust. We must, however, balance our communications to ensure we continue messaging around our journey of improvement. Internal Communications have framed our communications to outline:

• Overall, we have had a strong year for staff survey results, with over 93% of questions showing year on year improvements. Furthermore, we are the most improved ambulance trust year on year.
• This is further evidence that we have made good progress in improving the culture at EEAST as evidenced by the Trust being moved out of special measures.
• We are pleased to see that fewer of our people report experiencing discrimination, bullying or harassment from patients and public and that they have greater flexibility and choice in how they work. Our people are also reporting have better development and training opportunities.
• As a result, there has been a 10% increase in people recommending EEAST as a place to work.
• However, despite progress in these areas, too many of our people are experiencing bullying and harassment.
• We also have more work to do in developing our managers which is why we have launched a Leadership Development programme and increased resources so that managers have more time to spend developing and engaging with their people.

Options

The following approaches have been presented to ELT to ensure the NHS staff survey is fully reviewed and communicated. ELT have approved Option 2. which is now being implemented:

1. We will continue to embed our approach to cascading and informing Leadership teams at EEAST in the same way as 2023 and in line with the Internal Communications Plan.
2. We have proposed an additional activity to introduce ‘Listening into action’ events for Directorates/Sectors.

Summary

The NHS staff survey provides EEAST with an organisational health check; a compass for seeing progress, ongoing challenges and the impacts of intentional change programmes. The results indicate that EEAST has made some great strides forward in terms of its culture and in many respects, has continued to shape a positive employee narrative about working here.

It remains important to reflect that, whilst great progress has been made, EEAST must continue to demonstrate, through tangible actions, that continuous improvements are being made. The NHS staff survey serves as a useful reminder that changing the culture is a journey, not a destination but the data from 2023 shows EEAST is continuing to head in the right direction.