Why NHS staff engagement matters

The work I was privileged to lead in 2009, The NHS Health and Wellbeing Review, demonstrated clearly that NHS staff health and wellbeing is important to good patient care and improved organisational efficiency.

While I believe some NHS organisations have seen the value of improvements, investing in measures to support staff health, the data referred to in the Staff Care report, published yesterday by the Point of Care Foundation, remains worrying.

‘Too often managers conclude that making savings means initiatives to care for staff are too costly. Quite simply that is rubbish’

The report builds on the evidence base articulated in 2009, and by other authors, particularly highlighting the association between staff satisfaction and patient outcomes, such as mortality and hospital acquired infection.

In my experience NHS staff care deeply about the work that they do. Against that background, it is deeply worrying that the new report suggests only 55 per cent would recommend their organisation as a place to work.

David MacLeod and Nita Clarke, in their research into the factors associated with successful major businesses, concluded that employees’ wellbeing was inextricably linked with success. I have worked with many companies that understand and promote that link.

Disempowered staff

In 2009, my review team suggested NHS staff were in danger of being “cobblers’ children” − so focussed on caring for their customers they didn’t take care of their own needs. I was keen to work with the Point of Care Foundation to understand whether that had changed. Regrettably that may not be the case − despite the recommendations of my review being accepted and supported by policymakers.

‘Good managers create the space that enables those they work with to identify and make the changes they need to thrive’

We all know that the modern NHS faces enormous challenges to adapt and change. The Francis and Keogh reports show clearly the difficulty of delivering high quality care against a background of stretched resources. Too often managers conclude that making savings means initiatives to care for staff are too costly. Quite simply that is rubbish.

Staff Care: How to engage staff in the NHS and why it matters seeks to show clearly that simple measures to improve staff engagement need not be costly. My 2009 team found staff care about even small actions to demonstrate care, such as managers saying “thank you”, demonstrating respect and simply listening to staff concerns.

It was interesting to hear the experiences of members of the working group with vast experience of working in the NHS. Staff often feel disempowered to take responsibility to make small changes that can make a big difference. It can be difficult when the workload is high to think about what can be done to improve.

Not rocket science

In the years since my review I have seen many good examples of staff engagement in the NHS, and once again this latest report shares some case studies that show inspiring leadership and good management can create the working environments that promote health. This is good for staff, good for patients and good for taxpayers. It is not rocket science.

As a doctor who has made the transition to management and leadership roles, I know that being a good clinician does not necessarily give you the skills and experience to manage and lead others. Training is often forgotten in the pressures of demand, but it is essential − good managers create the space that enables those they work with to identify and make the changes they need to thrive.

The NHS is the largest employer in the country and has a duty to embrace the contents of this report. Good practice exists but it remains inconsistent and the data published in Staff Care should not be ignored.

More than words

Values and behaviours are often dismissed as cuddly, fluffy HR words; I am pleased to see that the authors of the report describe clearly the need to articulate values in plain English to enable them to become more than words on a poster. Ensuring staff are able to develop the behaviours needed to solve problems that improve care is essential.

‘I hope this report is taken seriously. Its messages are clear and deserve attention from all that work in NHS organisations’

The messages and case studies have been carefully explored by the expert advisory group that backs this work. Sick staff, whether at work and at risk of underperforming or absent from work due to illness or injury, cost large employers dearly.

My review team concluded that the NHS could say over half a billion pounds a year by improving its practices − I continue to think that that figure is a conservative one and the real savings of improved staff care and better staff engagement are significantly higher.

I hope this report is taken seriously. Its messages are clear and deserve attention, not just among senior leaders and managers, but from all that work in NHS organisations. Small differences can effect cumulative change − and not all cobblers children have bad shoes.

Dr Steven Boorman is chief medical adviser at Capita