The Point of Care Foundation Report on NHS Performance 

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NHS called on to accelerate efforts to engage staff in order to improve patient care, efficiency and financial performance

report published by The Point of Care Foundation shows that the way healthcare staff feel about their work has a direct impact on the quality of patient care as well as on an organisation’s efficiency and financial performance.

The report, Staff Care: how to engage staff in the NHS and why it matters, argues that it is not only necessary for healthcare providers to encourage staff engagement (the process by which staff come to have a positive attitude towards the organisation and its values) but to accelerate it.

The report, which reviewed evidence from a wide range of sources, highlights that:

  • Patient satisfaction is consistently higher in trusts with better rates of staff health and wellbeing
  • There is a link between higher staff satisfaction and lower rates of mortality and hospital-acquired infection
  • The NHS could save £555 million a year if it reduced sickness absence by a third.
  • Stress and burnout are more frequent in the NHS than in other sectors. Approximately 30% of sickness absence in the NHS is due to stress.

It points out that NHS staff engagement fell for three consecutive years from 2009 before rising very slightly in 2012. Only 55% of staff would recommend their organisation as a place to work.
The Foundation calls on healthcare organisations to increase staff engagement at both a strategic and operational level by making support for staff central to their strategies to improve patient care, productivity and financial performance. It also sets out simple steps being used in parts of the NHS to improve staff engagement.

However, the report demonstrates there are discrepancies between what senior managers and staff think and say when it comes to how effectively their organisation supports staff and promotes high quality patient care:

  • Putting patients first: While 62% of NHS staff agree the care of patients and service users is their organisation’s top priority, over a third either disagree (17%) or neither agree or disagree (21%). In contrast, 95% chief executives who responded to a survey for the Foundation reported that a focus on the quality of patient care was either fully in place or mostly in place within their organisation.
  • Solving problems: While 74% of staff say they are able to make improvement suggestions, only one in four (26%) say senior managers act on them. CEOs, however, report that staff engagement is one of their top three priorities. Worryingly, while 86% of CEOs surveyed by the Foundation are confident staff are able to raise concerns, the Chartered Institute of Personnel Development found that fewer than six in ten staff (58%) felt confident about doing so.
  • Listening to and involving staff: only one in three NHS staff (35%) say communication between senior managers and staff is effective. Yet despite CEOs reporting that they prioritise staff engagement, nearly half (46%) of foundation trusts rely solely on the annual staff survey to formally canvas staff opinions.

Steps that board members and managers can take to increase staff engagement are set out in the report, including:

  • articulating values in plain English and showing how they translate into behaviours
  • giving staff responsibility and authority to solve the problems they think affect patient care
  • creating space for staff to reflect on the emotional challenges of caring for patients
  • training line managers in people management skills – including the large number of clinicians who lead and supervise other staff but who don’t think of themselves as managers

Director Jocelyn Cornwell, commenting on the report, said: “It’s the experiences of staff that shape patients’ experiences of care, for good or ill, not the other way around. Working in healthcare ought to rank amongst the best jobs in the world, but far too many healthcare professionals feel over-worked, disempowered and unappreciated.
“Caring for patients is very hard and challenging work. Boards need to support managers at every level so that they in turn support staff to deliver the best possible patient care. “We want the NHS to be notable for being not only the largest employer in the country, but also the best. There is much good practice in the NHS, but for it to become the norm we need to close the gap between rhetoric and reality.”
Staff care includes eight case studies of good practice in supporting and engaging staff working in healthcare. The aim of the case studies, and the report overall, is to inspire senior managers and everyone responsible for leading healthcare staff to take action and support staff to deliver patient-centred care.

The full report can be accessed here.

The Point of Care Foundation was established in April 2013 as an independent charity working to improve patients’ experience of care and increase support for the staff who work with them. It grew out of the work of the Point of Care programme at The King’s Fund (2007-2013), which was led by the Foundation’s Director Jocelyn Cornwell. The measure for the level of NHS staff engagement is drawn from a composite score from the NHS staff survey which takes into account staff involvement, overall job satisfaction and willingness to recommend the organisation as a place to work.
The report cites evidence from a wide range of sources including the 2012 NHS staff survey (the latest for which results are available), The Boorman Review and interim report (2009), work by Professor Michael West of Lancaster University’s management school and a survey of NHS chief executives conducted for the Foundation in 2013.
The Chairman of the Foundation’s board of trustees is Sir Adrian Montague. Its trustees are: Robert Francis QC, Professor Jill Maben, Dr Sean Elyan, Rebecca Gray and Ceinwen Giles. More information about the board of trustees is available from the Foundation’s website.


Twitter: @pointofcarefdn #StaffExperience
For further information, members of the media should contact Creina Lilburne, Communications Manager, on 07941 156 827. Other enquiries should be referred to The Point of Care Foundation’s main number – 020 7637 7252.

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