Biggest ever survey of NHS staff reveals pressures of caring during the Covid pandemic

The NHS Staff Survey, published today, is the largest ever undertaken. Based on almost 600,000 responses, it is the most reliable measure of the views of the NHS workforce. Conducted from October to November 2020, it reflects experiences through the first wave of the Covid pandemic and shows staff morale holding steady through the crisis. Remarkably, the proportion of staff who would recommend their organisation as a place to work has increased by 3.5% from 63.3% in 2019 to 66.8% in 2020.

Despite positive results, there is cause for concern regarding the toll that Covid has taken on front-line staff. Overall, 44.0% of staff reported feeling unwell due to work-related stress in the last 12 months – an increase of 3.7% from last year. But the increase was particularly marked amongst front-line staff, of whom 46.6% reported stress compared to 41.7% in 2019 – a 4.9% point increase. Amongst staff working on Covid wards or areas, almost half (49.6%) reported stress.

NHS staff pay has attracted considerable attention in recent days following the Government’s proposal of a 1.0% uplift for most NHS staff. Whilst the survey was undertaken before this announcement, it provides insight into how valued staff feel and their satisfaction with pay levels. The results show a small decline of 1.3% points in the proportion of staff who were ‘satisfied’ or ‘very satisfied’ with their pay (from 38.0% in 2019 to 36.7% in 2020). However, results for different staff groups reveal increasing polarisation. Pay satisfaction has increased amongst non-patient-facing staff (up 1.7% points from 40.7% to 42.4%) and for medical and dental professionals (up 1.9% points from 55.0% to 56.9%. At the same time, pay satisfaction amongst registered nurses and midwives has fallen from 36.4% to 32.5% – a 3.9% point decline – and amongst nursing and healthcare assistants (from 24.5% to 22.0%, a drop of 2.5% points).

Commenting on these findings, Chris Graham, CEO of Picker who managed the survey for NHS England and NHS Improvement, said:

Results from the NHS Staff Survey illustrate the profound impact of the Covid pandemic on the NHS workforce – and the strength and resilience it has shown in maintaining services throughout the crisis. Incredibly, morale has remained high and measures related to staff engagement show the deep commitment of NHS personnel. At the same time, results around work-related stress and pay satisfaction show the toll that 2020 has taken on NHS staff, particularly in front-line and non-medical roles.

Whilst the results do indicate improvements in efforts to support staff wellbeing, there is a need to accelerate this and to focus on ensuring that NHS staff are looked after and supported. This will be all the more important after the second peak in Covid cases, which has come after the survey was completed. We urge all employers to carefully and thoroughly review their results and to work with staff to identify supporting actions.

Notes for editors

  • Picker is an international charity working across health and social care. We believe in high quality person centred care for all and promote this by measuring and encouraging the use of staff and patient feedback.
  • 595,270 people responded to the survey, from 280 NHS organisations, including all 220 Trusts across England, with a response rate of 47%.
  • Full details of the survey methodology, questions, and results are available on the dedicated survey website at
  • Chris Graham is available for media interview. To arrange your interview, or if you have any other media enquiries, please contact the Communications Manager at Picker, Emma Newton –

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