NHS Staff Survey shows growing concern over staffing levels

The NHS Staff Survey 2021, published today, provides worrying evidence of a workforce under pressure. There have been sharp declines in the proportions who say there are enough staff at their organisation for them to do their job properly and that they would recommend their organisation as a place to work. Meanwhile, rates of work-related stress have continued to increase, and one in six say they will leave their organisation “as soon as I can find another job”.

Results from the survey are hugely important because of its scale and detail, and the questions are designed to measure progress against the NHS People Promise. Collecting almost 650,000 responses, the NHS Staff Survey is now the largest workforce survey in the world – and it provides detailed insight into the experiences of staff working in a wide range of NHS organisations and professions. This year’s survey was conducted from October to early December 2021, during a period where few Covid measures were in place nationally and daily Covid hospitalisations were typically averaging 7-8,000.

The previous national survey, conducted at the start of the second wave of Covid in England in 2020, showed staff morale holding steady through the crisis. This trend has not been maintained in 2021, with morale declining across a range of measures. In 2021, only 59.4% of staff would recommend their organisation as a place to work – a decline of more than 7% percentage points from 66.8% in 2020, and lower than at any point in the last five years.

One of the biggest changes compared to the 2020 survey was in the proportion who said that there were enough staff in their organisation for them to do their job properly. This fell from 38.4% in 2020 to 27.2% in 2021 – a fall of more than 11% points. The drop was even steeper in ambulance trusts, where only one in five staff answered positively (20.3% in 2021 vs 36.7% in 2020 – a drop of more than 16% points).

There were also worrying results for a number of questions relating to pressures on staff:

• The proportion of staff who felt unwell as a result of work-related stress in the last 12 months rose to 46.8% – almost half. This was an increase of 2.8% from the 2020 figure (44.0%) and continued a trend: the figure has risen each year since 2017, when 38.4% of staff reported work-related stress.
• Almost one-in-three (31.1%) say they “often think about leaving” their organisation – an increase of 4.6% points vs the 26.5% recorded in 2020. And one-in-six (16.6%) say they will leave their organisation “as soon as I can find another job” – a 2.7% point increase from 2020.
• Only 52.5% of NHS staff say that they look forward to going to work – a decline of more than 6% points from 58.8% in 2020.
• New questions in the survey suggest that many staff are experiencing burnout. Overall, more than a third of staff (34.3%) said that they ‘always’ or ‘often’ “feel burnt out because of [their] work”. The proportion was even higher for staff in patient facing roles (for example, 40.5% of registered nurses and midwives) and especially for ambulance personnel (51.0%).

Commenting on the results, Chris Graham, Chief Executive of Picker, the charity that coordinated the survey on behalf of NHS England and NHS Improvement, said:

“The NHS Staff Survey results are deeply alarming and demonstrate that the health service workforce has growing concerns about their working conditions. Perhaps the single most striking result is an unprecedented fall of 11% points in the proportion of staff who say that there are enough colleagues in their organisation for them to do their job properly. This adds to an existing body of evidence. Vacancy rates for clinical roles are known to be high – one in ten nursing posts in England are empty [1], for example – and results from the British Social Attitudes survey, also published today, show that a lack of NHS staff is a key cause of rising public dissatisfaction with the health service [2]. But the staff survey adds to this by showing the personal impact of pressure in the form of work-related stress, burnout, and intention to leave.

“Urgent action is now needed to improve staffing levels and support for existing employees in the NHS. At a national level, a comprehensive workforce plan and funding are required to strategically address the problem: this should build on the existing NHS People Plan, and future development of this should reflect the priorities identified in the survey. And locally, we encourage providers to review their own staff survey results and work with colleagues to identify areas for improvement – especially in those areas that support staff wellbeing”.

View the infographic summarising key results.

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.
• 648,594 people responded to the survey, from 280 NHS organisations, including all 217 trusts across England, with a response rate of 48%. All organisations bar one surveyed all of their eligible staff.
• Full details of the survey methodology, questions, and results are available on the dedicated survey website at nhsstaffsurveys.com.
• 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 – emma.newton@pickereurope.ac.uk, or Greig Box Turnbull at Fortitude Communications – gbt@fortitudecommunications.com.