National Guardian’s Office: Fear and futility - What does the Staff Survey tell us about speaking up in the NHS (8 June 2023)

Summary

The NHS Staff Survey is an essential tool for assessing the experiences and opinions of NHS workers in Trusts in England. It also provides valuable insights to help understand the speaking up culture in the NHS. In this report the National Guardian’s Office analyse the results of the 2022 NHS Staff Survey, focusing on questions relating to speaking up.

Content

Key findings from this report include:

• The Freedom to Speak Up sub-score declined from 6.5 in 2021 to 6.4 in this year’s NHS Staff Survey. This fall equates to a 1.5% change. Given the size of the survey (over 600,000 workers) this equates to a declining perception of over 9,000 workers.
• There was a marked fall for raising concerns relating to clinical practice (following 2021 when there was a marked improvement).
• For the first time, bank staff completed a bank staff survey. The results were in line with the core survey results for all four speak up questions.
• By sector, ambulance trusts continue to score least well (and are continuing to worsen) whereas community trusts continue to perform best.
• The gap between community and ambulance/acute trust results is widening, potentially indicating the impact of pressures on frontline services.
• The Freedom to Speak Up sub-score positively correlates with Care Quality Commission ratings.
• There is a marked disparity between the highest and lowest scoring organisations, and this has increased for three out of the four Freedom to Speak Up questions since the 2021 survey.
• The North East and Yorkshire, North West and South East regions scored the highest. East of England scored least well for all four Freedom to Speak Up questions. In particular, the results for both questions about workers feeling that their organisations will address concerns were markedly low.

Related reading

• NHS Staff Survey Results 2022 (9 March 2023)
• Patient Safety Learning: Still not safe to speak up: NHS Staff Survey Results 2022 (23 March 2023)