News: Prescription for better practice

The annual NHS staff survey is taking place. The results should offer lessons reaching far beyond the health service. Frank le Duc reports

Almost a thousand Brighton hospital trust staff are being asked to say what they think about their jobs and their bosses. They have until the end of the month to complete a questionnaire. The results in previous years have not always made comfortable reading. And given some of the current tensions over cuts and outsourcing, perhaps this year’s staff survey should come with a health warning.

Those tensions have been close to the surface since the arrival of Matthew Kershaw at Brighton and Sussex University Hospitals NHS Trust in the spring. The trust runs the Royal Sussex County Hospital and the Royal Alex Children’s Hospital in Brighton. The new chief executive is openly referred to as Matthew “the Axeman” Kershaw by the GMB union. The GMB was one of the organisations behind the march and rally against NHS privatisation organised for the weekend.

“Standards have to be high whether the staff in question are cleaners, nurses, doctors or work in admin”

Perhaps there’s never a perfect time for a staff survey if the temperature is to be taken accurately. Or perhaps it would be better to take the temperature more frequently. Mr Kershaw and his boardroom colleagues decided that the national survey of NHS staff did not give them enough information or often enough about the trust’s vital signs.

The national survey is sent to 10 per cent of staff and not all of them respond. A report to the board about last year’s national survey said: “The small sample size was noted… There were positive trends in emphasising a safety culture was evident in the trust and the level of staff engagement had increased. The negative trends were themed around management capacity and capability.”

Steps were announced to address those concerns. The trust intranet includes a “You said, we did” section to show that feedback is taken seriously. And when the latest staff survey started Mr Kershaw wrote an open letter encouraging his employees to take part.

He said: “It is completely anonymous and your opportunity to have your say about what you like and enjoy about your job and working here as well as what you don’t. There are also though limitations to how much the National Staff Survey can tell us. It only happens once a year and even if 70 per cent of our staff return their surveys (which is a very high return rate) that is still only just less than 600 people or 10 per cent of our whole workforce.

“So we have plans to introduce our own, more regular staff surveys, to help gather more information about where staff want us to focus our efforts to improve working conditions and practices and, as a result, provide better care for patients.

“The plan is that everyone will have the opportunity to take part in quarterly staff surveys and that surveying more people more frequently will enable us to gain a detailed and current understanding of where people are at and better track if any changes we make are having a positive impact on staff morale and their view of the trust as whole.”

Some people are sceptical about staff surveys. They say that those most likely to respond are the management lackeys or the malcontents who always want to moan about something. Too many questions can mean too little thought is given to meaningful answers. And there is often cynicism about whether they’re worth filling in because nothing will change.

Even with the best will in the world it can be hard to design an effective set of questions. And busy staff may lack the time they need to do the questions justice. But Mr Kershaw and his colleagues have tried to dispel the doubts. They also have other ways of communicating with their staff – to give them information as well as to listen to them.

There is some way to go before everyone is won over. And some, of course, will never be. But the staff survey ought to be worth the effort. If the changes that are made as a result of the survey improve the way that employees feel about their jobs, the results should be positive. The standard of performance has to be high whether the staff in question are cleaners, nurses, doctors or work in admin. Their mistakes can cost lives. Their motivation is immeasurably important.