Working in the NHS

The staff pledges that are part of the NHS Constitution define what the NHS expects from staff and what staff can expect from NHS employers. One of these pledges is to provide support and opportunities for staff to maintain their health, wellbeing and safety. Further to this, the NHS England Chief Executive announced a major drive to improve the health and wellbeing of health service staff, in a bid to benefit both staff and taxpayers (September 2015).

Staff satisfaction with resourcing and support

In 2015, the scale used to measure the work pressure felt by staff was adjusted to measure staff satisfaction with resources and support and is not comparable with previous findings. Staff were asked to rate on a scale of 1 to 5 how satisfied they were with the resources (e.g. materials, supplies and adequate staff numbers) and support from colleagues to do their work and meet conflicting demands.

Nationally, staff were quite satisfied (3.4 out of 5) with the resources. This was similar across staff groups, although ambulance staff scored a lower 3.1. Those aged 16-30 years had a higher satisfaction score (3.5) than the other age groups (data not shown). Staff without a disability felt more satisfied than those with a disability.

How many staff report working extra hours?

One way work pressure may manifest itself is staff working extra hours (more than five hours per week) than they are contracted to do so (either paid or unpaid).

Between 2003 and 2006 a large proportion (over 70%) of NHS staff were reporting that they had worked extra hours. This then fell in 2007 and remained static around at 65-66% until 2011. From 2012 the percentage of NHS staff working extra hours began to increase again, to 73% in 2015.

Although responses from staff in ambulance trusts follow a similar u-shaped trend over time they consistently report working extra hours more than staff in other trust types.

Are there differences between staff groups in reporting working extra hours?

The extent to which different staff groups report working extra hours varies quite dramatically between the groups.

Approximately 16% more staff from three clinical staff groups (medical/dental, registered nurses and health visitors) reported working extra hours than the national average of all staff groups investigated. General managers were the most likely to work extra hours and 29% more staff in this group reported working extra hours than the national average.

There was also variation in staff reporting working extra hours based on staff characteristics. More male staff reported working extra hours than females, this ranged between 4 and 7 percentage points greater than what is reported nationally in each year (data not shown). Also, there is a consistent difference in how many staff report working extra hours based on staff age. Fewer 16 to 30 year olds (3% less on average across all years) and more 41 to 50 year olds (3.5 percentage points more on average across all years) report working extra hours compared to the number of staff reporting nationally (data not shown).

Have there been changes in staff reporting being ill due to work-related stress?

Another way work pressure may manifest itself is in staff becoming ill due to work-related stress. Overall, less than half of staff reported feeling unwell due to work-related stress.

In 2004 and 2005, nationally around 35% of staff reported that they had been ill due to work-related stress. This fell by approximately 7 percentage points to lows in 2008 and 2009. From 2010, the number of staff reporting stress began to increase again. There was a sharp increase of 8 percentage points in reports of illness between 2011 and 2012 and it remained at this level through 2013 and 2014. A small improvement was seen in 2015 as the percentage fell to 36% nationally.

Up until 2011 there were similar levels of reporting between the different trust types, although on average lower numbers of staff from acute trusts reported illness due to work-related stress than staff from ambulance and mental health & learning disability trusts. However, from 2012 the number of staff in ambulance trusts reporting illness due to work-related stress continued to grow at a higher rate and the disparity between ambulance trusts and the levels reported nationally or from other trust types was greater than it had been previously; in 2012 the difference from the nationally reported level was 6% and in 2013 this had increased to a difference of 11%, which has been sustained.

Are there differences between staff groups in reporting being ill due to work-related stress?

50% of staff with a disability reported being ill due to work-related stress, compared to 32% of staff without a disability.
More females reported being ill due to work-related stress compared to men; in 2015 36% of females compared to 33% of male staff reported being ill due to work related stress. White staff were more likely to report being ill due to work related stress (36%) than non-white staff (30%). (Data not shown)

What do staff say about feeling pressured to work when unwell and how has this changed?

Many staff feel pressure to attend work despite being ill. In 2009, just over one fifth of staff reported that they felt pressure to attend work when feeling unwell in the previous three months. Subsequently, there was a year-on-year increase in staff reporting feeling pressure to work when feeling unwell, rising to 27% in 2012. This dropped to a quarter of all staff in 2013 and 23% in 2014, which is still greater than when the data was first collected in 2009.

Ambulance trust staff consistently reported feeling more pressure to attend work when feeling unwell in the previous three months when compared to acute, mental health & learning disability, and community trusts.

In 2015, this indicator was changed to ask not only whether staff members feel under pressure from colleagues to come to work while unwell but also whether they additionally put themselves under pressure to come to work. Once this is included, the percentage of staff feeling under pressure to go to work when unwell doubled.

Are there differences between staff groups in reporting feeling pressure to work when unwell?

In line with staff reporting that they have been ill due to work related stress, the proportion of disabled staff who say that they felt pressure to attend work when ill is consistently greater than in staff who are not disabled. In 2014, 34% of disabled staff said that they felt pressure to work, compared to 20% of staff who are not disabled. This doubled in 2015, given the addition of the questions as to whether there was self-inflicted pressure to go to work when unwell.

About this data

For more information, please see <a href="http://www.nhsstaffsurveys.com/Page/1010/Home/NHS-Staff-Survey-2015/">NHS Staff Survey 2015</a>.

The data is unweighted. National averages include other organisations outside of the sectors shown in the charts, for example PCTs and CCGs. In 2015 extra categories were created for acute trusts and mental health and learning disabilities trusts that are combined community trusts. Where these trusts were previously coded as either acute trusts or mental health & learning disability trusts the analysis included them in the categories they were previously in.

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