Still a culture of fear? What the NHS staff survey tells us

National officer Rob Quick detects a continued trend of stifled voices in the results of the new NHS Staff Survey

In February an HCSA member won around £1.2 million in compensation for unfair dismissal by a hospital trust.

He had previously blown the whistle about lack of resources and cuts which he believed were having a serious impact on patient care. He suffered bullying and harassment over a long period of time because he was trying to speak out on behalf of his patients and colleagues.

As the HCSA team of national officers have witnessed in supporting members around the UK, he is not alone.

The annual NHS Staff Survey in England is sometimes taken with a pinch of salt and a health warning, but each year this survey – the biggest employee survey in the world with around 300,000 taking part – highlights the genuine concerns of staff working in the NHS.

For over 15 years the survey has been tracked by the Care Quality Commission, NHS employers and health unions as a barometer of staff sentiment across NHS England.

It shows rising complaints about staff bullying and widespread concern about the approach towards whistleblowers.

Just a quarter of NHS doctors and nurses believe that they are treated fairly by hospitals.

Less than a third said that hospitals encouraged them to speak up when safety is at risk, and only 24 per cent said that colleagues who had become involved in a safety incident had been treated fairly.

Doctors and nurses complained that when blunders or “near-misses” were reported, hospitals failed to learn from them. Those who do dare to raise concerns face being bullied and harassed by managers, the findings reveal.

It is in many ways unsurprising that the figures suggest that one in five NHS workers has been bullied by a manager or colleague in the previous 12 months – some because they raised concerns about safety.

Last year a major review commissioned in the wake of the Mid Staffordshire scandal called for better training for all staff and “safety” guardians to be installed in every hospital.

Ministers have repeatedly promised to overhaul the culture of secrecy in the NHS to make it easier for whistleblowers to speak up. Only time will tell whether these promises will turn into the cultural shift among managers that is required.

• There has been plenty of debate in the media recently about the impact on morale of junior doctors of the government’s attempts to impose a new contract.

HCSA members working shoulder to shoulder with junior doctors are well aware of this impact. Low morale is endemic amongst many NHS staff.

Increasing workloads, cuts to the health service, unreasonable expectations and long working hours are some of the factors they say are damaging the lives of NHS professionals at a time of escalated pressure.

The NHS staff survey findings on this issue appear to be having an impact on NHS Employers. In response, the organisation’s chief executive Danny Mortimer said: “The variation in staff experience across the NHS remains a real concern for employers and boards will want to do more to address this.”

Chris Graham, director of research and policy at the Picker Institute and the staff survey’s chief investigator, said: “Too many staff complain about inadequate resources, staffing shortages, and the deleterious impact of their work on their own health and well-being.

“We call on all employers to closely review their results and take action to ensure staff are supported and listened to.”

• Other findings in the staff survey also made for concerning reading. A third of staff felt they had experienced work-related stress, a quarter had faced harassment by colleagues and one in 10 had felt discriminated against.

The harassment figure has barely changed in four years and nor has, at 15 per cent, the proportion who say they have been on the receiving end of physical violence from patients, relatives or other members of the public. There has been only a slight fall in harassment, bullying or abuse by patients and the public, with just under three in 10 staff saying they had experienced this in the last year, according to the staff survey, which was conducted by the Picker Institute, an international charity specialising in health and social care.

These worrying findings are underpinned by the HCSA’s own survey of 800 senior hospital doctors on the causes of growing stress that hit the Guardian front page in September 2015.