NHS staff in England are facing record levels of discrimination from the public, and more than one in five say they will look for a new job within the next year as issues including burnout, pay dissatisfaction and resourcing pressures persist.
The 2023 NHS staff survey, published this week, found that one in 12 respondents faced discrimination while treating patients – the highest proportion since this question was first asked in 2019.
Nearly 8.5% experienced discrimination from patients, service users or members of the public, while 9% experienced discrimination from managers, team leaders or colleagues.
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For the first time, the 2023 survey asked about unwanted behaviour of a sexual nature in the workplace. Nearly 9% had experienced it from patients in the past 12 months and almost 4% from colleagues.
The NHS staff survey is one of the largest workforce surveys in the world and received responses from more than 700,000 NHS workers in autumn 2023 – a response rate of 48%.
Some 268 NHS organisations took part, including all 213 trusts in England.
Dr Navina Evans, chief workforce, training and education officer said: “It is very distressing that more than 58,000 NHS staff reported experiencing unwanted sexual behaviour from the public last year and such conduct should not be tolerated in the NHS.
“That is why the NHS launched its first ever sexual safety charter last year which provides clear commitments to improve reporting on unacceptable behaviour, as well as appointing more than 300 domestic abuse and sexual violence leads who will review and improve trust policies for reporting of sexual harassment.
“While there is still more to do, it is good news that less than 12 months on from the publication of the NHS Long Term Workforce Plan staff are happier at work than last year thanks to initiatives such as flexible working hours, clinical support squads to help menopausal women at work, and human resources stay advocates”.
Fewer thinking of leaving
The survey found that fewer NHS staff in England are planning to leave the organisation. However, 29% said they often think about leaving, with 21% stating they will probably look for a new job within the next 12 months and nearly 16% planning to leave as soon as they can find another role.
The survey’s overall “thinking about leaving” score improved in 2023, but remained worse than in 2020. Staff in ambulance trusts were still the most likely to consider leaving.
Less than half (47%) of the NHS staff polled said they could meet all conflicting demands on their time at work, up from 43% the previous year. Only a third (32%) said there are enough staff to do their job properly (up from 26%).
Thirty-four per cent found their work emotionally exhausting and 30% felt burnt out. Nearly one in five (19%) felt that every working hour was tiring for them.
Only 56% felt their employer acted fairly with regard to career progression or promotion, regardless of ethnicity, gender, religion, sexual orientation, disability or age.
Just three in 10 NHS staff (31%) were satisfied with their level of pay, albeit this was an improvement on 2022’s survey (26%).
We need to end the endless ‘recrention’ cycle in which poor retention and insufficient recruitment are driving invaluable clinicians out the door.” – Dr Anas Nader, Patchwork Health
Dr Anas Nader, healthcare workforce specialist and co-founder of healthcare staffing platform Patchwork Health, said: “Despite some improvements in this year’s figures, the big picture remains the same: NHS staffing isn’t working for NHS staff.
“Almost one-third still say they’re burning out and more than one-fifth plan to leave their roles in the next 12 months. Our health service simply cannot afford for this to happen. We need to end the endless ‘recrention’ cycle in which poor retention and insufficient recruitment are driving invaluable clinicians out the door. We need collaborative, fully-funded, holistic action to rebuild an NHS workforce that works for future generations – and we need it now.”
Danny Mortimer, chief executive of NHS Employers, noted that it was encouraging to see that the survey revealed improvements in five of the eight indicators of staff sentiment, but expressed concerns about discrimination and equality.
“Scores on equality and diversity have not improved which is very concerning, and we must all reflect on why this might be. There were only small improvements on the inclusion metric, with significant equality gaps remaining in the experience of women, those from black and minority ethnic backgrounds, disabled and LGBT staff. These results show beyond doubt that focusing on diversity and inclusion is key to improving the NHS for our people and the diverse communities we seek to serve,” he said.
“Most importantly, this has been the first staff survey to record data on sexual harassment in the NHS. The data shows that there are issues to understand and address across all staff groups, not just the medical profession and the ambulance service, which is where a lot of the work has been progressing to date. NHS organisations have been developing action plans to address these issues and will continue to do so.”
The Royal College of Nursing called for more action to tackle racism, discrimination and sexual abuse.
RCN director for England Patricia Marquis said: “Nursing staff go into work to care for others, and it is a disgrace that racist, sexual and other discriminatory abuse is becoming the norm for so many. But this is potentially just the tip of the iceberg, with no data presented on the levels of physical violence faced by staff. We know NHS workers are repeatedly being attacked at work and it is deeply concerning that the data is not available.
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“Nursing staff remain unhappy with their pay and say there isn’t enough time or staff to do their job properly. When this happens, patients suffer.”
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