Staff morale in NHS England is declining and almost a third often think about leaving the organisation, the 2021 NHS staff survey has revealed.
The survey’s morale score (5.8, down from 6.1 last year) has fallen to its lowest since 2017, with increases in the proportion of staff thinking about changing jobs, feeling unable to meet all conflicting demands at work, and feeling unwell because of work-related stressors.
Thirty-one per cent say they often think about leaving the NHS organisation they work for, an increase of more than four percentage points over a four-year period.
Nearly a quarter (23%) say they will probably look for job at a new organisation in the next 12 months – the highest proportion in four years – and less than 17% say they will leave as soon as they find another role.
Asked about their workload and resources, just 43% feel able to meet all demands on their time at work – a five year low – and 27% say there are enough staff at their organisation for them to do their job properly, compared with over 38% last year.
Bullying and harassment are also rife, the 2021 NHS staff survey found. Twenty-seven per cent have experienced harassment, bullying or abuse from patients, service users, relatives or members of the public; nearly 12% from managers; and nearly 19% from other colleagues. Physical violence from members of the public and patients was experienced by 14.3% of those surveyed.
NHS staff shortages and culture
Mental and physical health is declining, with the proportion experiencing musculoskeletal problems increasing over four consecutive years to nearly 31%; and almost 47% stating they have felt unwell as a result of work-related stress in the past 12 months (44% in 2020 and 40.3% in 2019).
More than half (51%) of ambulance staff felt burnt out, as did 40.5% of registered nurses and midwives and 38% of nursing and healthcare assistants.
Matthew Taylor, chief executive of the NHS Confederation, which represents organisations that deliver NHS services, said: “NHS leaders know only too well the relentless demand being placed on their teams due to the staffing vacancies which now stand at 110,000.
“There is no hiding from the fact that the NHS is facing chronic workforce shortages, which are getting steadily worse, and with nearly three quarters of staff reporting that there are not enough staff to do their jobs properly.
“Whilst our dedicated staff continue to work flat out, the government cannot simply keep demanding even more from the service without ensuring the NHS has the tools it needs to do the job and one of the most vitally important tools is a fully funded and fully staffed workforce. Our staff are the lifeblood of the health service, and we need them now more than ever.”
Taylor said the government needed to commit to setting out full and transparent staffing requirements for the NHS, stating that not doing so would “only serve to heighten staff shortages and jeopardise the inroads the health service can make into driving down patient waiting lists”.
We have been warning time and again that staff are being taken for granted and asked to do the impossible and that, without a sea change, they will vote with their feet.” – Dr Claudia Paoloni, HCSA
Dr Claudia Paoloni, president of the hospital doctors’ union HCSA, said: “These results are shocking and reflect an NHS which is descending into the abyss.
“We have been warning time and again that staff are being taken for granted and asked to do the impossible and that, without a sea change, they will vote with their feet.
“The warning there are not enough of us to do our job properly is due to successive decisions to suppress pay and an abject failure to properly acknowledge or grasp the nettle on increasing workforce gaps.
“Taken alongside years of underfunding and complacency towards staff, who seem to be seen by policy-makers as a costly inconvenience rather than the core component of our health service, this is leading to rampant ill health and threatens a further exodus.”
Unison head of health Sara Gorton said NHS staff needed an “urgent and significant” wage rise if they were to avoid leaving the health service for better pay and less stress. Only 31% of 2021 NHS staff survey participants say they are satisfied with their level of pay.
“Staff are feeling less valued, their work is increasingly unrecognised and they’re not allowed to progress in their jobs,” she said.
“Waiting lists will only reduce if staff stay in their jobs and people join the health workforce. That requires swift action on pay and an urgent retention package.
“With household bills going through the roof and staff being hit by hospital parking charges, nurses, porters, paramedics, cleaners, healthcare assistants and all other vital employees will be thinking long and hard about their futures in the NHS. The government must ensure they stay by showing they’re valued.”