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NHS Staff Survey shows recovery from pandemic but raises concerns over sexual harassment

By some indices, the NHS workforce appears to be recovering from the impact of the Covid-19 pandemic, according to the newly-released NHS Staff Survey 2023, but concerns were raised over issues with sexual harassment identified in a new survey question.

Across England, over half of the 700,000 surveyed staff (55.17%) reported that they now look forward to going to work – the best result since 2020.

Some 69.02% reported being enthusiastic about their job, which was, again, the best result since 2020 but remains around six percentage points lower than in 2019. Enthusiasm amongst medical and dental staff increased following four consecutive years of decline on this measure, the results showed.

When it came to the issue of wellbeing, staff reported experiencing less pressure at work than before, with the work pressure sub-score having improved in 2023 after a sharp decline between 2020 and 2021 and little change in 2022.

A total of 46.71% said they were able to meet all the conflicting demands on their time at work, however this remained lower for medical and dental staff (34.44%) than for many other staff groups and over 12 percentage points lower than the average.

Professor Em Wilkinson-Brice, director for staff experience and leadership development at NHS England said: ‘It is really encouraging that the experience of NHS staff at work improved over the past year, even as they faced near record levels of pressure including the busiest summer recorded in A&E, as well as managing the disruption of industrial action.‘

And Dr Navina Evans, chief workforce, training and education officer at NHS England, said: ‘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.‘

However, Dr Emma Runswick, deputy chair of the British Medical Association council, noted that ‘while there have been some small positive changes made in certain aspects from staff shortages to time pressures, it’s imperative to differentiate between “improvements” and what is deemed as satisfactory or acceptable’.

Dissatisfaction with pay increases among medical staff

The NHS Staff Survey arrives at a time of ongoing workforce shortages, mounting pressures and widespread dissatisfaction with pay.

While satisfaction with pay recovered to levels similar to 2021 across a number of staff groups, the survey found only 32.05% of medical and dental staff were satisfied with their pay. This adds to the persistent decline over the last three years and is 23 percentage points lower than in 2020.

Dr Runswick said: ‘The vast majority of medical and dental staff (68%) are dissatisfied with their pay, all while clearly struggling with unacceptable workloads, unreasonable time pressures, and inadequate resources.

‘The Government must recognise the urgent need for fair pay and systemic improvements to support and prioritise the wellbeing of our invaluable healthcare workforce.’

Staff report discrimination and sexual harassment

The survey results also revealed widespread reports of discrimination and sexual harassment by patients and colleagues.

Discrimination hit a record high, with one in 12 staff (8.48%) having reported facing discrimination from patients, service users, their relatives or other members of the public, up from 7.20% in 2019. This rose to 9.07% for people who reported personally experiencing discrimination from managers, team leaders or colleagues, up from 7.68% in 2019.

However, overall, staff were reportedly increasingly likely to feel their organisation respects individual differences such as cultures, working styles, backgrounds and ideas (70.63%). This measure is up two percentage points since 2021.

This was the first time the NHS Staff Survey ran a question on sexual harassment, and the results showed that 8.67% of staff said they had faced sexual harassment from patients, patients’ relatives, or other members of the public within the last year.

In fact, more than 58,000 NHS staff reported experiencing ‘unacceptable’ levels of unwanted sexual behaviour from the public.

The survey also found 3.84% of staff faced unwanted sexual behaviour from staff or colleagues.

The sector responds

Commenting that these figures are very distressing, Dr Evans said: ‘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.

Medical leaders condemned the survey findings on sexual harassment. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said: ‘Discrimination or abuse of any kind must not be tolerated – anywhere, ever. Everyone has a responsibility to call it out.

‘Such behaviour is abhorrent and in a clinical setting, utterly disrespectful to our hardworking NHS staff and to patients receiving or waiting for medical attention. Staff are most effective when they feel psychologically safe in a workplace.

‘NHS staff cannot walk away when someone needs help – being harassed or feeling vulnerable should never be considered “part of the job”.’

Professor Vivien Lees, vice president of the Royal College of Surgeons of England (RCS England) and lead on sexual misconduct, said: ‘Gathering this data is an important step as it gives us a better picture of the scale of the problem.

‘It is essential that staff members feel empowered to report instances of misconduct without fear of reprisal or negative impact on their career progression. They also need to feel confident that reports will be believed.’

She added: ‘RCS England is committed to a zero-tolerance approach to sexual misconduct, and we will actively work to eradicate this behaviour in surgery and healthcare.’

Coinciding with the publication of the NHS Staff Survey, the Royal College of Physicians and Surgeons of Glasgow launched its 10-point action plan aimed at tackling sexual misconduct in healthcare.