Paul Deemer, Head of Diversity and inclusion at NHS Employers

Does the NHS Staff Survey reveal differences between staff groups in terms of trust?

Nurse at patient's bedside

The NHS Staff Survey 2017 was published this morning (6 March 2018) and, for the first time, the results to national-level questions have been split by ethnicity allowing for comparisons between how different staff groups respond on every question within the survey.

Paul Deemer, Head of Diversity and inclusion at NHS Employers, reflects on the findings and considers whether they have revealed differences between staff groups in terms of trust.


“In God We Trust” is the official motto of the United States of America. Fantastically simple, unequivocal and clear. You read that and you know what it means. I’ve always admired the Americans for their sense of patriotism and allegiance to their country. The sense of civic pride that the majority of Americans seems to display at their schools, colleges and sporting gatherings is, in my book, something to be aspired to.

In my mind, this sense of a shared purpose and values is something that any organisation – even the NHS – would love to achieve. A sense of belonging and being that you would want to instil and ingrain in your staff. But could we say that this applies to the NHS? Could we (hand on heart – as the national anthem plays) really claim that we arouse that much devotion and love from our staff?

More pertinently for me (looking at this from a human resources and diversity perspective) there are two further questions to ask:

  1. Could we replace “God” with “managers”?
  2. Could we say that all groups – from all backgrounds – share the same sense of loyalty and devotion?

Our best barometer for this is the NHS Staff Survey: our “temperature check” and “pulse test” of the NHS heartbeat. So – what do the latest results tell us about the differing experience of black, Asian and minority ethnic (BAME) staff compared to others?

I’ve been looking at a few specific questions in the survey which might give us some insights into this – questions which focus down on very personal perceptions of an individual’s sense of belonging and purpose. And the results are interesting….

The first two questions I looked at where relating to how enthusiastic people are about their job (Q2b) and whether or not people felt trusted to do their job (Q3b). The two results suggest to me that 78% of all BAME staff who completed the survey (around 56,000 staff) were enthusiastic about their job – almost 6% more than the white staff who completed the survey. But even more amazingly, over 90% of all staff who completed the survey reported feeling trusted to carry out their job – with only a small percentage difference between BAME and white staff (with BAME staff reporting a higher level of trust).

Also of interest were the questions which focussed on the extent to which people felt that they were involved in the work of their team / organisation (Q4b, Q4c and Q5f) – in terms of their ability to make suggestions at work and how much the organisation values their work. This comparison showed very little difference between BAME and white staff on the first two questions. But, on the question around the extent to which the organisation values their work – 51% of BAME staff reported being satisfied – compared to only 42% of white staff – a full 9% difference.

Also worth consideration is how effective communication was between senior managers and staff – because I think this is central to all of this. Interestingly, this showed that just over 58% of BAME staff agreed or strongly agreed with the statement that their manager asked for their opinion before making decisions about their work – compared to just over 55% of white staff. In the same line of questioning, “Communication between senior management and staff is effective”, over 48% of BAME staff agreed or strongly agreed – compared to just over 39% of white staff – again, a full 9% difference.

So – what are my conclusions from this “toe dip” analysis? I have drawn three.

Firstly, I think the first thing this tells us is that the picture is not as clear and simple as we might think sometimes. We’ve often read about BAME staff reporting significantly higher levels of harassment and dissatisfaction around the extent to which their employer is an equal opportunities employer. But here – those same staff seem to be also telling us that they feel significantly more valued than their white counterparts.

Secondly, I think that the healthcare sector should be very pleased and proud that over 90% of all staff feel trusted to carry out their job. That is a great base from which to build a strong and positive workplace culture.

Finally, and perhaps not surprisingly, is that we need to dig into this data a bit more and try to understand what really lies behind some of these figures and what we can do to make our workplaces a great place for all staff. A place where trust is something that everyone feels and believes in.



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