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Michelle Hodgkinson, Deputy Director of Engagement and Education at Royal National Orthopaedic Hospital

Putting the NHS Staff Survey to work as a springboard for change

Michelle Hodgkinson, Deputy Director of Engagement and Education at Royal National Orthopaedic Hospital, considers what the real value of the NHS Staff Survey is; gaining insights and then acting upon them.


The NHS Staff Survey is the largest workforce survey in the world and in 2017, the survey was distributed to almost 1.1million staff across 309 NHS organisations and gathered 487,227 responses, an increase on 2016 participation. The survey collates answers from individual survey questions and groups them into 32 summary indicators, referred to as ‘Key Findings.’ Key Findings are then grouped into nine themes.

Nationally 11 Key Findings improved since 2016 but 21 Key Findings are in decline. Reassuringly though, whilst staff clearly feel under pressure they say they are being better supported by their NHS managers. Furthermore the average staff engagement score is up to 3.78 out of 5 in 2017, up from 3.68 out of 5 in 2012.

At the Royal National Orthopaedic Hospital in Stanmore, we have been making a concerted effort to improve staff experience, and we use the annual NHS Staff Survey as one way of measuring, informing and focusing our efforts.

Back in 2014 we realised that for the majority of staff, their experience of working here was amongst the best, if not the best, in the country but we needed to do more to celebrate this excellent experience. However, we also knew that for a significant minority of staff, when staff experience was bad in the Trust, it could be really bad. We looked to our Trust values to help us guide interventions to improve this.

Our values have been in place since 2008 and define who we are as an organisation. There is a wealth of research that demonstrates that well-embedded values offer a whole host of benefits to an organisation: They assist in the decision-making process; they can provide a competitive advantage; they are a key recruitment and retention tool and influence behaviour.  In 2014, we assessed that we were doing really well at meeting two of our Trust values (Patients first, always and Excellence, in all we do) but staff were telling us we did much less well meeting our other two values: Trust, honesty and respect, for each other and Equality, for all.



In 2016, we launched the RNOH VAL-YOU campaign aiming to improve the experience our staff have of working at the Trust. Our stated aim is to be the best place to work in the NHS! we held our first VAL-You events in September 2016 and invited staff from across the organisation to talk to us about what was good and not so good about working at the RNOH and identify behaviours that reflect Trust values. We used these conversations to define a Charter of Behaviours and ‘checked’ the first drafts with our staff.

Since that point, we have been working to embed VAL-YOU into all areas of the Employee Lifecycle and raise awareness around the Trust. So far, we have made significant changes in a number of ways:

  • We have completely reengineered our induction process; the whole of the first day is now about our values, our organisation, what we do and what we expect from our staff . We have also created our own board game “Dilemma” that we play with staff at induction to really bring our values to life
  • We’ve introduce Employee of the Month & Team of the Quarter Awards where both staff and patients can nominate individuals and teams for the awards
  • We’ve simplified our appraisal process, giving values & behaviours much more prominence. We’ve also produced Self-Assessment Tools and Managerial Toolkits to help guide individuals through the process
  • We’ve created a leadership portfolio – A detailed guide of all the training, development, help, support and resources available to managers and leaders at the RNOH
  • We’ve devolved Learning & Development budgets to divisions, with funding calculated on a headcount & staff group basis. We’ve also created an Education Committee to strengthen governance of Education & Development and are currently creating the first fully integrated Education Strategy for the Trust
  • We have really invested in the Health and well being of our staff, including running free exercise classes on site
  • We’ve also fully adopted the Freedom to Speak Up Guardian role, running a nomination process from amongst our staff for FTSU guardians. We went on to appoint 3 staff who have dedicated time for FTSU and last year won FTSU Guardian of the Year

In terms of impact of VAL-YOU, this year the RNOH has improved in 23 of 32 key findings on the NHS staff survey, often significantly. The findings paint a really positive picture of changes going on at the Trust. On Key Finding 3, 95% of our staff feel that they can make a real difference to patient care, the highest score of any NHS Trust in the country. Indeed, on 3 of the Key Findings, we had the best score of any Acute Specialist Trust in the country. We were also very close to the best score in 4 other key findings – just 0.2% behind. We were above average when compared to other Acute Specialist Trusts on 17 of the 32 key findings.  We have also improved our overall staff engagement score from 3.97 to 4.04. The national average for Acute Specialist Trust is 3.95 and the best score for Acute Specialist Trusts was 4.07.

The return on investment from engaging with staff has been measurable in other ways too. We have seen turnover and vacancy rates drop significantly, along with sickness absence. Our scores in the national NHS inpatient and outpatients surveys have also improved correspondingly, once again underlining the real link between staff experience and patient care.

There is still more work to be done here at RNOH; there are teams/directorates of high performance and also areas that continue to be of concern. However, we are now seeing the fruits of our labours.

I would encourage all NHS organisations to use the NHS Staff Survey results as a springboard for change. Take the time to really analyse the results for your organisation and value the insights, whether they be good or bad! Believe me, the benefits are really worth it!

Tags: communication, National Survey Programme, NHS, service improvement, Staff.

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