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Staff morale improves, but one in five still want to leave NHS

Hospital trainees in a corridor

The 2023 NHS Staff Survey showed a modest improvement in staff morale, job satisfaction and levels of burnout, but found NHS workers were facing record levels of discrimination from the public and a significant proportion still plan to leave their jobs in the near future.

More 700,000 of the NHS’s 1.4 million workers took part in the survey at the end of last year, answering dozens of questions of every aspect of their working lives, including questions on sexual harassment for the first time.

NHS England’s chief workforce officer, Navina Evans, said it was “good news” that “staff are happier at work than last year” but “there is still more to do”. The high levels of sexual harassment and discrimination from the public revealed by the survey were “distressing” and “should not be tolerated in the NHS”, she said.

Despite some signs of improvement, MiP chief executive Jon Restell warned “the overall experience of working in the NHS today is still well below what it was before the pandemic.”

Following last year’s 5% pay rise, satisfaction with pay rose slightly to 31% – but this was still the second lowest level recorded since the survey began in 2003. More than one in five staff want to leave the NHS within the next year, with almost one in six wanting to go as soon as possible.

“As two in every three staff are still not satisfied with their pay, it’s easy to understand why so many are considering leaving the health service this year,” added Restell. “The government have an opportunity to reverse this trend as staff are due a pay rise from 1 April, but ministers have yet to put anything on the table.”

He said positive results for line managers—73% said their immediate manager valued their work and was supportive—were “to be celebrated especially given the pressure on staff and services”.

NHS staff reported more than 58,000 incidents of “unacceptable and unwanted” sexual behaviour from patients, relatives or other members of the public during 2023. Overall, 10% of staff experienced sexual harassment from the public, but only 4% from colleagues. Levels of discrimination remain high: only 56% said the NHS treats staff fairly when over career progression and promotion, and nearly one in ten said they had personally experienced discrimination at work.

Restell described the level of violence, discrimination and sexual harassment staff were facing from the public as “truly shocking” and warned that a comprehensive strategy to reduce violence, agreed by NHS employers and unions in 2020, would need “sustained leadership and investment to make a difference”.

Commenting on the survey results, Sarah Woolnough, chief executive of the influential King’s Fund think tank said: “There are some positive improvements across various indicators, but we can’t ignore the main message from this survey: that NHS staff are feeling undervalued, stretched and unwell and there is still work to do to make health and care a more attractive career.”

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