Place staff engagement firmly on the board agenda

Our final message is that the boards of NHS organisations need to dedicate greater time and attention to staff engagement, not as a passing fad, but as a subject demanding regular discussion and reflection. Senior leaders need to place staff engagement in the ‘too-important-to-ignore’ tray, alongside patient experience, patient safety and clinical outcomes, given the sheer weight of evidence that engaged staff raise these measures of the quality of care.

In a major recent study, researchers investigated what the boards of NHS trusts and foundation trusts considered to be their strategic priorities and what types of innovations they were introducing to improve quality and safety. The boards of 38 per cent of the providers investigated identified staff engagement as a key priority. But only 30 per cent of these had introduced any innovations to increase engagement in the 18 months from January 2010 to June 2011 (Dixon-Woods et al 2014).

Other research has shown that senior leaders need to treat staff engagement as an ongoing priority and, in many cases, make gradual changes in a potentially wide range of areas to create highly engaged organisations (Review of Staff Engagement and Empowerment in the NHS 2014). For example, the board of Bromley Healthcare discusses staff engagement at each of its board meetings, as a standing item alongside quality of care. Wrightington, Wigan and Leigh NHS Foundation Trust has monthly staff engagement meetings, led by the chief executive, with other board members, staff and staff-side representatives.

Boards can use the NHS Staff Survey as an excellent starting point for these discussions. It also offers a basis for ongoing innovation and evaluation, given the range of comparative data that it provides on both the conditions for engagement and levels of engagement within trusts, such as leadership styles, fairness of procedures, levels of trust and other features of the working environment.

Board members should ask the following questions

  • How often does the board discuss levels of staff engagement and how they could be improved?
  • Are we making best use of the NHS Staff Survey and do we need other data to assess levels of engagement in different teams?
  • What steps have we taken to increase levels of staff engagement in the past year?

Collective leadership: how we can help