As an employer, the NHS needs to not only encourage current staff to stay, but also make a career in the NHS appealing to people not currently working in the system.
According to our recent survey, half of the public say they would encourage a friend or family member to consider a career in the NHS and a similar proportion describe the NHS as a good employer (50 per cent and 53 per cent respectively).
For many employers these findings would be welcome. However, given that the public see the NHS as a national treasure (with 77 per cent saying that the NHS is crucial to British society and must be maintained), the fact that only half see it as a good employer is perhaps surprising.
With a quarter of people (25 per cent) neither agreeing nor disagreeing that the NHS is a good employer, the NHS needs to bridge this gap; translating the love the public hold for it into a choice to pursue a career in the NHS. But what might explain this gap? And what are the likely challenges for the NHS in overcoming it?
First, the public are acutely aware of staffing pressures and are pessimistic about the future. Four in five (79 per cent) say that the NHS does not have enough staff to provide a good service and more than half (56 per cent) expect staff shortages in the NHS to get worse over the next few years. This pessimism for the future increases to 64 per cent among those who say there are currently not enough staff. More widely, staff shortages have also been cited as one of the top reasons for overall dissatisfaction with the NHS.
This translates into support among the public for special visas for EU citizens to work as doctors and nurses when the UK leaves the EU. Overall, 84 per cent support this for doctors and 82 per cent for nurses, a finding that replicates views seen in 2017. The public support special visas for doctors and nurses more than any other group of workers asked about, including academics, care home workers and construction labourers (73 per cent, 66 per cent and 56 per cent respectively). This is indicative of both the value the public place in the NHS and awareness they have of the current staffing pressures.
Second, the public are also understanding of and concerned about the impact current pressures have on those working in the NHS and the system overall. Around four in five (83 per cent) say that staff are overworked, and when we ask people globally if they believe the health care system in their country is overstretched, Great Britain ranks higher than the any of the other 27 countries surveyed (with 85 per cent saying that the NHS is overstretched).
It is not surprising therefore that when we ask the public about the most important issues facing Britain today, the NHS is consistently one of their greatest concerns. Currently, one in three (36 per cent) mention the NHS in this context, second only to the EU and Brexit (65 per cent), and notably higher than other issues such as crime and the environment (22 per cent and 15 per cent respectively).
In short, public awareness of staffing issues and the resulting concern they have for the NHS and its staff present challenges for the NHS being seen as a great place to work.
The good news is that these concerns do not reflect experiences for the public. As well as being proud of the NHS, the public remain positive about the care they receive, with 76 per cent saying NHS staff provide high quality care to patients. This is testament to the work of NHS staff; the public regularly tell us in qualitative discussions that they see staff doing their best against the odds. It probably also does not come as a surprise that nurses and doctors remain the most trusted professions in our most recent Veracity Index, ahead of others including teachers, scientists and the police.
In addition, those who are arguably closer to the current pressures are in fact more positive about the NHS. Those who work in the NHS or have close family or friends that do are more likely than those without this proximity to both say the NHS is a good employer (60 per cent compared with 50 per cent) and to encourage a friend or family member to consider a career in the NHS (57 per cent compared with 47 per cent). The 2018 NHS staff survey also found that 62 per cent of staff would recommend their specific NHS organisation as a place to work, further suggesting that proximity shapes positive views.
The rewarding nature of the work carried out by staff in the NHS may go some way to explaining this. At Ipsos MORI, our qualitative work with staff consistently shows that many chose their professions because of the opportunity to deliver care and improve the quality of lives by developing meaningful relationships with patients. This is also reflected in the NHS staff survey, in which nine in ten staff (89 per cent) said that their role makes a difference to patients and services users. While staff may not always feel that they get to deliver care to a level they would like to in the current climate – something we hear in qualitative discussions and recognised in the Interim NHS People Plan – overall, working for an employer that allows you to make a difference may contribute to more positive perceptions.
This bodes well for the national agenda and the direction set out in the Interim NHS People Plan to create an NHS where these benefits and others can be better realised for staff. The challenge will be ensuring the public more widely – well aware of the current challenges – are also brought closer to these changes if more of them are to see the NHS as a good employer and a great place to work.