The survey provides rich data on the lived experience of staff working in the NHS. Understanding this data matters, otherwise the risk is that these experiences become ‘patterns in the wallpaper we no longer see’.
I wonder, how can the survey data be used by busy managers and leaders to help them take action to support the health and wellbeing of their teams?
The publication of the NHS Staff Survey got colleagues and myself thinking about how we could use the ABC framework (see below) to provide, at a very simple level, a practical and accessible way into the survey data and to help support team conversations about health and wellbeing. The framework identifies the three core psychological needs which must all be met for people to flourish and thrive at work:
- autonomy – the need to have control over their work lives, and to be able to act consistently with their values
- belonging – the need to be connected to, cared for, and caring of others around them at work, and to feel valued, respected and supported
- contribution– the need to experience effectiveness in what they do and deliver valued outcomes.
The idea of using the ABC framework to help make the data more accessible, felt like a mini lightbulb moment, and we went about mapping questions we identified as relevant from the NHS Staff Survey to the three needs in the ABC framework. The graphic below sets out our thoughts about this mapping.
To illustrate how leaders and managers might use the ABC framework to get a different perspective on their Staff Survey results, we have taken one question from each of the ABC categories (highlighted in the graphic above) and mapped them against the results for three different trusts. The table below illustrates the variation in how staff experiences track against the ABC framework.
Even the best performing of the three trusts (Trust A), leads the way on two aspects of the ABC framework (autonomy and contribution) but needs to improve on the third (belonging) The other two trusts need to improve on at least two of the three aspects of the framework, while Trust B is leading the way on one aspect (belonging). And each trust will have its own unique pinch-points – staff at Trust C will have different concerns to Trust A and Trust B.
There is also other data in the Staff Survey that all organisations need to take account of – for example data on harassment, bullying and abuse and potential attrition challenges, including the level of satisfaction by staff with the opportunities they have for flexible working patterns – which we have not referenced here.
I have offered these thoughts about the ABC framework as a useful way to re-energise efforts to use the NHS Staff Survey to help improve wellbeing. I hope this approach may provide a different way of looking at some of the data, and encourage all to take action with their teams to improve health and wellbeing. Rather than risk becoming accustomed to the patterns revealed by the survey – ultimately, no one team or organisation have their approach to meeting core needs sorted – let’s ensure meeting the core needs of staff is an ongoing area of work that we constantly pay attention to.
This analysis is based on the local NHS staff survey results from 2021. All Trusts of a similar type are ordered and split into quartiles for each survey question.
- Bottom quartile = lowest scoring 25 per cent of trusts = grey
- Quartile 2 = 25 to 50 per cent = dark purple
- Quartile 3 = 50 to 75 per cent = mid-purple
- Top quartile = highest scoring 25 per cent of trusts = light purple
Possible questions from 2021 Staff Survey to compare to the ABC framework
- Autonomy - 3f; 3e; 5b; 6b
- Belonging - 7h; 8b; 8d; 9e
- Contribution – 6a; 2b; 3i; 20d
This example compares acute and acute community trusts only, but the same analysis can be used for other types of trust.