NHS staff are disillusioned and demoralised, says The King's Fund research

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The government must act urgently to boost morale among NHS staff, says work published today by The King's Fund.

Counting the Smiles: Morale and motivation in the NHS, by Belinda Finlayson, confirms that morale is low in the NHS, putting at risk the government's plans to modernise the service. The two biggest causes of low morale are chronic staff shortages, which make working conditions difficult, and the strong perception among staff that their work is not valued.

Based on focus groups with NHS staff and managers, Counting the Smiles shows that morale is lowest where NHS staff feel their views are not heard by managers, especially where political imperatives prevail over local priorities. Many staff said training and development opportunities were denied them because shortages forced them to take extra shifts instead. In this atmosphere, it is hard for them to provide the best possible care to patients or to improve the quality of service they deliver.

Counting the Smiles argues that morale can be improved if managers spend more time listening to staff and communicate patients' thanks for their efforts. While staff shortages are being tackled, NHS organisations should ensure flexible working arrangements are made, adequate training opportunities are provided and staff are involved in efforts to improve the service.

King's Fund chief executive Rabbi Julia Neuberger said: "The NHS needs highly-motivated staff. Too many nurses, doctors, managers, therapists, care assistants and ancillary staff are demoralised. That damages their motivation and contributes to the dangerously high levels of staff turnover experienced by many NHS trusts.

'It is crucial that NHS staff know that their political masters value their work, not merely through rhetoric but through concerted action to promote the value of public service, to continue improving pay and career opportunities, and to make their working lives considerably better. Politicians of all hues should listen intently to the views of NHS staff and patients when making plans for the service's future.'

The King's Fund also publishes two further studies today, one looking at London's public health workforce and the other examining the values that lie behind the NHS:

Public Health in the Balance shows that London faces a serious shortage of public health workers and warns that some of the expertise amassed over recent years in health and local authorities may be lost when primary care trusts take up responsibility for public health next week. This may hamper efforts to reduce health inequalities in the capital.

Hidden Assets shows that staff, patients and citizens hold diverse views about the service. It argues that by listening to the views of patients, workers and the public, the NHS can benefit considerably as it changes to meet the demands of the new century. It adds that people should be consulted about the trade-offs between conflicting values, such as choice and equity, that are inherent in the NHS.

Read the report: Counting the Smiles: Morales and motivation in the NHS

Notes to editors

The research for Counting the Smiles: Morale and motivation in the NHS, by Belinda Finlayson, was funded by the Edgar Lawley Foundation.

Hidden Assets is edited by Bill New and Julia Neuberger. Contributors to the book include Julian Le Grand, David Hunter, Ziauddin Sardar and Iona Heath.

Both titles will be launched at the second King's Fund Open Day on 26 March 2002. Journalists are cordially invited to attend.

For more details about the Open Day, or a review copy of either publication, please contact Andrew Bell on 020 7307 2585 or 07831 554931, or Daniel Reynolds on 020 7307 2581.

More details about Public Health in the Balance are available on a separate press release.