Improving NHS care by engaging staff and devolving decision-making

This report details the conclusions of the Review of Staff Engagement and Empowerment in the NHS, commissioned by the Minister for Care and Support, Norman Lamb MP, in November 2013. The review was chaired by Chris Ham, Chief Executive of The King's Fund, and supported by a panel of 17 experts.

The review found compelling evidence that NHS organisations with high levels of staff engagement – where staff are strongly committed to their work and involved in decision-making – deliver better quality care. These organisations report: 

• lower mortality rates 
• better patient experience
• lower rates of sickness absence and staff turnover.

Organisations with low levels of staff engagement are more likely to provide poor-quality care – the failures in care at Mid Staffordshire NHS Foundation Trust are a high-profile example of this.

While staff engagement levels have increased across the NHS in recent years, the review found significant variations between organisations. It calls on all NHS organisations to make staff engagement a key priority in order to improve care at a time of unprecedented financial and service pressures.

The review found emerging evidence that staff-led mutuals deliver higher levels of staff engagement and, as a result, recommends NHS organisations are given greater freedom to become mutuals, on a voluntary basis. It calls on the government to launch a programme of pathfinders to gather further evidence about the benefits of mutuals and whether they could be adopted on a larger scale across the NHS.