Last year, staff from more than 300 NHS organisations (including all 230 trusts in England) took part in NHS England’s annual Staff Survey – one of the world’s largest workforce surveys which has been conducted every year since 2003.

The results – published on 26 February 2019 – show key findings in the following areas:

Health & Wellbeing

  • The highest number of staff in the past 5 years reported feeling unwell as a result of work-related stress at some time in the last 12 months (39.8%). 
  • Similarly, staff experiencing musculoskeletal problems as a result of work in the last 12 months has continued to increase since 2015, and was reported by 27.6% of staff in 2018. 
  • In spite of this, less staff felt that their organisation takes positive action regard staff health and wellbeing in 2018 than in 2017 (28.6%, 3.2% lower than in 2017). 
  • Satisfaction with opportunities for flexible working has improved since 2017 (by 1.3% to 53.1%) 
  • Whilst the number of staff working additional unpaid hours has decreased by 0.6%, almost 3 in 5 members of staff (57.8%) still work additional unpaid hours on a weekly basis.


  • There was a notable improvement in staff satisfaction with their salary at 36.3% (up 5% since 2017). 
  • Over half of staff (54.4%) were satisfied with the recognition they received for doing good work, and just under half (46.1%) were satisfied with the extent to which their organisation values their work. Both of these show improvement from the 2017 results (by 4% and 3% respectively). 
  • Almost 3 in 5 members of staff (58.7%) said they often or always look forward to going to work, which is an improvement of 1% since 2017. 
  • However, new questions included in the 2018 Survey revealed that 29.9% of staff said that they often think about leaving their organisation, and over 1 in 5 members of staff (21%) indicated that if they chose to leave their job, they would want to leave the NHS altogether.

Equality & Diversity

  • Since 2014 there has been a steady decline in staff who felt their organisation provides equal opportunities for career progression and this has continued in the 2018 results, which show over 4 in 5 members of staff (83.4%) thought their organisation provides equal opportunities. This figure is much lower among BME staff (69.9%). 
  • Continuing the clear upward national trend since 2015, 12.8% of staff reported experiencing discrimination in the workplace in 2018, with ethnic background once again being cited as the most common reason for the discrimination. However, gender-related discrimination increased by 0.5% from 2017 to 2018. 
  • Discrimination from patients or other members of the public has increased (by 0.3% from 2017’s figure of 6.6%), although discrimination from managers or colleagues has remained the same (8.1%). 
  • However, looking at the results at Trust level, the range of staff experiencing discrimination has fallen from between 7% and 25% in 2017, to between 6% and 24% in 2018. The highest percentages of staff experiencing discrimination were at London-based Trusts, with the most staff experiencing discrimination at North Middlesex University Hospital NHS Trust in both 2017 and 2018.

Working Environment

  • Well over a quarter (28.3%) of staff said that they had experienced bullying or harassment from patients or other members of the public in the past 12 months (an increase of 0.2% from 2017). 
  • A further 13.2% reported bullying and harassment from managers and 19.1% from other colleagues, both of which represent an increase from those reporting bullying or harassment in 2017 (which were 12.8% and 18% respectively). 
  • However, the number of staff reporting experience of physical violence fell overall in 2018 compared to 2017: 14.5% experiencing violence from patients or other members of the public (compared with 15.4% in 2017); 0.6% from managers (0.7% in 2017), and; 1.6% from other colleagues (1.9% in 2017). Trusts in the Midlands and East of England had the highest percentage of staff reporting physical violence, with a rate of 21% at James Paget University Hospitals NHS Foundation Trust (although this still represented a 1% decrease since 2017).

Patient Safety

  • The highest number of staff in 5 years reported having witnessed a safety incident which could have harmed a patient within the past month – 27.8% of staff – an increase of 3% since 2017. London-based Trusts were among the higher percentages of staff witnessing such incidents, and King’s College Hospital NHS Foundation Trust had the highest percentage of all trusts nationally, with 43% of staff reporting such incidents (up from 41% in 2017). 
  • However, 70.4% felt that their organisation takes action to ensure that reported incidents do not happen again (a 1.8% improvement since 2017). 

The results have attracted some criticism from trade unions. A recent article written by the BMA said the results “[revealed] a workforce in crisis” and UNISON’s Head of Health, Sara Gorton has urged government action “or the health service’s problems will go from bad to worse".

How can Bevan Brittan help?

Whilst staff morale has generally improved and the number of staff being subjected to violence at work has reduced, staff health and wellbeing remain a concern, and increases in bullying and discrimination will be particular areas on which NHS organisations will need to take action both nationally and locally in 2019.

These are difficult areas to address and need expert, in-depth solutions. With 200 lawyers acting in healthcare, advising almost two thirds of NHS Trusts and Foundation Trusts, and HealthInvestor Awards two years in a row as "Legal Advisors of The Year – Public" and "Legal Advisors of the Year Transactional (Public)" Bevan Brittan provides expert, in-depth solutions for NHS employers.

We work in partnership with NHS organisations, delivering off-the-shelf and bespoke interventions, from:

  • Challenging behaviours amongst senior medical staff and upskilling medical management with our modular Medical Workforce Toolkit; to
  • Engaging expert independent investigators, mediators and team facilitators through our Associates Network of senior independent HR professionals and former healthcare lawyers; to
  • Shifting blocks to bullying cultures or entrenched negative perceptions risking equalities challenges with tailor-made training and development packages; to
  • “Difficult conversations”, performance management, raising concerns and bullying and harassment training packages to engender confidence and core skills in your management teams; to
  • Consultancy and advice on contractual optimisation and flexibility of national terms and conditions to recruit, retain and improve morale.

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