Health and social care - everyone matters pulse survey: national report 2020

Independent report by Webropol providing detailed information and analysis of staff experience in health and social care during the initial COVID-19 period.

Management and Leadership

Two iMatter metrics refer to the extent to which line management and the organisation care about staff health and well-being. It is notable that the two metrics are the highest and lowest scoring of all those included in the Pulse Survey. Staff are very positive about their line manager's role in supporting their well-being but less so about the organisation's role. 

Compared to 2019, iMatter, the line manager rating on the Everyone Matters Pulse Survey 2020 is 5 points lower, whilst the organisation rating is 1 point lower.

Line Managers

Across the areas of worry and support identified by staff, line managers feature strongly with 19% of staff who answered the open question about support, talking about their line managers and 9% of those answering the open question about worries referencing line managers. Line managers who are supporting their staff are doing so by demonstrating empathy, offering practical and emotional support to their team. Typically, it is the lack of open and timely communication and information from line managers that causes worry for staff. 

Senior Management/Leadership Teams

As noted above, the organisation caring for staff health and well-being is the lowest rated measure and some staff are critical of how they perceive senior management have handled the COVID-19 pandemic. 6% of staff answering the open question say senior management or leadership issues have caused them worry. Often it is a lack of clear and timely communication, visibility of leadership teams or conflicting/ changing information that lead to staff worries. 

It may be that some issues are outside of management control as COVID-19 is a novel and evolving situation and so many decisions adapt and change as the pandemic progresses. This doubtless leads to changes and even reversals of decisions taken and clearly increases the challenge for leadership teams when communicating with staff.

There are also examples of how staff feel they have been supported by senior management. 2% of staff responding to the question about sources of support, talk about senior management providing support. This is typically through sharing of information, showing empathy to staff and communicating openly.

Individual Boards

NHS Shetland and NHS Grampian have the highest scores for both line managers and the organisation caring about staff health and well-being.

Geographic Boards My direct line manager cares about my health and well-being My organisation cares about my health and well-being
NHS Ayrshire & Arran 79 70
NHS Borders 79 67
NHS Dumfries & Galloway 79 67
NHS Fife 79 69
NHS Forth Valley 77 66
NHS Grampian 81 72
NHS Greater Glasgow & Clyde 78 67
NHS Highland 79 68
NHS Lanarkshire 80 70
NHS Lothian 79 69
NHS Orkney 77 68
NHS Shetland 81 74
NHS Tayside 78 66
NHS Western Isles 78 65

Among the National Boards NHS Education for Scotland and Healthcare Improvement Scotland score highly for both line manager and the organisation caring about health and well-being. Public Health Scotland also has a high score for line managers, but performs less well for the organisation, perhaps reflecting the newness of the Board structure.

Scottish Ambulance Service has the lowest scores of all Boards for both measures.

National Boards My direct line manager cares about my health and well-being My organisation cares about my health and well-being
Healthcare Improvement Scotland 87 82
NHS 24 83 70
NHS Education for Scotland 88 82
NHS Golden Jubilee 76 64
NHS National Services Scotland 84 77
Public Health Scotland 87 76
Scottish Ambulance Service 71 59
The State Hospital 78 66

Healthcare Improvement Scotland and NHS Education for Scotland have the highest scores for 'my organisation cares about my health and well-being'. Healthcare Improvement Scotland, have seen the greatest increase from iMatter 2019 and have reflected on actions taken that are believed to have contributed to this score:

Healthcare Improvement Scotland moved rapidly to enable all staff to work from home from c.18th March. Since this date there has been clear and consistent messaging throughout in respect of well-being from the Board and the Executive Team 

  • Via regular email updates, virtual all staff Huddles conducted via MS Teams
  • Specific initiatives such as the Sleeposium (led by Dr Colin Espie), Wellbeing Drop-in sessions, Randomised Coffee Trails, Step Challenges, Action for Happiness daily prompts
  • Recognition of the importance of general 'chat' such as sharing individual interest and events via our local intranet arrangements on the Source 
  • A bespoke 'local' survey and follow-up focus groups were conducted within weeks of lock down, asking staff how they were adapting
  • Ensuring staff have the appropriate equipment to allow them to work effectively at home
  • Shared a range of staff blogs with the organisation which cover individual experiences in different roles both internal and external to the organisation

NHS Education for Scotland have explored in depth what is contributing to their staff feeling the organisation cares about their well-being. Again, the Board successfully transferred staff to home working. In June they carried out a Staff survey, the results of which have driven actions around communications and listening, Line Manager support, psychological well-being and technical/ digital/ practical support.


Communications are an area of concern noted by 4% of staff and an aspect of support for 2% of staff answering the open questions. Communication is not just about sharing work related information; it is about staying in touch with people and there are many stories that reference communication activity including the example below from NHS Lanarkshire:

Keeping Connected – laughter through the challenges

"The Organisational Development Team in the HR Directorate recognised both the need to stay connected and the ‘heavy’ nature of so many of their virtual meetings. They therefore introduced a light-hearted quiz to the end of their weekly team meetings to support the sense of team spirit and to provide “ten minutes of escapism from reality – to allow the team to laugh together."

NHS Lanarkshire



Back to top