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.

Response Rates Overview

Overall Response Rate 

In total 83,656 Health and Social Care staff took part in the Everyone Matters Pulse Survey 2020. This is an overall response rate of 43% and so provides robust and representative data on Health and Social Care staff well-being and work experiences.

Response rates vary considerably across individual Boards. The 5 Boards with the highest response rates are all National Boards.


* Health and Social Care is the national average across all NHS Boards and participating Health and Social Care Partnerships. 

Public Health Scotland is a new organisation bringing together the work of Health Protection Scotland, Information Services Division and NHS Health Scotland.

An example of how the survey was promoted to staff both in the lead up to, and during, fieldwork is provided by NHS 24:

NHS 24

Pre survey:

  • Banners and survey explanation to all staff, team managers and Directorate leads

2nd September onwards:

  • Medical Director video on the importance of the survey on Intranet and signposted
  • Content in regular newsletter going out from L&OD to all staff
  • Meetings with shift leads at the start of the evening shifts (in two of the larger call centres) encouraging them to remind everyone of the importance of the survey.
  • Updates on completion rates sent to Clinical Services Managers etc. to ensure staff were released from calls for 10 minutes to complete survey.
  • All teams under 33% completion rates targeted with emails and then survey link sent to the team members. This was done on each week while the survey was open.
Among the Geographic Boards, NHS Dumfries & Galloway has the highest response rate (54%).

Reasons for Lower Response Rate

The response rate for 2020 of 43% is below that achieved for iMatter 2019 (62%) but is considerably above the Dignity at Work survey of 2017 that achieved a response rate of 36%.

There are several reasons suggested for why response rate is lower than iMatter 2019. These cannot be verified or quantified without further exploration with staff:

  • The COVID-19 situation meant some staff may not have time or inclination for the survey.
  • There was less opportunity for promotion of the survey, given the compressed timeline and workload pressures.
  • As the survey results are only being reported to Directorate level there may be a lower level of peer encouragement within teams to take part.

Partials and Non-Completion

There is a notable increase in the number of recipients who open the survey link but do not continue to complete the survey. For iMatter 2019 a total of 6,653 employees opened the survey but did not continue. That figure almost doubled to 12,564 for the Everyone Matters Pulse Survey 2020. Additionally, 787 paper surveys were not processed because they were only partially complete or could not be processed for other reasons (unscannable, duplicates, completion errors).

Survey Methods 

The Survey was primarily distributed online, with email invitations being sent to 170,190 staff, of whom 28,100 (14%) work within Health and Social Care Partnerships (see Appendix 2 for details). Paper surveys were issued where email invitations were not possible. An SMS survey method was used by 11 Boards.

The online survey achieved the highest response rate overall (46%), with SMS 24% and paper 17%. Further details of the postal response rates by Board are contained in Appendix 3.

Everyone Matters Pulse Survey 2020 Volume Issued % of Volume Issued Usable Response Volume % of Responses Received Response Rate by Method
Online 170,190 87% 78,815 94% 46%
Paper 22,747 12%   3,936 5% 17%
SMS 3,847 2% 905 1% 24%
Total 196,784   83,656   43%


Following a successful 2019 pilot in the West Dunbartonshire HSCP (NHS Greater Glasgow and Clyde) during iMatter 2019, SMS survey invitations were made available to all Boards for the 2020 Pulse Survey. 9 Geographic and 2 National Boards used SMS for the Pulse Survey.

3,847 SMS invites were sent, representing 2% of the total survey volume. 905 SMS surveys were completed, representing 1% of the total survey responses. The overall SMS response rate was 24%, above the paper response rate, but below the online response rate.

The experiences of the Boards that made greater use of SMS for the Pulse Survey provide valuable information for the continued development of this method for use in future surveys:

NHS Lanarkshire invited 2,262 staff via SMS and achieved a 14% response rate. The SMS Pulse Survey was used to reach HSCP areas who haven’t been included before. Suggested reasons for the low response rate include:

  • Survey fatigue –staff had recently been asked to participate in a survey sent out from the partnership
  • Lack of time to promote another survey with a large group of staff who all work remotely
  • SMS issues – staff reported the survey link not opening on their phones, the IT department from the partnership are investigating if it is security settings on the phones, work was still ongoing when the survey closed. Pressures within this group meant they gave up when it wouldn’t open first time.

In NHS Greater Glasgow and Clyde 1,081 staff across 3 HSCP’s were invited to the Pulse Survey via SMS and 39% responded:

  • West Dunbartonshire, who had supported the pilot were keen to use this format again and had the highest response rate of these 3 areas, at 45%.
  • East Renfrewshire and Renfrewshire HSCP used SMS for the first time. They experienced some phone issues similar to those in NHS Lanarkshire. It was also noted that the phone number the SMS would come from should be communicated to staff in advance so that they know it is safe to click on.

Note: Details of response rate by Board and by survey method are shown in Appendix 3.



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