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.



Given the COVID-19 pandemic and the impact it is having on Health and Social Care, a strong focus has been given to well-being within the survey, with both quantitative and qualitative questions:

Source Questions
Questions based on the Office for National Statistics (ONS) personal well-being metrics
  • Overall, how satisfied are you with your life nowadays ("Life Satisfaction")
  • Overall, to what extent do you feel the things you do in your life are worthwhile ("Worthwhile")
  • Overall, how happy did you feel yesterday ("Happiness")
  • Overall, how anxious did you feel yesterday ("Anxiety")
Two open questions
  • Thinking about your experiences of work over the last 6 months, what are you currently most worried about?
  • Thinking about your experiences of work over the last 6 months, what is most supporting your well-being?
Two iMatter questions
  • I feel my direct line manager cares about my health and well-being
  • I feel my organisation cares about my health and well-being 

It should be noted that the ONS metrics are a 'snapshot' in time, based on how individuals felt at the time they completed the survey (September 2020) and as such they are indicative measures of staff well-being. These metrics cover all aspects of the individual's life and so are influenced by personal circumstances as well as work experiences. ONS data for UK population is contained in Appendix 6.

Note: The ONS well-being questions have been answered on a 10 point scale (1 – 10). ONS benchmarks are based on an 11 point scale from 0 through to 10. Therefore, direct comparison of absolute scores cannot be made. 

The "Average Score" is the mean score. For the 'positive' statements (Life Satisfaction, Worthwhile and Happiness) higher scores are better. For Anxiety the lower the score the more positive the result.

Responses have been clustered to protect anonymity risks from showing the scale in full. The names of the groups reflect those used by the ONS and other organisations to categorise levels of well-being.

Staff Well-Being

The chart below shows the distribution of responses across the four clusters and the mean score for each of the four statements.

* Anxiety is a reverse measure: A low score is more positive than a high score.

Health and Social Care staff score higher for their sense of Worth than for Life Satisfaction or Happiness. This differs from the general population where there is greater consistency of scoring across the three positive measures. This suggests that roles within Health and Social Care contribute to many staff's overall feeling that things they do in their life are Worthwhile. This feeling may be heightened by the COVID-19 situation and the public response.

Those who have experienced work or personal change through the COVID-19 pandemic are a little less positive about their overall well-being and tend to be more anxious (see Appendix 10).

Workplace well-being support comes in many different forms, from large scale projects to small acts of kindness and support such as the NHS Lanarkshire Public Health Directorate Pray to start the Day; a daily 15-minute telephone prayer meeting.

There are many Staff Experience Stories and individual comments that reference the care taken over health and well-being of individuals and teams. Of particular note are:

  • The introduction of safe spaces in the workplace, that provide staff with an area that they can go to get away from the difficulties of their work. The following two examples illustrate this.
  • The distribution of 'comfort boxes' providing staff with simple treats of food, toiletries etc. is illustrated in NHS Lothian's "Wellbeing Hub in a Tub" and NHS Grampian's Comfort Boxes stories that follow. 

Relaxation and Recuperation (R&R) Hubs

"The aim in creating these Hubs was to give members of staff the space to relax and recuperate away from their clinical work environments. We drew upon learning from China where hospital clinicians working directly with the impact of COVID-19 benefitted significantly from relaxation and recuperation facilities which supported them to cope better with the significant extra demands being placed on them and enabled mental and physical recovery for their next shift.

Each Hub has different spaces: Café Space, Active Space with games and possibly gym equipment, Quiet Space for Relax/ Reflection. The Hubs are open to all members of staff 24 hours a day." Be Kind: Video link

NHS Greater Glasgow and Clyde

SWEETS Wobble Rooms

Wobble rooms and safe spaces were created across the Board, based on staff feedback:

"It was always about the simple things, a comfy seat to sit on in my break, somewhere that’s quiet. Not huge and earth shattering."

"Everyone has done it differently, because they were all different, their spaces were all different and their needs different. Once one area started other areas started to pay attention and notice, then other places introduced their own spaces."

NHS Dumfries & Galloway

Comfort Box Campaign

"In response to the coronavirus pandemic, we funded and delivered over 1,000 boxes to every NHS ward, team, department and care home across Grampian region. The boxes also featured inspiring artwork from children for the Rainbow Project organised by art health charity Grampian Hospitals Art Trust (GHAT). The comfort box campaign was launched in partnership with the Evening Express, Original FM, Sheddocksley Church, John Clark Motor Group and GHAT to support the health and social care workers who are working flat out and we wanted to support them for their heroic efforts."

NHS Grampian

Wellbeing Hub in a Tub

"NHS Lothian and its official charity partner, Edinburgh and Lothians Health Foundation ‘Wellbeing Hub in a Tub’ project, recognised that not all staff had access to the Wellbeing rooms that were set up across some of the hospital sites and needed alternative ways to access support to make a positive difference to their health and wellbeing during the Coronavirus pandemic. The boxes included sleep packs, hand cream, lip balm, energy snacks, refreshments, car chargers, headphones, and many other items to support the wellbeing of teams in the community as they carry out their day to day role. They also contained a wellbeing booklet on how to look after their own emotional and physical health during these challenging times."

NHS Lothian

The iMatter 2019 National Report included the story from Scottish Ambulance Service RUOK? Team at Livingston Station of two colleagues who identified a need for better welfare support and collaborated to improve staff experience whilst removing the stigma of mental health, not just in their own local teams, but throughout the Scottish Ambulance Service and extending to Ambulance Trusts across the UK. The importance of the RUOK? project has grown still further through the COVID-19 pandemic and the team behind it have been involved in promoting and developing the concept beyond, and within, the Scottish Ambulance Service:

RUOK? Team One Year On….

"The need for RUOK? and supporting one another has never been greater as we all deal with the impact of a global pandemic in 2020." Over the past year the team have been involved in:

1. NHS England 'Quick Action' Guide for Allied Healthcare Professionals to supporting staff health & well-being

2. Contributed to a book on Healthcare Practitioners mental health 

3. Presented at the Royal College of Physicians and Surgeons 'Making Life Work Better' Conference

4. Continuing to work with Lifeline Scotland supporting Emergency Responders across Scotland

5. Scottish Ambulance Service working group looking to develop Peer Support Network for staff 

 Scottish Ambulance Service

Staff Groupings

Overall, there is very little difference in well-being scores between NHSScotland and Local Authority Employees (see Appendix 10 for details).

Senior Managers in Local Authorities have the highest well-being scores overall and NHSS Senior Managers have the highest scores within NHS Scotland. Staff employed in NHSS Health Science Services have the lowest scores for Life Satisfaction, Worthwhile and Happiness, with NHSS Medical & Dental Support having the highest levels of Anxiety. 

Individual Boards

Geographic Boards are quite consistent in their well-being scores, with the highest being reported in the three island Boards (NHS Shetland, NHS Western Isles and NHS Orkney). 

Geographic Boards Life Satisfaction Worthwhile Happiness Anxiety
Health and Social Care 6.8 7.4 6.8 4.4
NHS Ayrshire & Arran 6.8 7.5 6.9 4.5
NHS Borders 6.8 7.5 6.9 4.3
NHS Dumfries & Galloway 6.9 7.4 6.8 4.4
NHS Fife 6.8 7.4 6.9 4.4
NHS Forth Valley 6.8 7.5 6.8 4.5
NHS Grampian 6.8 7.5 6.9 4.3
NHS Greater Glasgow and Clyde 6.6 7.4 6.7 4.5
NHS Highland 6.9 7.5 6.9 4.3
NHS Lanarkshire 6.8 7.5 6.9 4.4
NHS Lothian 6.8 7.5 6.8 4.4
NHS Orkney 7.1 7.7 7.1 4.2
NHS Shetland 7.1 7.6 7.0 4.1
NHS Tayside 6.8 7.4 6.8 4.3
NHS Western Isles 7.1 7.8 7.2 4.0

Following are examples of various actions taken by individual Geographic Boards to support staff well-being, that illustrate the array of differing support activity that is in place across the country. The actions and support described in these stories will likely have a positive impact across staff's well-being as well as specifically in the work environment.

Wellbeing Space for Staff – Physio Team Fitness Classes

The Physio Team in East Lothian organised fitness classes for staff including Lunch Circuits. They also ran twice weekly Tai Chi and daily exercise classes delivered by the physio team along with outdoor spinning classes and riverside walks in between patient contacts.

NHS Lothian

Psychological Safety - Speaking Out in the Right Place at the Right Time: What Makes It Safe?

"Building psychological safety in our teams is a core leadership responsibility and we have developed a range of interventions and resources to provide an understanding of what this is, together with some materials to help our leaders develop local action plans to promote and encourage an effective culture for all of our staff."

Work Related Worries

"The Acute Services Paediatric Service team focused on understanding why staff did not always speak up in multidisciplinary discussions around the ward.

A survey identified that staff who held back from speaking out often lacked confidence or were worried they had knowledge gaps. The resulting campaign was designed to encourage staff, give them confidence to speak out, and ensure they feel that their opinion is valued."

NHS Ayrshire & Arran

Hospital Peer Supporters Pulling together to try and make a difference – Staff Care is not just a Buzz Phrase  

"The Staff Care and Wellbeing Peer Supporters Team turned out to be a pretty awesome bunch of people. Ridiculous really when you consider the multiple disciplines involved: mental health nurses, occupational therapists, speech and language therapists, orthoptics and psychologists, all specialists in their own fields but not a clue what was expected of them."

"Under the guidance of the Healthcare Chaplains and their expertise we somehow managed to bring a hospital together, when staff were fatigued, emotionally drained, frightened, and overwhelmed at the magnitude of the task they were facing. As peer supporters our role was to have that conversation to allow staff to offload, not to fix their difficulties, but to guide them in how to normalise their situation, stabilise and acknowledge their crisis, facilitate understanding of their emotions and nudge them in the correct direction for ideas on effective coping strategies and ways to be kind to themselves to ready them for the next crisis that was surely waiting for them around the next corner. On occasion it was necessary to refer them to someone else as their difficulties exceeded our boundaries and remit."

NHS Lanarkshire 

Staff well-being scores vary more across the National Boards: 

  • NHS Education for Scotland and The State Hospital have positive scores for Life Satisfaction, Worth and Happiness and low scores for Anxiety. 
  • In contrast, NHS Golden Jubilee scores less well, with Anxiety levels being highest of all Boards.
National Boards Life Satisfaction Worthwhile Happiness Anxiety
Health and Social Care 6.8 7.4 6.8 4.4
Healthcare Improvement Scotland 6.9 7.3 6.8 4.5
NHS 24 6.6 7.3 6.7 4.3
NHS Education for Scotland 7.0 7.5 7.0 4.2
NHS Golden Jubilee 6.6 7.4 6.8 4.6
NHS National Services Scotland 6.8 7.4 6.8 4.4
Public Health Scotland 6.8 7.3 6.7 4.4
Scottish Ambulance Service 6.8 7.2 6.7 4.3
The State Hospital 6.9 7.5 6.9 4.1

The State Hospital story below illustrates the actions taken to support staff well-being:

Promoting positive staff health and well-being

Positive actions including  

  • Frequent and multiple communications about the 'ProMIS' National Wellbeing Hub 
  • Developing 'Staff Wellbeing Zone'
  • daily 'Covid-19 Bulletin'
  • Soup and a roll to all ward-based nursing staff 
  • Increased access to psychological first aid for staff

The team are evaluating the services through an initial survey and a follow-up one planned for the winter.

The State Hospital



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