Publication - Corporate report

Health and social care staff experience: report 2019

Independent report by Webropol providing detailed information and analysis of staff experience in Health and Social Care.

88 page PDF

3.0 MB

88 page PDF

3.0 MB

Contents
Health and social care staff experience: report 2019
iMatter EEI per organisation

88 page PDF

3.0 MB

iMatter EEI per organisation

The Employee Engagement Index (EEI) is calculated based on the number of responses for each point on the scale (Strongly Agree to Strongly Disagree) multiplied by its number value (6 to 1).  These scores are added together and divided by the overall number of responses to give the score to show level of engagement.

The overall EEI score of 76 for Health and Social Care is one point higher than in 2017. There was no reported score for 2018 as the threshold response rate of 60% was not achieved.

Chart: 2019 EEI Score

NHS Education for Scotland now has the highest ever reported Board EEI score of 82. NHS Health Scotland has the second highest score this year, remaining at 81.

Among the Geographic Boards NHS Lanarkshire has achieved the highest EEI score (79).

NHS Dumfries & Galloway and NHS Highland have the lowest reported EEI scores at 74. It is noted that the lowest EEI score in 2018 was the Scottish Ambulance Service (67) which did not reach the response rate threshold to receive a report this year.

Whilst there is a tendency overall for National Boards to have higher EEI scores than Geographic Boards, there is not a clear and obvious link between the EEI score and the size of a Board.

Chart: EEI By size of Board

Comparing 2019 EEI to Previous Years

Of those Boards that received an EEI score this year 5 have increased by 1 point over their previous score (achieved in either 2018 or 2017). 8 Boards remain unchanged from their previous score. Four Boards have a lower EEI score than previously, three having gone down by 1 point and one Board (Healthcare Improvement Scotland) by 2 points.

EEI Score 2017 2018 2019 Movement from previous reported EEI*
Health and Social Care 75 No Report 76 +1
Golden Jubilee Foundation  78 78 77 -1
Healthcare Improvement Scotland  80 80 78 -2
NHS 24  75 77 78 +1
NHS Ayrshire & Arran  76 No Report 76 0
NHS Borders  74 No Report No Report  
NHS Dumfries & Galloway  75 No Report 74 -1
NHS Education for Scotland  80 81 82 +1
NHS Fife  75 No Report 76 +1
NHS Forth Valley  75 75 75 0
NHS Grampian  76 77 77 0
NHS Greater Glasgow & Clyde  No Report No Report No Report  
NHS Health Scotland  81 81 81 0
NHS Highland  No Report No Report 74  
NHS Lanarkshire  77 78 79 +1
NHS Lothian  76 77 77 0
NHS National Services Scotland  77 76 76 0
NHS Orkney  75 76 75 -1
NHS Shetland  78 No Report 78 0
NHS Tayside 74 No Report 75 +1
NHS Western Isles  No Report No Report No Report  
Scottish Ambulance Service  67 67 No Report  
The State Hospital  76 77 77 0

*Movement is shown from the most recent year each Board previously received a report. 

Looking at the Boards who have received reports in all 3 years, it is notable that NHS 24, NHS Education for Scotland and NHS Lanarkshire have shown continuous improvement in their EEI score across all 3 years. NHS 24 have the largest reported improvement overall from 75 in 2017 to 78 in 2019

Two Boards; NHS Health Scotland and NHS Forth Valley have no reported change in their EEI score across all 3 years.

Chart: EEI scores for Boards reported every year

Several team stories highlight progress over 3 or 4 years of the iMatter programme, demonstrating the value in continued focus in driving sustained change as illustrated below (further examples are included within the Team Story section on this report).

The team has successfully focused on continuous improvement, by having regular reviews and open discussion. Through this process they have “identified alternative, more effective & efficient ways of working to reduce staff pressures, alongside achieving better outcomes for service users and releasing time to care.”

This has been reflected in considerable progress in iMatter metrics:

Table

East Dunbartonshire Alcohol & Drugs Service HSCP, ‘The Road to Success’ 

Whilst NHS Dumfries and Galloway have seen a drop of 1 point from 2017 when an EEI report was last received to 2019, the Board are utilising the QI Hub process to support staff:

Case Study 8: NHS Dumfries and Galloway QI Hub

“The Board has a local QI Hub which provides networking sessions and drop-in opportunities for staff to receive QI advice and support for their projects. There are also formal courses; around 150 staff to date have taken the Scottish Improvement Skills course.  The Board is encouraging 2-3 members of a team to attend the course to build up whole team QI skills.  The Board has also introduced the Scottish Coaching and Leading for Improvement course which provides more advanced training.  The aim is to help local teams integrate QI skills within their projects from the outset.” 

NHS Dumfries and Galloway

Relationship between Response Rate and EEI

Across the Boards who have received reports in all three years, there is no consistent relationship between response rate movement and EEI movement.

Response Rate EEI
Organisation  2017 2018 2019 2017 2018 2019
Golden Jubilee Foundation 68% 63% 67% 78 78 77
Healthcare Improvement Scotland  80% 86% 90% 80 80 78
NHS 24  67% 70% 65% 75 77 78
NHS Education for Scotland  81% 84% 87% 80 81 82
NHS Forth Valley  65% 62% 68% 75 75 75
NHS Grampian  64% 60% 62% 76 77 77
NHS Health Scotland  85% 91% 93% 81 81 81
NHS Lanarkshire  65% 62% 65% 77 78 79
NHS Lothian  65% 63% 63% 76 77 77
NHS National Services Scotland  76% 77% 82% 77 76 76
NHS Orkney  73% 83% 66% 75 76 75
The State Hospital  78% 77% 79% 76 77 77

Of the 4 Boards that have seen improvement in response rate year-on-year across the three years: 

- NHS Education for Scotland has also seen an increase in EEI year-on-year
- Healthcare Improvement Scotland’s EEI has declined each year
- The EEI for NHS Health Scotland has remained unchanged across the three years
- NHS National Services Scotland saw a drop of 1 in EEI from 2017 to 2018 and in 2019 it remained unchanged

Therefore it is reasonable to assume that continuing to increase response rates in future years will NOT have a direct detrimental effect on EEI score. 

iMatter Report of EEI scores for Teams per Organisation 

Across the whole of Health and Social Care (including both Boards that did receive a report and those that did not) the distribution of teams across each of the score bands is as shown below. The vast majority of teams that received a report score in Strive to Celebrate (67-100). Across the whole of Health and Social Care there are only 59 teams that have an EEI score between 34 and 50 (less than 1% of all teams) and just one team with a score of 33 or less.

Organisation Number of Teams Percentage of Teams
Strive & Celebrate (67-100) 8,438 59%
Monitor to Further Improve (51-66) 988 7%
Improve to Monitor (34-50) 59 0%
Focus to Improve (0-33) 1 0%
No Report 4,902 34%
Total Health and Social Care 14,388 100%

Of the 60 teams that scored 50 or less, 16 of them (27%) are in Boards that did not receive a report in 2019. This compares with 25% of the teams scoring Strive and Celebrate and 33% of the teams scoring Monitor to Further Improve being in Boards that did not receive a report. 

The table below shows the distribution of team scores for each Board that received a report in 2019.

NHS Health Scotland is the only board with all teams in the Strive and Celebrate band. Additionally, there is one Geographic Board and three National Boards that have all teams with reports scoring either Strive and Celebrate or Monitor to Further Improve:

- NHS Orkney 
- NHS 24
- NHS Education for Scotland 
- The State Hospital 

90% of the volume of teams in reported Boards are in Geographic Boards and only 10% in National Boards. Of teams scoring Strive and Celebrate, 89% are in Geographic Boards reflecting the slightly lower overall EEI among Geographic Boards.

The above threshold categories were developed and recommended in the Staff Experience Project Report and Recommendations 2013 and approved in June 2013 by the Scottish Workforce and Staff Governance Committee.

Boards that received a report in 2019 Strive & Celebrate 67-100 Monitor to Further Improve 51-66 Improve to Monitor 34-50 Focus to Improve 0-33 No Report Total
Golden Jubilee Foundation 95 7 2 0 42 146
65% 5% 1% 0% 29% 100%
Healthcare Improvement Scotland 63 8 1 0 17 89
71% 9% 1% 0% 19% 100%
NHS 24 110 11 0 0 93 214
51% 5% 0% 0% 43% 100%
NHS Ayrshire & Arran 566 58 3 0 321 948
60% 6% 0% 0% 34% 100%
NHS Dumfries & Galloway 187 25 1 0 72 285
66% 9% 0% 0% 25% 100%
NHS Education for Scotland 91 1 0 0 10 102
89% 1% 0% 0% 10% 100%
NHS Fife 475 45 4 0 294 818
58% 6% 0% 0% 36% 100%
NHS Forth Valley 343 49 3 0 141 536
64% 9% 1% 0% 26% 100%
NHS Grampian 799 76 2 0 462 1,339
60% 6% 0% 0% 35% 100%
NHS Health Scotland 31 0 0 0 0 31
100% 0% 0% 0% 0% 100%
NHS Highland 415 69 2 0 285 771
54% 9% 0% 0% 37% 100%
NHS Lanarkshire 704 37 6 0 326 1,073
66% 3% 1% 0% 30% 100%
NHS Lothian 1,313 129 10 0 736 2,188
60% 6% 0% 0% 34% 100%
NHS National Services Scotland 285 23 2 0 45 355
80% 6% 1% 0% 13% 100%
NHS Orkney 49 5 0 0 23 77
64% 6% 0% 0% 30% 100%
NHS Shetland 84 6 1 0 44 135
62% 4% 1% 0% 33% 100%
NHS Tayside 693 105 7 0 501 1,306
53% 8% 1% 0% 38% 100%
The State Hospital 54 4 0 0 5 63
86% 6% 0% 0% 8% 100%

EEI scores for Teams per Organisation comparison over time

The table below shows the EEI scores for the Boards that achieved reports in all three years. Percentages are based on the teams receiving a report. Overall there is consistency in the distribution of team scores over time. However, 3 Boards have increased the proportion of teams with reports scoring Strive and Celebrate across all three years

- NHS 24 (87% in 2017, 89% in 2018, 91% in 2019)
- NHS Education for Scotland (93%, 94%, 99%)
- The State Hospital (87%, 90%, 93%)

The proportion of teams with reports who have scored in the Strive and Celebrate band has decreased each year for The Golden Jubilee Foundation (95% in 2017, 93% in 2018 and 91% in 2019), leading to increases in the percentage of teams in the Monitor to Further Improve and Improve to Monitor bands.

Percentages based on all Teams receiving a report Strive & Celebrate
67-100
Monitor to Further Improve
51-66
Improve to Monitor
34-50
Focus to Improve
0-33
Golden Jubilee Foundation 2017 95% 4% 1% 0%
2018 93% 6% 1% 0%
2019 91% 7% 2% 0%
Healthcare Improvement Scotland 2017 90% 10% 0% 0%
2018 93% 7% 0% 0%
2019 88% 11% 1% 0%
NHS 24 2017 87% 13% 0% 0%
2018 89% 11% 0% 0%
2019 91% 9% 0% 0%
NHS Education for Scotland 2017 93% 6% 1% 0%
2018 94% 6% 0% 0%
2019 99% 1% 0% 0%
NHS Forth Valley 2017 90% 10% 0% 0%
2018 87% 12% 1% 0%
2019 87% 12% 1% 0%
NHS Grampian 2017 91% 7% 0% 0%
2018 93% 7% 0% 0%
2019 91% 9% 0% 0%
NHS Health Scotland 2017 100% 0% 0% 0%
2018 100% 0% 0% 0%
2019 100% 0% 0% 0%
NHS Lanarkshire 2017 93% 7% 0% 0%
2018 95% 5% 0% 0%
2019 94% 5% 1% 0%
NHS Lothian 2017 90% 10% 1% 0%
2018 91% 8% 0% 0%
2019 90% 9% 1% 0%
NHS National Services Scotland 2017 93% 7% 0% 0%
2018 91% 9% 0% 0%
2019 92% 7% 1% 0%
NHS Orkney 2017 74% 10% 1% 0%
2018 96% 4% 0% 0%
2019 91% 9% 0% 0%
The State Hospital 2017 87% 12% 1% 0%
2018 90% 8% 1% 0%
2019 93% 7% 0% 0%

Overall Experience

The overall experience question has shown a small improvement from 2018 to 2019 with an increase in the mean of 0.1 to 6.89. This increase is being driven by small increases in the percentages scoring 9 or 10 and a decrease in the percentages scoring 2 or 3.

Chart

Across the Boards receiving a report, the overall experience mean score ranges from 7.75 for NHS Education for Scotland to 6.64 for NHS Highland.

Chart

The distribution of responses across the 11 point scale illustrates the differences between the highest and lowest scoring Boards. To demonstrate this point, the chart below compares the distributions for NHS Education for Scotland and NHS Tayside with the overall NHS Scotland distribution.

The high NHS Education for Scotland score is driven by a greater proportion of staff using the top end of the scale, with 59% of staff in this Board scoring 10, 9 or 8, compared to 41% of Health and Social Care staff overall. In contrast only 37% of NHS Tayside staff score 8, 9 or 10.

Distributions for all Boards receiving an EEI report are shown in Appendix 6.

Chart

Summary

The 2019 iMatter EEI score for Health and Social Care is 76, one point higher than the last reported score of 75 from 2017. Of the Boards that received an EEI score the highest is NHS Education for Scotland at 82 and the lowest NHS Dumfries and Galloway and NHS Highland, both with a score of 74. Five Boards have an improved EEI score this year, 8 are unchanged and 4 have a lower score than last time they received a report.

Several Boards show evidence of continuous improvement year on year in their EEI score, with individual Team Stories illustrating how this can be achieved through continued long-term commitment to improvement Action Plans. 

At team level, the vast majority (89%) of those that receive a report score in the Strive and Celebrate band (67-100) with just 60 teams across the whole of Health and Social Care scoring 50 or less.


Contact

Email: alison.carmichael@gov.scot