Health and social care - staff experience: report 2021

Independent report by Webropol providing detailed information and analysis of staff experience in health and social care across Scotland during 2021.


Employers in Health and Social Care are committed to improving patient and public services through enhancing staff experience.

Our 2021 Vision for Health and Social Care makes a commitment to valuing and empowering everyone who works in NHSScotland, including those working within Health & Social Care Partnerships (H & SCPs), and supporting them to work to the best of their ability. We recognise that improved staff experience is critical for delivery of the Scottish Government's Health and Social Care Delivery Plan, to provide better care, better health and better value.

It is therefore essential that staff at all levels are empowered and enabled to have their voices heard, that they are valued within their immediate team and wider organisation, and that their views, opinions, and actions contribute to continuous improvement.

The work to measure and report staff experience in Health and Social Care in 2021 was commissioned by the Scottish Government and carried out by Webropol Ltd, an independent company.

The iMatter Continuous Improvement Model

The iMatter Continuous Improvement Model was developed by NHSScotland staff and aims to engage staff in a way that feels right for people at every level. As a team-based tool, iMatter offers individual teams, managers, and organisations the facility to measure, understand, improve and evidence staff experience.

Arrangements for the delivery of the iMatter model were developed in full partnership and have been endorsed by the Scottish Workforce and Staff Governance Committee (SWAG) and approved by the Cabinet Secretary for Health and Social Care. iMatter was initially rolled out over a three-year period from 2015 to 2017 to all staff across NHSScotland and 24 Health & Social Care Partnerships that chose to participate. The 2018, 2019 and 2021 programmes have repeated that process.

The implementation of iMatter has enabled us to obtain a comprehensive picture of staff experience. Indicating areas of success and those which require improvement both nationally and locally, helps inform progress in delivering the commitments of our Staff Governance Standard.

iMatter Process

The iMatter questionnaire enables staff the opportunity to feed back their experience within their team and at organisational level on a real-time basis. iMatter results are directly reported at all levels throughout an organisation. Once team results are delivered, teams are invited to collectively share responsibility for developing an action plan within an 8-week period and to review actions and progress made throughout the year. As an integral part of the iMatter process, teams come together to review the results and share thoughts and ideas in order to develop and implement Action Plans. See Appendix 1 for further details.

The iMatter process is normally supported by Team Stories, that provide best practice examples of how to address challenges and provide inspiration and ideas for other teams and for the organisation as a whole. As a direct consequence of the COVID-19 pandemic and the ongoing situation faced by Health and Social Care, the decision was taken to not request Team Stories in 2021. We aim to resume this in iMatter 2022 with an emphasis on showing how action plans created in response to 2021 iMatter result in tangible change and benefits to staff.

Data Collection

The iMatter process uses Webropol to distribute electronic and paper questionnaires (see Appendix 2) to NHSScotland employees, as well as those employed by the local authority who work in a Health & Social Care Partnership who chose to participate. In 2021, all 22 Health Boards and 28 H & SCPs took part (see Appendix 2 for details).

For 2021 all fieldwork was carried out between 9 August and 11 October. The 2021 questionnaire contains all that was in 2019. Additionally, questions exploring what type of change, if any, staff have experienced, and demographic questions covering protected characteristics were also included. Further details of the questionnaire are included in Appendix 3.

Public Health Scotland

Public Health Scotland is a new organisation bringing together the work of Health Protection Scotland, Information Services Division and NHS Health Scotland and therefore trend data is not applicable. Previous scores for NHS Health Scotland are shown for reference, but direct comparisons are not made.

Classifying Boards

In past iMatter reports, Boards were split into two categories:

  • Geographic Boards: those that provide regional healthcare services
  • National Boards: those that provide support services at a national level or specialist services such as those provided by The State Hospital

Whilst this classification was appropriate from an organisational perspective, it is evident that, in terms of staff experience, Boards can be broadly allocated to one of three groups. It is therefore the following grouping that is referenced in this report. Colour-coding as illustrated is used throughout the report to highlight the different types of Boards.

An overview of the role of each National Board is included in Appendix 4.

Geographic Boards (Patient-facing)

  • NHS Ayrshire & Arran
  • NHS Borders
  • NHS Dumfries & Galloway
  • NHS Fife
  • NHS Forth Valley
  • NHS Grampian
  • NHS Greater Glasgow & Clyde
  • NHS Highland
  • NHS Lanarkshire
  • NHS Lothian
  • NHS Orkney
  • NHS Shetland
  • NHS Tayside
  • NHS Western Isles

National Boards (Patient-facing)

  • Golden Jubilee Foundation
  • Scottish Ambulance Service
  • NHS 24
  • The State Hospital

National Boards (Support)

  • Healthcare Improvement Scotland
  • Public Health Scotland
  • NHS Education for Scotland
  • National Services Scotland

iMatter Report 2021

This report provides detailed information and analysis of the iMatter responses for 2021. It also contains comparisons to 2019, 2018 and 2017 where appropriate. The Everyone Matters Pulse Survey carried out in 2020 focused on well-being and included only a small number of iMatter metrics. As the different questionnaire content may influence the way in which staff answered individual questions, the data is not included within the main historic iMatter comparisons in this report. Where appropriate, reference is made through the report to individual scores and a summary is included within Appendix 5.

The findings from this report will be used by a range of stakeholders, including:

  • Individual organisations (Health Boards and local authorities)
  • The Scottish Government
  • Partnership Groups such as the Staff Governance Committee (SWAG), the Scottish Partnership Forum (SPF) and the Scottish Workforce.

Statistical Analysis

Significance testing has been carried out on the data and a summary is included in Appendix 6.



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