Health & Social Care Staff Experience Survey 2023

Introduction

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

The National Workforce Strategy for Health and Social Care, issued in 2022, sets out a vision of a sustainable, skilled workforce with attractive career choices where all are respected and valued for the work they do. The NHS Recovery Plan 2021-2026, which seeks to drive long term recovery and sustainability in the system, also reinforces the importance of positive staff experience in delivering positive patient outcomes.

It is therefore essential that staff at all levels are empowered to have their voices heard and valued, and staff views and actions contribute to continuous improvement in their teams and organisations.

The iMatter Continuous Improvement Model was developed by NHSScotland staff with the aim of engaging all staff in a way that feels right for them. The focus is on team-based understanding of experience, but it also offers information at various levels within organisations to evidence and help improve staff experience. As such, it can provide clarity on where to focus efforts for maximum impact, which in turn leads to better care, better health, and better value.

iMatter was initially rolled out over a three-year period from 2015 to 2017 to all staff across NHSScotland and the wider Health and Social Care Partnership community who chose to participate. Since then, it has run each year, except for 2020, when a shorter pulse survey was run instead due to the pandemic. The implementation of iMatter has enabled us to obtain a comprehensive picture of staff experience, indicating areas of success and improvement, and helping to inform delivery on the commitments of our Staff Governance Standard.

The work to measure and report staff experience within Health and Social Care for 2023 was commissioned by the Scottish Government and carried out by Webropol Ltd, an independent company.

iMatter Process

The iMatter questionnaire gives 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.

Data Collection

The iMatter process uses Webropol to distribute electronic and paper questionnaires to NHSScotland employees, as well as those employed by the Local Authority who work in a Health & Social Care Partnership who choose to participate. In 2023, all 22 Health Boards and 29 H & SCPs took part (see Appendix 2 for details). Access to the survey is provided via three alternatives:

1. An email invitation with a link to the online survey (Email)

2. A paper survey printed and distributed to those without online access (Paper)

3. An invitation sent via SMS with a link to the online survey (SMS)

For 2023 all fieldwork was carried out from 15 May to 17^th July 2023.

Questionnaire

The 2023 questionnaire has some changes from 2022:

• The questions relating to changes staff had experienced have been removed. These questions were first introduced to the pulse survey in 2020 in response to the impact of the Covid pandemic and are therefore no longer appropriate to ask.
• Two additional questions are included in the 2023 questionnaire covering how staff feel about raising concerns:
• I am confident that I can safely raise concerns about issues in my workplace
• I am confident that my concerns will be followed up and responded to

The full questionnaire is included in Appendix 3.

Classifying Boards

Boards can be broadly allocated to one of three groups:

• Geographic Boards: those that provide regional healthcare services
• National Boards: those that provide support services to the organisation at a national level e.g., Public Health Scotland
• National Boards: those that provide specialist patient-facing services such as those provided by The State Hospital

Colour-coding as illustrated is used throughout the report to highlight the different types of Boards.

An overview of each Board and a link to its website 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 and Clyde
• NHS Highland
• NHS Lanarkshire
• NHS Lothian
• NHS Orkney
• NHS Shetland
• NHS Tayside
• NHS Western Isles

National Boards (Patient-facing)

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

National Boards (Support)

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

Response Rate Threshold

The previous response rate requirement of 60% for teams of 5 or more to receive an EEI report was removed in 2021. The 100% response rate for teams of 4 or less to generate a report remains a requirement for 2023. This is to ensure anonymity and the higher the response rate, the more realistic the feedback of how staff feel about working in their team.

iMatter Report 2023

This report provides detailed information and analysis of the iMatter responses for 2023. It also contains comparisons to previous years where appropriate. The Everyone Matters Pulse Survey (EMPS) 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.

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 Scottish Workforce and Staff Governance Committee (SWAG), and the Scottish Partnership Forum (SPF)

This report is supported by the Health and Social Care Staff Experience Survey 2023: iMatter Data File (iMatter 2023 Data File) in which contains more detailed data.

Team Stories

The iMatter process is 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. Illustrations from Team Stories are included through the report. Appendix 5 has a full list of Team Stories submitted this year.

Statistical Analysis

Significance testing has been carried out on the data, to explore the extent to which differences in scores between different groups (e.g. Boards, Staff Groupings etc.) are statistically significant.

Correlation analysis has also been carried out, to understand the relationship between the individual measures included within iMatter. An overview of the analysis done is in Appendix 6 and summaries of the data are included in the iMatter 2023 Data file.

Whole Number Reporting

As with previous years, all iMatter 2023 results are reported to the nearest whole numbers i.e. without any decimal places shown. This is the case for both Board level and national reporting and applies to the presentation of the various scores and index values calculated from the individual survey responses. Whilst this approach does potentially hide some significant movements in the total Health and Social Care dataset and within some of the larger Boards, reporting whole numbers only ensures focus is on those movements that are most statistically significant. The only exception to this is the Overall Experience question which is scored on an 11 point scale (from zero to ten) and is reported to one decimal place. This approach has been agreed, in partnership, by Scottish Workforce and Staff Governance Secretariat.

Profile of Staff Completing the iMatter Survey

The demographic profile of staff completing the iMatter survey in 2023 is similar to that of previous years.

Staff are asked to confirm if they are NHSScotland or Local Authority staff and within that the staff grouping they are in.

Further details of demographics and staff groupings are included within the iMatter 2023 Data file^[1].