iMatter Health & Social Care Staff Experience Survey 2025

Response Rates

Introduction

The response rate shows the number of recipients issued with the questionnaire and the number of respondents as an overall percentage.

In total 207,397 questionnaires were issued, the highest number to date for iMatter, and 119,173 usable responses were received. This equates to an overall response rate of 57%.

Board Response Rates

Response rates across individual Boards range between 52% to 90%.

To view this table in its original format please see the PDF.

There are some large movements, both positive and negative, in response rates in 2025 compared to 2024.

Among the Geographic Boards the greatest improvement is NHS Western Isles, where the response rate has increased 8 pps from 62% in 2024 to 70% in 2025. It is now the highest response rate from a Geographic Board.

Feedback from the Board attribute the sustained improvement in response rate (up 18% overall from 2018) to activities that boost engagement in the iMatter process:

NHS Western Isles Board Feedback

“Senior leaders have continually reinforced the message that iMatter is not a one-off survey but a vital part of our organisational culture, rooted in listening, hearing and acting. Particular emphasis has been placed on “closing the loop,” ensuring that feedback leads to meaningful team discussions and jointly agreed action plans, which has helped build trust and ownership. The rise in completed action plans in recent years appears to correlate strongly with improved response rates, suggesting that when staff see their input being acted upon, they are more likely to engage again. While iMatter has also been referenced in job descriptions to reinforce its importance, the primary driver has been authentic, visible engagement and a commitment to embedding staff voice into everyday practice. Overall, we have seen the benefit from prioritising genuine messaging from leaders, supporting full survey engagement including action planning, operational support from HR and visibly demonstrating that staff feedback leads to tangible improvements.”

The largest decline among the Geographic Boards is NHS Shetland down 4 pps from 60% to 56%.

NHS Shetland provided feedback on why they believe the response rate has declined:

NHS Shetland Board Feedback

“Our analysis of the 2025 iMatter data shows a mixed picture. NHS Shetland has maintained a strong response rate of 69%, reflecting sustained engagement with the tool. However, we have observed a decline in the overall response rate, primarily due to a reduction in participation from Shetland Islands Council employees, whose response rate now stands at 39%. Feedback suggests that some Council employees perceive iMatter as less aligned with the broader range of engagement initiatives already in place within their organisation.”

NHS Tayside has declined 3 pps from 56% to 53%, compounding a longer term decline (65% in 2017) NHS Highland has the lowest response rate (52%).

Among the National Support Boards, National Services Scotland has declined 3 pps to 77%. NHS Education for Scotland (NES) has increased 3 pps to 90%, making it the Board with the overall highest response rate.

Among the National Patient-facing Boards, NHS 24 have improved their response rate by 6 pps from 76% in 2024 to 82% in 2025. This continues improvements seen since 2021 when NHS 24 response rate was 57%. NHS 24 identify several factors that have contributed to this increase:

NHS 24 Board feedback

The following actions were noted as improving response rates:

Leadership Development Programme (LDP) – This programme has enhanced leadership skills and fostered more engaging work environment. This has led to higher levels of employee engagement and satisfaction, encouraging more staff to participate in the iMatter survey. The LDP's emphasis on psychological safety and a positive work culture has made employees feel more valued and respected, further boosting their willingness to provide honest feedback.

Delivery of NHS 24’s Management Essentials Programme (MEP) – This is a comprehensive programme that equips managers with essential skills including Communication and Emotional Intelligence, emphasising the pivotal role of managers in fostering a positive and engaging work environment.

Tracking response rates – Data is monitored and shared twice weekly with the Director of Workforce, reminders are sent to managers, and managers are empowered to lead team confirmation, monitor response rates and facilitate action planning.

Having a comprehensive communication plan – This includes but is not limited to; “You Said, We Did” content; introduction of iMatter local drop-in sessions; iMatter feature in Directorate development days; and iMatter resources page on NHS 24’s intranet.

A move towards a more performance-oriented culture – This includes the use of iMatter data in local annual KPIs and the creation of a Culture Dashboard to monitor both the directorate and overall organisation positions in these indicators.

Our Culture Matters Programme – As part of this programme each directorate has an annual Culture and Wellbeing Action Plan in place; iMatter engagement is promoted through this channel. Staff Experience Groups promote iMatter and examples of “You Said, We Did” actions. A representative from the Workforce directorate attends every Regional Partnership Forum meeting wherein iMatter can be promoted further.

In contrast, The State Hospital has declined 6 pps and is now at its lowest ever response rate of 66%. Feedback from The State Hospital includes information on steps being taken to address concerns around survey fatigue and overload:

The State Hospital Board Feedback

“We are actively looking at our model of two-way communication and how we can improve direct and meaningful engagement with staff. This also links to our leadership and managerial development programme and extending their capabilities and with a focus on workplace safety, both physically and psychologically. The focus on 'Employee Voice' links through a number of areas currently in terms of clinical performance and safety, equalities, speak up and improvement programmes.

We are also trying to coordinate and control the surveys we send out, whilst increasing other new ways to interact with our teams. i.e. through communal areas, canteen and even attend team meetings.”

The Scottish Ambulance Service response rate has declined 4 pps to 55%. Operational pressures are identified by the Board as a barrier to taking part, but actions have been implemented to improve engagement in iMatter and therefore response rate:

Scottish Ambulance Service Board Feedback

“We continue to reinforce the benefits of completing the survey and the value of staff voice in shaping change, recognising that some colleagues remain sceptical about its impact. This is being supported through clearer communication, stronger accountability for action planning, and by highlighting tangible examples where iMatter has led to positive change.”

A Team Story from NHS 24 reflects on actions taken within the team to improve engagement:

NHS 24 ICT Directorate

“Over the past year, the ICT Directorate at NHS 24 has made significant strides in fostering a positive culture of communication, recognition, and continuous development, guided by iMatter survey feedback. This commitment is reflected in a remarkable 96% response rate in the latest iMatter results. Key achievements include the formation of a Communications Champion Group with representatives from every team, which launched a quarterly ICT Directorate Newsletter. This publication celebrates new starters, achievements, and shared interests, strengthening staff connection to NHS 24 values and enhancing belonging across the Directorate.”

Further details of response rates are included in Appendix 7 and in the iMatter 2025 Data file^[6]