In the wake of the NHS anniversary celebrations, a think-tank has found that an engaged and happy workforce is the key the NHS thriving for another 70 years.

As a result of a 12 month study, the Work Foundation, a leading provider of analysis and policy advice around the world of work, calls for individual Trust performances to be measured by the issues that matter most to NHS employees. Better engagement with employees also needs to become a top priority if the NHS is to solve its staffing crisis, and for mortality rates to be improved across the UK, the report says.

Solving the Employee Engagement Puzzle in the NHS: Making a Better Case for Action recommends that individual Board members are held accountable for the issues that employees care most about, such as sickness absence, bullying and diversity; to ensure early action can take place well before problems occur.

Lesley Giles is the Director of the Work Foundation and one of the report authors. She said: “There is clear evidence that there is a direct link between how happy and supported doctors and nurses feel at work, and the quality of patient care across the country. So, presenting a business case to help the NHS become a model employer of ‘good work’ has never been so important. Not just for its employees who are working under increasingly difficult circumstances, but for every NHS patient.

“The NHS is under serious pressure due to a host of issues including increasing demand, issues with staff recruitment and retention, challenges that Brexit may bring, changes to the training bursar – and all while cost savings need to be made. It is clear that action needs to be taken now, before the current level of goodwill from NHS employees runs out.

“Policy should be changed so the measures used to monitor NHS performance include scores that collectively demonstrate true employee engagement - such as satisfaction with patient care, effective team work and effective management - to get a true picture of how the NHS is performing. When staff are more engaged, there is evidence of better patient care and higher levels of patient satisfaction – so a happy and engaged workforce needs to be recognised and prioritised from the very top of the organisation. Achieving this can result in reduced employee sickness levels and numbers of bank and agency staff, which also has an impact on the quality and continuity of care.”

While results from staff surveys suggest employee engagement has improved over the last 5 years, there were concerns that this does not convey the true picture. This led to the in-depth study which took place over 12 months and comprised of a series of expert interviews, in-depth case studies, analysis of NHS staff survey data, and a review of the existing evidence on NHS staff engagement.

The researchers quickly discovered varying levels of staff satisfaction, support and general happiness in NHS Trusts right across the UK. Although ‘employee engagement’ is currently measured through the staff survey for example, researchers identified how differently the term is defined and understood by employees and managers. Executive level staff recognised the priority of achieving good quality patient care but discussed employee engagement in very ‘organisational terms’ – focusing on the need for employee motivation towards organisational goals and the importance of Trust advocacy. Middle management, however, tended to define engagement in a way that related to an important element of their role, developing the employment relationship and two way communications. Whereas front-line staff were very much focused on engagement towards their role of providing positive patient care and ensuring that their local team worked well together.

The Work Foundation, which is part of Lancaster University Management School, also recommends all line managers should receive mandatory employee engagement training and should be trained to conduct effective appraisals. Authors also suggest managers need to assess how jobs are designed and what flexible working practices are in place to support staff and encourage team cohesion.

The full report, commissioned by independent charity the Health Foundation, is available on the Work Foundation website. Details of case study analysis of three NHS trusts, which fed into the Work Foundation report, is also published today by the Point of Care Foundation, one of the partners in the project.