All organisations rely on their people for success. It’s a mind-numbingly obvious statement - but also an exceptionally complex one when it comes to making real changes to how people think, feel and engage with their actual day-to-day work. We know that if employees are more committed to their employer, positive about their role and motivated to give more of themselves, then organisations do better. Some studies have suggested that improving employee engagement within the UK to match the levels seen in the top tier of high performing countries could add £25.8 billion to the economy.

Since the global financial crisis of 2008 there’s been more interest in employee engagement. The sudden pressures on both business and public sector employers to deal with austerity - to do more with less, to rescue growth and productivity - has meant more demands on employees in all sectors. The ‘Engage for Success’ initiative, for example, has played an important part in gaining attention for employee engagement. The group of business school thinkers and senior HR professionals has worked to inspire the development of a wider movement through the sharing of good practice around what works to create a more committed, happier and engaged workforce. There have been other schemes, like the business-led Be the Business (www.bethebusiness.com), which have all emphasised people management and employee engagement as a key to unlocking productivity.

In many ways these are long-standing problems rather than a post-2008 phenomenon. People have traditionally been promoted on the basis of technical capability and expected to manage; when situations go wrong there aren’t necessarily the right support structures, and relationships and the culture turn sour. But problems with management and employee engagement have taken on a modern flavour. Some organisations have had difficulties in making sure the introduction of new technologies is accompanied by new, more appropriate ways of working. The changes are just bolted on to traditional attitudes and management practices. There isn’t the necessary investment in training and development, and instead there is a breakdown in communications, unhappy staff and all the conditions that most often make for failure.

So despite all the impetus and energy behind improving employee engagement, evidence of substantial changes and impact on productivity is hard to find. We wanted to understand more about what was happening, what was getting in the way of progress, the lessons for employers of all shapes and sizes, by looking into initiatives at the UK’s largest employer.

Healthy attitudes

When it comes to the NHS, levels of employee engagement really do become the difference between life and death. Staff wrestle with ongoing day-to-day challenges at the coalface, tightened resources and new service pressures, that threaten the conditions that allow for more consistent levels of staff engagement. We explored the role of employee engagement in the organisation, what the term meant to people, why it mattered in terms of patient care and quality, and whether the case for better employee engagement had been made as effectively as it could have been.

A basis for measuring, monitoring and benchmarking engagement levels across the sector were put in place since 2009. Looking at figures from the NHS Staff Survey, employees are feeling more engaged overall since 2012. But a closer examination shows a clear variation in engagement levels, both between and within Trusts - suggesting that, in reality, the story isn’t as simple as it might appear. Relying on averages from staff survey responses can’t be relied on as evidence of overall success.

We found a lack of consensus when it came to defining what employee engagement actually is and looked like. For example, executive staff defined employee engagement strategically, in line with how engagement is measured in the NHS staff survey. For frontline staff, engagement primarily centred around their role in the delivery of high quality patient care and working closely with colleagues to ensure their team was not let down in anyway. Middle managers saw engagement as a core part of effectively developing the employment relationship and achieving two-way communication. The formal measures in the survey didn’t appear to take into account what the majority of NHS staff considered employee engagement to be. As a result, local teams were having to think about supplementing the survey with wider intelligence to get a fuller picture of how employees were feeling.

Unpacking engagement

Although surveys are a helpful tool, the danger is that surveys become the strategy. As a result, managers are given the task of ‘getting the scores up’, so a ‘teaching to the test’ approach, a set of un-coordinated activities rather than trying to address the fundamental issues and experiences of staff themselves.

The work with the NHS may have involved a very specific set of circumstances and pressures, but we have found that the challenges and concerns raised apply to organisations in general. For example, when talking to managers at a number of levels for a programme for the manufacturing sector (Performance Through People) there was evidence of the same issues: of variety across sites and divisions in their levels of engagement, in management styles.

What makes employee engagement is a good all-round experience, a whole package of HR and management practices: how work is being allocated; making sure staff are being listened to; ensuring staff feel there’s an appropriate level of flexibility; there’s feedback; there’s access to training and development when it’s needed; giving people the space to take stock and make a positive contribution. So it’s about getting all the nuts and bolts of a working environment right, and ultimately that means good management practices.

Employee engagement is a multi-dimensional problem - there’s no silver bullet - it’s based on creating a positive, well-managed environment where people feel able to have open conversations, to talk about problems, and know they will be understood and supported. In other words, a grown-up and professional working culture.

Making engagement work

A strategy should be developed where outcomes of employee engagement are clear, including the aims and vision of the strategy, what practices are explicitly supporting implementation, and evaluation and monitoring of what’s being done.

The strategy needs to be owned at Board level with all members assuming a responsibility for regularly tracking results and discussing the implications for improvement plans with the Executive team. Reports need to incorporate narrative accounts around HR issues such as diversity, sickness, recruitment difficulties and development opportunities.

NHS leaders and managers need to be trained and developed to equip them to understand the link between employee engagement on the one hand and outcomes on the other, whether organisational performance, employee health and wellbeing and/or patient outcomes. Their actions need to be judged in terms of whether they contribute or undermine employee engagement.

Training on employee engagement should be an integral part of line management training and leadership development (at local, regional and national levels). Training into conducting appraisals and managing employees should also be provided to line managers.

Organisational values should include employee engagement, and should be co-created to support widespread ownership, and then regularly monitored with employees at all levels. Additionally, employee behaviour should be monitored according to the values at all employee-facing opportunities, including: values-based recruitment, values- based inductions and values-based appraisals and performance reviews.

Regular review is important: undertaking surveys; recognising where change needs to take place; reducing education and implementation gaps; and ensuring that the employment engagement does not remain stagnant and continues to be embedded effectively.

Lesley Giles is the Director of the Work Foundation, the leading provider of analysis, evaluation, policy advice and know-how in the UK and beyond. Former Deputy Director of the UK Commission for Employment and Skills, Lesley has substantial experience within government working in Department for Education and Employment; the Employment Service and the Cabinet Office, and a particular focus on supporting business-led action in skills and employment issues.

The ‘Solving the Employee Engagement Puzzle in the NHS: making a better case for action’ report produced by Zofia Bajorek, Lesley Giles and Karen Steadman alongside partners at RAND Europe and The Point of Care Foundation, can be downloaded from www.theworkfoundation.com

Best practice resources from Engage for Success are available at http://engageforsuccess.org