Driving employee engagement in the NHS with staff feedback



Motivated, engaged employees are essential for a well-functioning National Health Service that delivers a high level of patient care. Two quotes sum up the benefits of engagement – as former NHS Trust CEO David Astley put it, “Happy staff make for happy patients”, or in the words of The Kings Fund, “Organisations with engaged staff deliver a better patient experience, fewer errors and lower infection and mortality rates. Financial management is stronger, staff morale and motivation higher and there is less absenteeism and stress.”

In fact, developing a more engaged workforce can help NHS organisations overcome many of their challenges and deliver improvements in a variety of ways as studies from the likes of The Kings Fund and West & Dawson suggest. Here are five important areas where it can help:

  1. Improving staff retention: Keeping hold of good people is a huge challenge for NHS – on average it has around 23,443 nursing vacancies (about 9% of the workforce). This increases recruitment costs, while gaps usually have to be filled with expensive temporary agency staff. Happier, more engaged employees are more likely to stay in their jobs easing the pressure to constantly recruit and train new staff.
  2. Improving patient care: Evidence suggests as employee engagement rises in NHS organisations patient satisfaction levels increase and mortality rates fall. It also coincides with a lower incidence of medical errors.
  3. Increasing efficiency: Higher employee engagement tallies with stronger financial management, which can help the NHS work towards achieving the £22bn in efficiency savings that has been targeted by 2020.
  4. Reducing absenteeism/sick leave/stress: Staff who are engaged are less likely to be absent and take sick leave and also less likely to suffer stress and burnout. This is a significant benefit as evidence in Lord Carter’s efficiency report suggests that a mere 1% reduction in sickness absence can save the NHS £280m in staff costs.
  5. Boosting productivity: Employees who are highly engaged do more and work more productively, as well being more likely to come up with new ideas and suggestions to make processes work better and increase productivity.



Improving employee engagement begins with listening to staff, making them feel more involved in decisions about way the organisation is run, as well as creating a dialogue in which everyone is able to contribute. Technology can help, providing a way of connecting with often widely spread, shift-based workforces and allowing Trusts to develop a real, ongoing dialogue with their people, such as through online communities.

The Kings Fund highlights six elements which it cites as being important for driving greater employee engagement:

  • Develop a compelling, shared strategic direction
  • Build a collective and distributive leadership
  • Adopt a supportive and inclusive leadership style
  • Give staff the tools to lead service transformation
  • Establish a culture based on integrity and trust
  • Place staff engagement firmly on the board agenda

An effective employee feedback platform that facilitates an open and honest dialogue between staff and management can help to support many of these areas, especially establishing a culture based on integrity and trust, creating a supportive and inclusive leadership style and developing a compelling, shared strategic direction.

Let’s take a look at some specific benefits that an online feedback platform can deliver.



By making it possible for employees to voice their opinions and concerns more easily, including from their own mobile devices, an online feedback platform helps to bring together the entire workforce in a dialogue with management. Staff can participate wherever they are located and whatever shifts they work.



It encourages employees to come up with new ideas to improve the way things are done, for example, and to share them with the whole organisation. At Northern Devon Healthcare NHS Trust (NDHT) its online community – dubbed Staff Voice and created using Tivian’s online feedback platform – underpins the sharing of ideas and best practise in this way. It receives two ideas on average every week, covering everything from the way appraisals are run to reducing congestion in the main hospital car park. 11 improvement programmes have been initiated due to staff feedback, with systems and processes changed to increase efficiency and enhance working practises.

It is easy to see how collaborative working, planning and decision making becomes easier as people can share and come up with solutions to common problems within and across departments. They can also learn through the community, with closed or open group that allow teams to share best practice or learn together, ensuring skills are kept up to date. Obviously, bringing together staff online is easier than in the physical world where people might be working in different locations and a variety of shifts.



Management is able to listen to staff and to do it in a more granular, sophisticated way. By adopting a central platform for feedback, for example, it becomes possible to plan and run all surveys through that single system with the ability to segment audiences to get a deeper understanding of particular groups and their concerns.

Efficiency gains and improved processes can be delivered. At NDHT, the online community is dramatically reducing HR paperwork because the certification process for new joiners is automatically triggered, and carried out through the platform, freeing up the equivalent of a full time member of staff, who has now been reassigned to more strategic roles. Creating and analysing new surveys is also faster and easier – each Staff Friends and Family Test now takes two days less work to manage.

On top of all this, an online feedback platform that supports an accessible two-way dialogue between employees and senior management signals a commitment to staff and to increasing engagement. Acting on employee feedback helps increase engagement and build an open, transparent culture of trust. At NDHT Staff Voice, is contributing to keeping engagement levels high at 3.85 out of 5, while also helping the Trust reduce employee turnover, leading to potential savings of £250,000 per year.

Staff engagement has never been more important for the NHS. It can play a role in helping healthcare organisations address many of their most enduring challenges. A big part of supporting engagement is about opening up new communication channels that support transparency, collaboration and trust. This is where community-based feedback technology can play a major role in successful engagement strategies.