The latest annual NHS Staff Survey reveals attacks on staff have increased since 2023, although numbers are below the record levels seen between 2020 and 2022 during and following the pandemic.
Staff experiencing discrimination at work reached its highest level in five years (9%), with more than half (54%) saying the discrimination they received from patients and the public was based on their ethnic background.
In addition, 9% of NHS workers experienced unwanted sexual behaviour, including offensive comments, touching and assault. The proportion of staff affected remains similar to the level reported in 2023 (9%) when the question was first asked.
The National Education and Training Survey reveals that that 13% of learners experienced or witnessed unwanted, harmful or inappropriate sexual behaviour by patients.
The NHS launched a new national sexual misconduct policy framework in October to ensure NHS trusts had robust policies in place to allow NHS staff to report incidents of sexual misconduct anonymously.
Every ICB and NHS Trust in England has signed up to the NHS Sexual Safety Charter, which commits them to a zero-tolerance approach to letting unwanted behaviours go unaddressed.
Dr Navina Evans, chief workforce, training & education officer for NHS England, said: ‘It's totally unacceptable that NHS staff are facing physical violence, sexual assault and discrimination from patients and the public while at work – and I'd urge anyone affected to report incidents to their employer and the police.
‘We know that the most important way to stamp out incidents of unacceptable behaviour is to give people the confidence to report it, and it is important that the voice of every member of NHS staff is heard through these surveys and acted upon.'
The annual staff survey also found that the number of NHS workers satisfied with flexible working options is at its highest level in five years (58%), while those achieving a good home and work life balance is at its highest since the question was first asked in 2021 (57%).
Staff satisfaction with pay has risen from 25.48% in 2022 to 32.05% in the latest survey, and satisfaction with line managers has also continued to rise, with 73% saying they feel valued at work.
Nearly three-quarters of a million people (744,358) took part in the 2024 NHS Staff Survey – the highest level in its 20-year history, and more than 43,500 took part in the National Education and Training Survey.
Reaction
Danny Mortimer, chief executive of NHS Employers, said: ‘NHS leaders will welcome the latest staff survey results which show that most indicators are now back to pre-pandemic levels and positively, seven of them are at the highest level ever. NHS staff experienced the busiest October on record for A&Es and across other parts of the healthcare system and dealt with a waiting list backlog, so it is good to see that scores achieved in 2023 were sustained in 2024 thanks to the concerted efforts of leaders and teams.'
He added: ‘However, while maintaining progress is important, further improvements were not achieved which is a real concern. Moreover, it is distressing that perception of discrimination from the public and perception of discrimination from managers worsened. Such behaviour undermines good care and we must act to improve the experience of our people in this vital regard.
‘It remains of profound concern that the experience of BME staff in the NHS is still poorer than for their white colleagues: the continued experience of racism in our workplaces is a stain on our aspiration to be better employers.
‘It is also worrying to see that levels of unwanted sexual behaviour rose from the public but fell slightly from other staff. All staff should be able to work without fear of unwanted sexual behaviour, whether from colleagues or patients.'
Interim chief executive of NHS Providers, Saffron Cordery, said: ‘It is really worrying to see from these findings that staff experience of discrimination at work has increased, with much of it based on ethnicity. The gap in discrimination and bullying, harassment or abuse from patients, their families and the public is growing compared with white colleagues. Clearly, there is still a long way to go for the NHS in its vital work to tackle racism.
'It is also a real concern to see the rise in attacks on staff, and continuing high incidence of unwanted sexual behaviour.
‘We can also see the impact of the relentless pressures many staff face, though it is encouraging to see improving satisfaction with flexible working, home and work life balance, and with line managers.
‘It is also heartening to see that the figures for people feeling unwell, as a result of work related stress, have fallen to a five-year low.'
Unison head of health Helga Pile said: 'A workforce that feels treated well is at the heart of getting the NHS back on track. But the survey shows there's a long way to go. Harassment, bullying and sexually motivated incidents remain shockingly high. Staff providing vital treatment and support must be able to do their jobs without fear of any kind of abuse, attack or unwanted advances. Employers must ensure everyone working in the NHS is safer and wrongdoers are dealt with severely.
'The latest figures show most NHS staff are anything but happy with their pay. It's clear the workforce is yet to feel any signs of the change promised by the new government. Employees know not everything can be fixed overnight. But the government has not done anything concrete to improve things for the workforce. Ministers must take heed and get wages right, as well as follow through on last year's promises to overhaul the NHS pay structure.'
Nuffield Trust senior fellow Dr Billy Palmer, said: ‘The modest improvements seen today do not detract from the scale of the challenge the government faces to build and retain a workforce fit for the future. Our analysis of staff surveys revealed a widening gulf in job satisfaction between the NHS's youngest and oldest staff over the past decade.
‘The future of the health service depends on these workers, so the survey results are a stark reminder of why policy action to improve retention and morale, especially for those early in their careers, is so crucial.'
Suzie Bailey, director of leadership and organisational development at The King's Fund, said: ‘The upcoming refresh to the NHS Long Term Workforce Plan will be a chance for the government to reset how it plans to train, recruit and retain staff. There are also actions the government can take more immediately to improve NHS working conditions. These include mandating the NHS to introduce minimum standards for facilities, expanding working options, ringfencing funding for wellbeing hubs to support staff mental health, and supporting the development of high-quality compassionate and inclusive leaders in health and care.
‘This snapshot of the experience of NHS staff comes ahead of the government publishing its plans to reform the service. Ministers will be relying on the NHS workforce to actually deliver much of its plans for improvement, and today's results will be cause for concern.'
