The recent Nuffield Trust Winter Insight briefing on ambulance services highlighted the increasing pressures on the ambulance service. It also drew attention to the NHS Staff Survey scores for ambulance staff. These demonstrate that the experience at work of staff in ambulance services tends to be less positive than for staff in the NHS as a whole. In particular, staff report higher levels of work-related stress, incidents of bullying, harassment and abuse, and do not feel as involved by their organisation as other staff groups. These are long-standing issues and will take time to resolve.
NHS Employers has been working in partnership with ambulance service colleagues and representatives from their staff organisations. We know that employers in the ambulance service are committed to working together to support more effective staff engagement and to take action on staff health and wellbeing.
The NHS Staff Survey results for 2016 demonstrate some positive movement in key areas. The overall staff engagement score for ambulance services improved, and so did scores for staff confidence in their employer taking action on health and wellbeing. There was also a rise in both the number of staff having an appraisal and the reported quality of appraisal.
These improvements follow a range of local actions being taken by employers. For example:
- The East Midlands Ambulance Service has implemented a new service to provide support for staff on mental health and wellbeing issues.
- The West Midlands has reduced sickness absence through offering a raft of new support measures, including a 'Staff Advice and Liaison Service' and resilience training.
- The London Ambulance Service has developed mediation skills training and improved investigation approaches as part of its commitment to tackling bullying. Staff confidence in reporting concerns has improved, though levels of bullying, harassment and abuse remain far too high.
The survey results also show an increase in the number of ambulance staff who feel supported by their immediate manager. Ambulance services recognise the importance of these line managers and many are implementing new approaches designed to provide greater support for teams.
These early Staff Survey results are encouraging, with some services making very significant improvements in their scores on some questions. The London Ambulance Service, for example, was the most improved organisation in the survey for staff engagement. However, we are all aware there is still more to do. There is still a big gap between the experience of staff in the ambulance service and those in other parts of the NHS. There is also variation between individual ambulance services, and signs of rising pressure on staff. Levels of bullying, harassment and abuse remain a key challenge and a priority for action in 2017. Safeguarding staff from violence also requires further attention.
NHS Employers will continue to work with employers and trade union colleagues to help make the ambulance service a better place to work that provides quality care.
Covill, S (2017) 'Ambulance services staff experience is improving, says NHS Employers'. Nuffield Trust comment, 7 June 2017. https://www.nuffieldtrust.org.uk/news-item/ambulance-services-staff-experience-is-improving-says-nhs-employers