Employee engagement, sickness absence and agency spend in NHS trusts 

Dawson, J. & West,  M. | NHS England | March 2018 | Employee engagement, sickness absence and agency spend in NHS trusts 

The Workforce Race Equality Standard (WRES) team at NHS England commissioned a report to examine the ‘real world’ relationship between staff engagement, sickness absence and reliance upon temporary staffing in NHS trusts.


The team had the hypothesis that where: employee engagement is lower, there will be a higher level of sickness absence among staff, and this will necessitate a higher level of spend on agency (and bank) staff.  They analysed data from three sources: NHS Staff Survey (employee engagement), NHS Digital (sickness absence), and NHS Improvement (agency and bank staff spend).

The report has now been published and finds clear associations between employee engagement and sickness absence; as well as between employee engagement and agency staff spend (whether or not spend on bank staff was included within this).

It concludes there is clear evidence that trusts with higher engagement levels have lower levels of sickness absence and have lower spend on agency and bank staff.

Simon Stevens, Chief Executive of NHS England said: “that staff engagement is not only good for employees’ health but reduces trusts’ cost and reliance on agency staffing. So doing the ‘right thing’ also helps trusts with their budget pressures. As such, this report offers important practical lessons for the whole NHS.”

The full report can be downloaded from NHS England


NHS workforce race equality: a case for diverse boards

This resource is targeted at NHS boards, especially the chairs of NHS boards. It  recognises the important role chairs play in shaping the way members interact, behave, and set priorities – in short, how they establish the culture of a board.

The guide is not about how boards become more ‘representative’. Instead, it is about how a board uses the talents of everyone who sits round the table. It is about how boards capitalise on their diversity.

Full document: NHS workforce race equality: a case for diverse boards

“Important improvements” for race equality in health service workforce

The Chief Executive of NHS England has welcomed signs of progress in tackling discrimination among health service staff, but warned of “hard work still ahead” in improving equality for all its workers.

NHS Equality and Diversity Council has published its latest annual report into race equality. The audit provides a comprehensive assessment of the experience of NHS employees from black and minority ethnic (BME) backgrounds, including whether or not they have equal access to career opportunities and receive fair treatment at work.

The 2017 Workforce Race Equality Standard (WRES) shows that an increasing proportion of senior nursing and midwifery posts is being filled by people from BME backgrounds, and that there has been a rise in senior BME leaders. The report confirms that an increasing number of trusts has more than one board member from a BME background, with 25 trusts being represented at board level by three or more people from BME communities.

However, the report highlights areas where the NHS needs to make further progress. Despite significant improvements in board and senior management representation, the overall number of BME background leadership positions is still not proportionate to the number of BME workers at other levels in the organisation.

Full report: NHS Workforce Race Equality Standard: 2017 Data Analysis Report for NHS Trusts

Women and leadership – (still) more to do

Despite the advances of recent years, two recent reports, Women in finance and Women on boards: 50:50 by 2020, once again draw attention to the problems women still face in obtaining senior leadership positions within the NHS and outside it | The King’s Fund


Women in finance is about fairness, equality and inclusion for women and men. It is predicated on a desire for gender parity and a balanced workforce because, as the evidence makes clear, this improves culture, behaviour, outcomes, profitability and productivity. However, the current situation in the financial services sector is quite different; more women than men start out in financial services but many women fail to move up the management scale. This leaves almost all the top jobs in the hands of men. The main reason for this, it appears, is organisational culture.

One study conducted in 2016 across a wide range of employment sectors found that unsupportive workplace cultures still present the most significant barrier to career progress for women. Amazingly this was the case for female respondents in the 20-29 age group as well as for older respondents. Gender inequality and discrimination were reported, as were difficult colleagues and managers, bullying, undervalued work, and women feeling that they have to over-perform simply because they are female. Recommendations following this study included building closer relationships between men and women in the workplace, and the provision of opportunities to discuss gender issues experienced within the organisational culture.