Health & Social Care Staff Experience Survey 2023

Raising Concerns

Two additional questions are included in the 2023 questionnaire covering how staff feel about raising concerns. The full question wording can be found in Appendix 3. These questions are not included within the EEI calculation of the Staff Governance Strand Scores.

The questions were not compulsory within the questionnaire, however 98% of staff completing the iMatter questionnaire answered them.

The scores have been calculated using the same method as used for iMatter score calculations.^[18]

Safely raising concerns with a score of 79 is 2 points above the EEI. It is in line with how staff feel about how performance is managed and is 2 points above the score given for confidence around ideas and suggestions being listened to. Concerns being followed up on with a score of 74 is 5 points below the EEI. It is one point above ideas being acted on and being involved in decisions.

71% of staff agree or agree strongly that they are confident to safely raise any concerns they have. Over half of staff (57%) agree or agree strongly that they are confident their concerns will be responded to.

Boards

There is variation in scores across the Boards. NHS Education for Scotland has the highest scores for both measures and Scottish Ambulance Service the lowest.

For most Boards the difference between the two scores is typically 5 or 6 points. The notable exceptions to this are:

• NHS Orkney where confidence that concerns will be followed up is 10 points lower (65) than being confident to raise concerns (75)
• Scottish Ambulance Service where the difference is 8 points (70 and 62)
• NHS Education for Scotland where the difference is only 3 points (86 and 83)

NHS Orkney were already aware of challenges in this area and have actions in place to address staff feedback. The recency of their introduction means that the impact has yet to be seen in iMatter:

“The feedback we receive from staff is that they are less confident and indeed in many cases frustrated that we do not consistently listen, act and close the loop when staff do speak up or raise concerns/share ideas and this remains a key area of improvement in the year to come. There are many examples already of things changing in real-time in response to feedback so the loop is closed and recognising that in turn, we will inspire confidence from our staff and teams that their concerns are listened to, taken seriously, and acted upon, resulting in positive change and improvements.” NHS Orkney, Chief Executive

Staff Groupings

Ambulance Services Staff are the least confident that their concerns will be followed up with a score of 61. Local Authority Senior Managers and Strategic Development score highest for the two measures and for both Staff Groupings the gap is only 3 points.

Among staff groupings the biggest difference between the two ratings is seen among Ambulance Services (9 points), followed by Health Science Services and Medical & Dental (both 8 points).

Relationship to EEI components

The way in which staff answer the two questions on raising concerns aligns with the way in which other questions are answered. The questions where the strongest statistical correlation is seen are those that relate to being heard, involved and valued:

• I am confident my ideas and suggestions are listened to
• I am confident my ideas and suggestion are acted upon
• I feel involved in decisions relating to my job
• I am treated fairly and consistently
• I feel involved in decisions relating to my team
• I am confident performance is managed well within my organisation

For example, if Staff ‘strongly agree’ that they can safely raise concerns they will be very likely to also say they strongly agree that they are confident that their ideas and suggestions will be listened to.