iMatter Health & Social Care Staff Experience Survey 2024

Introduction

NHSScotland are committed to enhancing and improving staff experience for all.

The National Workforce Strategy for Health and Social Care, issued in 2022, sets out a vision of a sustainable, skilled workforce with attractive career choices where all are respected and valued for the work they do. The NHS Recovery Plan 2021-2026, which seeks to drive long term recovery and sustainability in the system, also reinforces the importance of positive staff experience in delivering positive patient outcomes.

It is therefore essential that staff at all levels are empowered to have their voices heard and valued, and staff views and actions contribute to continuous improvement in their teams and organisations.

The iMatter Continuous Improvement Model was developed by NHSScotland staff with the aim of engaging all staff in a way that feels right for them. The focus is on team-based understanding of experience, but it also offers information at various levels within organisations to evidence and help improve staff experience. As such, it can provide clarity on where to focus efforts for maximum impact, which in turn leads to better care, better health, and better value.

iMatter was initially rolled out over a three-year period from 2015 to 2017 to all staff across NHSScotland Health Boards. Since 2017 it has been embedded across 22 Health Boards and participating Health and Social Care Partnerships, with the exception of 2020, when a shorter pulse survey was run instead due to the pandemic.

The implementation of iMatter has enabled Health Boards and Scottish Government to obtain a comprehensive picture of staff experience over the past 9 years, which has allowed us to identify areas of success and areas that require improvement. This helps inform delivery on the commitments of our Staff Governance Standard.

The work to measure and report staff experience within NHSScotland Health and Social Care for 2024 has remained consistent in that it is commissioned by the Scottish Government and carried out by Webropol Ltd, an independent company.

iMatter Process

The iMatter questionnaire gives staff the opportunity to feed back their experience within their team and at organisational level on a real-time basis. iMatter results are directly reported at all levels throughout an organisation. Once team results are delivered, teams are invited to collectively share responsibility for developing an action plan within an 8-week period and to review actions and progress made throughout the year. As an integral part of the iMatter process, teams come together to review the results and share thoughts and ideas in order to develop and implement Action Plans. See Appendix 1 for further details.

Data Collection

The iMatter process uses Webropol to distribute electronic and paper questionnaires to NHSScotland employees, as well as those employed by the Local Authority who work in a Health & Social Care Partnership (HSCPs) who choose to participate. In 2024, all 22 Health Boards and 29 HSCPs took part (see Appendix 2 for details). Access to the survey was provided via three options:

1. An email invitation with a link to the online survey (Email)

2. A paper survey printed and distributed to those without online access (Paper)

3. An invitation sent via SMS with a link to the online survey (SMS)

For 2024 all fieldwork was carried out from 13th May to 15th July 2024.

Questionnaire

The 2024 questionnaire remains largely unchanged from 2023, with minor wording changes to the introduction and the question relating to parental leave. The questionnaire consists of attitudinal questions relating to staff engagement, referred to in iMatter reporting as ‘Components’. Each question has six responses: ‘Strongly Agree’, ‘Agree’, ‘Slightly Agree’, ‘Slightly Disagree’, ‘Disagree’, ‘Strongly Disagree’.

The questionnaire is included in Appendix 3.

Calculation of scores for each question and the EEI

The aggregated scores for each question are placed into one of four categories for reporting:

Example: Thinking of your experience in the last 12 months please tell us if you agree or disagree with the following statements:

To calculate the average score for each question, the number of responses for each point on the scale (Strongly Agree – Strongly Disagree) is multiplied by the number value (6 – 1) (see above). These scores are then added together and divided by the overall number of responses to the question. The average score calculated is then divided by 6 (the highest possible score) and multiplied by 100 to give the reported score.

The Employee Engagement Index (EEI) is calculated based on the number of responses for each point on the scale for component questions^[1] (Strongly Agree to Strongly Disagree) multiplied by its number value (6 to 1). These scores are added together and divided by the overall number of responses to give the score to show level of engagement.

The questionnaire also measures overall experience, on a 10-point scale from very good to very poor. The report shows the mean score where again, higher scores are better.

Classifying Boards

Boards can be broadly allocated to one of three groups:

• Geographic Boards: those that provide regional healthcare services.
• National Boards: those that provide support services to the organisation at a national level.
• National Boards: those that provide specialist patient-facing services.

Colour-coding as illustrated is used throughout the report to highlight the different types of Boards.

An overview of each Board and a link to its website is included in Appendix 4.

Geographic Boards (Patient-facing)

• NHS Ayrshire & Arran
• NHS Borders
• NHS Dumfries & Galloway
• NHS Fife
• NHS Forth Valley
• NHS Grampian
• NHS Greater Glasgow and Clyde
• NHS Highland
• NHS Lanarkshire
• NHS Lothian
• NHS Orkney
• NHS Shetland
• NHS Tayside
• NHS Western Isles

National Boards (Patient-facing)

• NHS 24
• NHS Golden Jubilee
• Scottish Ambulance Service
• The State Hospital

National Boards (Support)

• Healthcare Improvement Scotland
• NHS Education for Scotland
• National Services Scotland
• Public Health Scotland

Response Rate Threshold

The previous response rate requirement of 60% for teams of 5 or more to receive an EEI report was removed in 2021. The 100% response rate for teams of 4 or less to generate a report remains a requirement for 2024. This is to provide anonymity and the higher the response rate, the more realistic the feedback of how staff feel about working in their team.

iMatter Report 2024

This report provides detailed information and analysis of the iMatter responses for 2024. It also contains comparisons to previous years where appropriate. The Everyone Matters Pulse Survey (EMPS) carried out in 2020 focused on well-being and included only a small number of iMatter metrics. As the different questionnaire content may influence the way in which staff answered individual questions, the data is not included within the main historic iMatter comparisons in this report.

The findings from this report will be used by a range of stakeholders, including:

• Individual organisations (Health Boards and local authorities)
• The Scottish Government
• Partnership Groups such as the Scottish Workforce and Staff Governance Committee (SWAG), and the Scottish Partnership Forum (SPF)

This report is supported by the Health and Social Care Staff Experience Survey 2024: iMatter Data File (iMatter 2024 Data File) containing more detailed data.

Team Stories

The iMatter process is supported by Team Stories, that provide best practice examples of how to address challenges and provide inspiration and ideas for other teams and for the organisation as a whole. Illustrations from Team Stories are included through the report. Appendix 5 has a full list of Team Stories submitted this year.

Board Feedback

Where results are of particular note, for example very high or very low scores, or scores that have changed considerably from 2023, Boards have been asked to provide comments. Feedback is typically around why the scores are as they are and any specific actions that have been put in place to address past or current areas of movement. This feedback is included within the report, either directly or in a summarised format.

Statistical Analysis

Significance testing has been carried out on the data, to explore the extent to which differences in scores between different groups (e.g. Boards, Staff Groupings etc.) are statistically significant.

Correlation analysis has also been carried out, to understand the relationship between the individual measures included within iMatter. An overview of the analysis done is in Appendix 6 and summaries of the data are included in the iMatter 2024 Data file.

Whole Number Reporting

As with previous years, all iMatter 2024 results are reported to the nearest whole numbers i.e. without any decimal places shown. This is the case for both Board level and national reporting and applies to the presentation of the various scores and index values calculated from the individual survey responses. Whilst this approach does potentially hide some significant movements in the total Health and Social Care dataset and within some of the larger Boards, reporting whole numbers only ensures focus is on those movements that are most statistically significant.

The only exception to this is the Overall Experience question which is scored on an 11 point scale (from zero to ten) and is reported to one decimal place. This approach has been agreed, in partnership, by Scottish Workforce and Staff Governance Secretariat.

Reporting movements and differences

Throughout the report movements from previous years are reported. Differences between Boards within the 2024 data are also commented on. For data reported as percentages the movement of difference is shown as percentage points and is abbreviated throughout the report to “pp” for a single percentage point or “pps” for multiple percentage points. Similarly, if the movement or difference being reported is in an index score such as the EEI or individual component scores, it is shown in points and is abbreviated throughout the report to ‘p’ for a single point or “ps” for multiple points.

Profile of staff completing the iMatter Survey

Staff are asked to confirm if they are NHSScotland or Local Authority staff and within that the staff grouping they are in.

Additionally, since 2021 demographic questions have been included within iMatter. These questions are optional, however a high number of respondents complete these questions.

Further details of demographics and staff groupings are included within the iMatter 2024 Data file^[2].