iMatter Health & Social Care Staff Experience Survey 2024

Employee Engagement Index (EEI)

Introduction

The Employee Engagement Index (EEI) is calculated based on the number of responses for each point on the scale for component questions (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.

Board EEI Scores

EEI scores for individual Boards range from 84 for NHS Education for Scotland to 66 for the Scottish Ambulance Service, both down 1ps from 2023.

The largest improvements have been achieved in NHS 24 and Public Health Scotland, both up 3ps from 2023:

• NHS 24 has increased from 74 to 77, the highest score achieved by the Board since 2019.
• Public Health Scotland scored 79 in 2024, up from 76 in 2023. This is the highest score the Board has ever achieved.

NHS 24 highlight in their Organisational Development Leadership and Learning (ODLL) story a number of focus areas that that led to the increase in EEI score:

NHS 24 iMatter team

“An inclusive and valued led culture is a strategic priority for us at NHS 24, and the past year has seen a huge collective focus on workplace culture, wellbeing and continuously improving staff experience at NHS 24. We are thrilled to see positive impact from that work through our iMatter results against the previous year – an increase of 6% in our response rate, and an increase of 3 in our Employee Engagement Index

The work has included various initiatives to support culture and wellbeing within the ODLL team.

Roll out of a bespoke multi-level Values and Behaviours Framework which both defines our organisational values and describes the desired behaviours – essentially how we treat each other and how we can expect to be treated. The framework provides a common language for how we go about our daily work. To maintain the values focus and ensure consistency.

More widely, we have aligned key ODLL workstreams, such as Induction, Appraisal and Leadership Development Programmes to the framework content.

Delivery of Values and Behaviours workshops, to build engagement and familiarity with the framework, and the ways in which it can be used practically to support and improve communications, treat each other with dignity and respect, and build personal connection to organisational values.

Establishment of a cross team Culture and Wellbeing Group to identify and deliver actions to improve staff experience and encourage feedback from colleagues. One piece of work the group recently delivered was a “Ways of Working Charter”, based on staff input, which defines good practice in how we communicate, structure meetings, and demonstrate consideration for the wellbeing of ourselves and our colleagues.”

The continued improvement in scores for NHS Orkney is attributed to a number of actions across the organisation:

NHS Orkney, iMatter Team

“Actions taken:

• A focus on visible and compassionate leadership
• Board walkarounds introduced
• Monthly CEO and Exec Team all staff briefings
• Monthly drop-in listening sessions with the CEO
• Fortnightly CEO blogs
• Launching ‘ways we listen’ across the organisation
• Chair and CEO walkabouts (informal)

We agreed 5 organisational priorities and clear improvements in each area in response to staff feedback and these areas have been a clear focus throughout the year with ‘you said, we did’ throughout the year:

• Reward and recognition – Long Service Awards, thank you cards, and Team Orkney staff awards launched
• Health and wellbeing – new Employee Assistance Programme launched, and Wellbeing Week
• Better involving staff in decision-making – new Senior Leadership and Extended Senior Leadership launched – for transparency of decision making with key items discussed and approved shared after each meeting. Any Members of staff are able to attend SLT to listen to discussions.
• Living our values
• Listening to and acting on feedback and closing the loop
• New Corporate Strategy, vision and values launched”

A Team Story from NHS Grampian demonstrates how positive action to support staff wellbeing led to an improvement in the EEI score of 4 points:

NHS Grampian, Specialist Mental Health & Learning Disability Services

“The Specialist Mental Health & Learning Disability Services at NHS Grampian has been making significant strides in improving staff governance and wellbeing. Through our monthly Staff Partnership Forum, co-chaired by the Lead for Service and Staff Partnership Representation, we have established a robust partnership structure that encourages staff participation in various leadership and service meetings.

The team's commitment to staff wellbeing is evident in our initiatives. We have developed a Staff Support Hub, providing a space for reflection and quiet time post-incident. The Gym has been made accessible to staff after hours and has seen 58 employees complete induction, with more waiting to join. The introduction of e-Bikes at their CAMHS site, with plans to expand to RCH, further promotes staff wellbeing.

Our efforts are yielding positive results. The iMatter survey, which measures staff experience linked to the Staff Governance Standard, showed an increase in response rate from 82% in 2022 to 83% in 2023, with the Employee Engagement Index rising from 79 to 83.”

The largest decline in EEI score is in Healthcare Improvement Scotland where the score declined from 80 in 2023 to 75 in 2024. This is the lowest score the Board has ever reported. The Board recognise the issues and the need to take action:

Healthcare Improvement Scotland

“There has been acknowledgement that this has been a challenging time for our organisation, with colleagues experiencing ongoing financial constraints, large scale organisational change, and cultural shifts in ways of working, as we ensure that Healthcare Improvement Scotland is flexible, adaptable and ready for the future. It is likely that a combination of system circumstances, alongside people’s experience of structural and cultural change at Directorate and organisational levels, are reflected in this year’s iMatter survey results. As an improvement organisation, we know that the insight offered through our results presents an important opportunity for reflection, learning and action.

Therefore, an organisational response has been developed, seeking to address our results from multiple angles, and sharing out responsibility for progress through nine actions, designed to create the best chance of delivering meaningful and sustainable solutions. This action plan has been discussed and approved through our Partnership Forum and Staff Governance Committee.”

EEI Score Distribution across Teams

Over three-quarters of teams (78%) achieve a ‘Strive and Celebrate’ EEI score. There remain a small minority of teams (16 teams in total) that have an EEI score of 33 or less.

Note: Teams with 4 or less staff and a response rate of below 100% did not receive a report.

No Report

1,635 Teams (10%) did not receive a report. These are all teams with less than 5 members, where the required response rate of 100% has not been reached. Further details of the proportion of small teams receiving reports are included in Appendix 7.

Boards that have a high proportion of teams without an EEI report may either be due to a large number of small teams, a relatively low response rate or a combination of both:

• Of the National Boards, NHS 24 has the largest proportion of teams without an EEI score (12%). This is mainly caused by 40% of NHS 24 teams being small (4 or less people), much higher than the Health & Social Care average of 20%, as the response rate of 58% is only 1pps below the overall average.
• Among the Geographic Boards 15% of teams in NHS Lothian and 13% of teams in NHS Tayside did not receive an EEI report this year. 23% of teams in NHS Lothian are small, a little above the overall Health and Social Care average and only 51% of them received a report, slightly below the Health and Social Care average of 55%. The figures for NHS Tayside are very similar with 22% of teams classified as small and 49% of them receiving a report.

Across the Boards, between 76% and 90% of teams score 67 or above (Strive and Celebrate). The exception to this is Scottish Ambulance Service where 56% of teams score in this range.