Cover: Employee Engagement in the NHS

Employee Engagement in the NHS

A secondary data analysis of the NHS Healthy Workforce and Britain's Healthiest Workplace surveys

Published Oct 11, 2018

by Marco Hafner, Martin Stepanek, Eleftheria Iakovidou, Christian Van Stolk

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Research Questions

  1. What is the potential link between organisational, personal and health-related factors and employee engagement?
  2. How is engagement linked with the outcomes at the individual or organisational level?

Staff health and wellbeing is an important area for employers. Leading a healthy life, both physically and mentally, helps the individual health of employees, but also benefits employers through boosting productivity in the workplace. The Five Year Forward View strategy, published by NHS England in 2014, underscores the importance of staff health and wellbeing as a crucial factor in improving the performance of the NHS and chief executive Simon Stevens announced a number of new initiatives and policy developments aimed at improving health and wellbeing within the workforce in 2015.

RAND Europe conducted an independent study to examine the factors associated with engagement among NHS employees as part of a project with the Health Foundation, a charity committed to bringing about better health and healthcare in the UK. RAND Europe analysed data from the NHS Healthy Workforce Survey, conducted in 2016 across 35 UK NHS organisations, as well as VitalityHealth's Britain's Healthiest Workplace (BHW) survey in 2016, which involved RAND Europe's analysis of the survey results. The views expressed in the study are the authors' own and do not necessarily represent the views of the Health Foundation.

Key Findings

  • Comparing the NHS to other sectors in the UK, the findings suggest that employee engagement in the NHS is lower than in some UK sectors, such as media and telecommunications and professional services, but better than in others, such as financial services and logistics.
  • When examining factors associated with employee engagement in the NHS, the report suggests that a number of demographic factors are associated with levels of engagement, including gender and age. For instance, female employees tend to report higher levels of engagement, whereas engagement tends to decrease with age before levelling in the mid-50s and then increasing again in the years before retirement.
  • Employees working in different NHS occupations report different levels of engagement. For instance, among employees in social care, admin and general management levels of engagement tend to be lower on average. In contrast, employees in medical and dental occupations, and nursing and healthcare assistants tend to report higher levels of engagement.


  • A 'one size fits all' approach to NHS staff engagement is unlikely to be the answer.
  • Staff engagement differs among the groups that make up the NHS population. Therefore, approaches aimed at improving staff engagement will need to be targeted at specific groups.
  • It is important to keep making the business case for improved staff engagement to key policy makers and decision-makers in the service starting possibly with finance directors and chief executives.

Research conducted by

The research described in this report was conducted by RAND Europe.

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