Press release: Analysis of results of joint NHS Confederation/HSJ snapshot survey

10 Apr 2003

With the national insurance rise due to hit taxpayers pockets this month, the spotlight is on the NHS as never before to demonstrate where the money is going and the difference it will make to patient care.

But as questions are raised about whether the investment is delivering results, little attention has been paid to the views of those working in the service. The NHS Confederation and the Health Service Journal have joined forces to find out what NHS leaders think about the successes at a local level, as well as the challenges ahead.

Who responded

The survey was sent to chief executives, chairs, PEC chairs and medical directors of PCTs, Trusts and Strategic Health Authorities in England. The survey was also printed in the 20th March edition of HSJ. 149 responses were received.

Chief Executives 64
Directors (Medical/Clinical/Finance) 52
Chairs 16
NEDs 2
Middle managers 3
PEC chairs 3
Other 9
(eg. Lead Nurse/consultant/
occupational therapist)
Total: 149

Key findings

Q1. Do you think that your local NHS is now delivering a better service to patients than a year ago?

88% (131) of respondents agreed that their local NHS was delivering better services than a year ago

Yes, Dramatic improvements have been made 5
Yes, Significant improvements have been made 62
Yes, Modest improvements had been made 64
No, There has been little change 13
No, There has been deterioration 5
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Q2. What are the three most important improvements your organisation has made to the patient experience in the last year?

Respondents most frequently identified improvements in specific services such as cancer care and chronic disease management (52%), reductions in waiting times (40%) and greater patient and public involvement (23%) as the three most important success stories in the last year, alongside improvements to A&E (19%), increases in staff (14%) and investment in better facilities (10%).

Improvements to specific services 78
Improved waiting times 60
Greater patient and public involvement 35
Improved A&E service 28
Increased workforce 21
Investment in facilities 15
Improved governance 4
More staff training 2
Positive CHI review 2
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Q3. What other organisational achievements are you most proud of over the past year?

9% of respondents cited supporting staff and building staff morale as other key organisational achievements
9% listed capital investment to improve facilities
7% said improving or maintaining star status

Supporting staff/building morale 13
Investing in facilities 13
Improving/maintaining star status 10
Improving team working 9
Greater user involvement 8
Positive CHI report 7
New clinical governance strategy 6
Effective financial management/reducing deficit 6
Managing trust mergers successfully 5
Increased workforce 5
Achieving performance targets 4
More effective management systems 4
More integrated services 3
Staff training programme 2
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Q4. What are the three most significant barriers to improving the service you provide to patients?

83% of respondents mentioned budget constraints
59% mentioned staff shortages
45% of respondents cited lack of time
43% said too many targets, 15% the reporting burden and 9% a lack of clinical engagement.

Budget constraints 123
Shortage of staff 88
Lack of time 67
Too many targets 64
Reporting burden 22
Lack of clinical engagement 13
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Q5. Over the next three years, how optimistic are you that your local NHS services will improve?

The vast majority of respondents (77%) reported they were confident that their local NHS services would improve over the next three years.
Only 9% of respondents were pessimistic or very pessimistic about the prospects for improvement.

Very optimistic 31
Optimistic 84
Neutral 15
Pessimistic 10
Very Pessimistic 4
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Q6. What do you see as your key leadership priorities for the next three years?

Supporting and developing staff was most frequently mentioned, with 18% of respondents saying it is a key priority over the next three years. Recruitment and retention was also top of the agenda for many (17%). Engaging clinicians was cited as a priority by 12% of respondents, along with maintaining staff morale (11%), developing better clinical governance (10%), and better communication with service users (9%).

Supporting and developing staff 27
Recruitment and retention 26
Engaging clinicians 18
Maintaining morale 17
Developing clinical governance 15
Better communication with service users 13

Other priorities included:
Meeting targets 9
Maintaining financial stability 7
Building management capacity 7
Developing partnership working 6
Performance management 6
Implementation of new GMS contract 5
Managing PFI projects 5
Managing the implementation of EWTD 4
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Q7. Is your job satisfaction and morale improving or declining?

Nearly a third of respondents (32%) said job satisfaction and morale was improving, 43% said they felt there had been no change, while 19% said job satisfaction and morale was declining.

Improving 48
No Change 64
Declining 28
No comment 9

Notes for editors

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