NHS staff’s wellbeing at work has direct impact on patient experience
New research involving Health Sciences academic Professor Alison Richardson, and carried out by the National Nursing Research Unit at King’s College London, strongly suggests that levels of satisfaction and wellbeing among NHS staff has a direct impact on patients’ experiences of healthcare. Investing in staff wellbeing is therefore not only important for the nursing workforce but also for quality of care overall.
The three year study was funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme and led by the National Nursing Research Unit.
Academics and practitioners from the Department of Management at King's College London and the University of Southampton undertook the study which involved over 200 hours of direct care observation, patient focus groups, interviews and surveys, as well as interviews with senior managers and frontline staff, and a staff survey at four different Trusts.
Professor Jill Maben, lead researcher and Director of the National Nursing Research Unit, said: "While it may appear self-evident that patients' experiences and the quality of health care they receive are influenced by the experiences of the staff providing that care, there was limited UK research that explored this link. This study strongly suggests that patient experiences are better when staff feel they have a good working environment, support from co-workers and their manager, and low emotional exhaustion.
"These findings are significant and demonstrate that staff wellbeing is an antecedent, not a consequence, of patient care performance. Thus seeking systematically to enhance staff wellbeing is not only important in its own right but also for the quality of patient experiences.
"High performing organisations are recognising this and are acting upon staff experience feedback as well as patient experiences of care - seeking to directly improve staff experience as part of quality improvement initiatives".
The study, entitled ‘Exploring the relationship between patients experiences of care and the influence of staff motivation, affect and wellbeing' aimed to determine which particular staff attitudes and behaviours impacted on patient experiences.
Professor Maben continued: "Our study highlights the importance of the team and the team leader role in supporting and nurturing staff and in building a strong climate for patient care. Local leaders have a critical role in supporting staff in their sometimes difficult work and also in setting expectations of values, behaviours and attitudes to support the delivery of patient-centred care. Thus investing time and energy in team building is of critical importance for patient care delivery".
Professor Glenn Robert, Chair in Healthcare Quality & Innovation at the NNRU, said: "As previous research has indicated patient recollections of their own and others' experiences are vivid and focus largely on the relational aspects of care. Our research suggests that interpersonal relationships with staff are critical to patient experience, but the level of ‘connection' with staff as reported by patients and/or observed by researchers in our study was often poor.
"Patients want staff to show genuine interest in them as people; to be non-judgemental and competent; continuity of staff enhances levels of trust and the confidence felt by patients that their care needs are fully understood. Patients also wanted their relatives and carers to be kept informed and involved.
"However staff often reported not being able to deliver the care they wanted to citing insufficient staffing levels and competing demands on their time as preventing them from delivering the high quality care they wished to give."
The report is available from the authors and from the NIHR website:
Maben J, Peccei R, Adams M, Robert G, Richardson A, Murrells T.and Morrow E. Patients' experiences of care and the influence of staff motivation, affect and wellbeing. Final report. NIHR Service Delivery and Organisation programme; 2012.
Notes for editors
The National Nursing Research Unit (NNRU)
The National Nursing Research Unit (NNRU) at the Florence Nightingale School of Nursing and Midwifery (King's College London) undertakes high quality empirical research and reviews to inform policy and practice relevant to the nursing workforce. We aim to produce world class health services research that is of relevance to policymakers and healthcare leaders and which contributes to improving the quality and effectiveness of nursing in its social, political, local, national and global contexts. For more information go to http://www.kcl.ac.uk/nursing/research/nnru/index.aspx
Florence Nightingale School of Nursing & Midwifery
The Florence Nightingale School of Nursing & Midwifery at King's College London is the world's first professional School of nursing established by Florence Nightingale.
The number one Nursing and Midwifery School in London and highly regarded by leading London NHS Trusts with links to industry, health services and policy makers, the School develops leading-edge nurses and midwives of tomorrow - practitioners, partners, and leaders in their field. The School has over 1,000 full-time students training to be nurses and midwives plus an extensive portfolio of undergraduate and postgraduate activities to meet the needs of a wide range of healthcare professionals seeking continuing professional development. The School is at the forefront of health services, policy and evaluation research and home to the influential National Nursing Research Unit (NNRU). For further information visit: www.kcl.ac.uk/nursing
King's College London
King's College London is one of the top 30 universities in the world (2011/12 QS international world rankings), and was The Sunday Times 'University of the Year 2010/11', and the fourth oldest in England. A research-led university based in the heart of London, King's has nearly 23,500 students (of whom more than 9,000 are graduate students) from nearly 140 countries, and some 6,000 employees. King's is in the second phase of a £1 billion redevelopment programme which is transforming its estate.
King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.
King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres.
King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: www.kingshealthpartners.org
The College is in the midst of a five-year, £500 million fundraising campaign - World questions | King's answers - created to address some of the most pressing challenges facing humanity as quickly as feasible. The campaign's three priority areas are neuroscience and mental health, leadership and society, and cancer. More information about the campaign is available at www.kcl.ac.uk/kingsanswers
The National Institute of Health Research Health Services and Delivery Research (NIHR HS&DR) Programme was established to fund a broad range of research. It builds on the strengths and contributions of two NIHR research programmes: the Health Services Research (HSR) Programme and the Service Delivery and Organisation (SDO) Programme, which merged in January 2012. The programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services, including costs and outcomes. The programme will enhance the strategic focus on research that matters to the NHS. The HS&DR Programme is funded by the NIHR with specific contributions from the CSO in Scotland, NISCHR in Wales and the HSC R&D Division, Public Health Agency in Northern Ireland. www.netscc.ac.uk/hsdr /
The NIHR
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).