The NHS has published their 2024 Staff Survey results, which saw marginal differences from 2023 results, but large increases in recorded bullying and harassment from staff members. HB looks into these results, and how best to address these problems
On 13th March 2025, the NHS published their 2024 Staff Survey results, in which over 1.5 million NHS employees across England were encouraged to participate between September and November 2024. Half of the invited staff (774,828) took part in the largest, longest-running staff survey in the world for its 22nd year.
The survey asks staff to rate their experiences working for the NHS in England in response to seven statements as part of the NHS People Promise, which sets out the elements which are most important for staff: ‘We are compassionate and inclusive’; ‘We are always learning’; ‘We are safe and healthy’; ‘We are recognised and rewarded’; ‘We each have a voice that counts’; ‘We are a team’, and ‘We work flexibly.’ Alongside the People Promise, staff were also asked to report on two long-standing themes: staff engagement and morale.
Under each theme, staff were presented with statements to respond to, across themes such as culture, leadership, burnout, and safety. The survey recorded results both nationally and locally, to allow for comparison across different regional areas, and separate staff surveys record the opinions of bank workers and GPs, following successful pilots.
Staff opinion remains steady
On the whole, results from the 2024 survey have remained steady and generate similar results across all categories. Of the nine criteria, two of these have unchanged scores from 2023, which are rated out of ten: ‘We are recognised and rewarded’ (5.99), ‘We are a team’ (6.80). Four of these saw marginal gains: ‘We are safe and healthy’ (6.14 up from 6.13), ‘We are always learning’ (5.67 up from 5.64), ‘We work flexibly’ (6.31 up from 6.28), and morale (5.96 up from 5.94), and three of these saw slight decreases: ‘We are compassionate and inclusive’ (7.28 down from 7.30), ‘We each have a voice that counts’ (6.69 down from 6.72), and staff engagement (6.85 down from 6.89). Although most statements were met with similar responses to 2023, some are still considerably lower than 2020 outcomes, such as morale (6.08), staff engagement (7.05), although these have steadily increased since the COVID-19 pandemic.
It is also important that, although no outcomes have significantly dropped from 2023 levels – and this might seem like a success – there has also been no noticeable positive change; a score of 5.67 isn’t particularly impressive, or indicative of an environment where staff feel supported, heard, and excited to come to work. In a year where the NHS has been promised huge transformations, following the election of the Labour government in July, it seems improving staff wellbeing and morale have fallen under the radar in the pursuit of better waiting list statistics, or more tangible indicators of NHS performance, and though a productive, happy workforce is a huge factor in delivering efficient, effective patient treatment. It is important to note, however, that the survey took place very early on in Keir Starmer’s premiership, with the NHS 10 Year Health Plan still awaiting publication.
Harassment, bullying and abuse remain alarmingly high
Under the ‘We are safe and healthy bracket,’ staff gave ‘negative experiences’ a sub-score of 7.82 out of ten, a slight decrease from 7.83 in 2023. Although this may seem like a positive score, and few negative experiences among survey respondents, one in seven staff (14.38 per cent) have experienced at least one incident of violence by patients, service users, their relatives, or other members of the public, making this the highest proportion since 2021. 0.78 per cent of staff experienced at least one incident of physical violence from managers, again up from 2023 (0.72 per cent), and 1.89 per cent from other colleagues, the highest proportion in a while.
Harassment, bullying and abuse, while incrementally decreasing, was still high: more than one quarter (25.08 per cent) of staff have experienced at least one incident of this within the past year from patients, service users, their relatives or other members of the public. Almost one in ten (9.46 per cent) and more than one sixth of survey respondents experienced this from managers and colleagues: both statistics are part of a wider decline, but these figures are still alarmingly high.
One in ten nurses experienced sexual misconduct in 2024
Since 2023, staff have been asked if they have received unwanted behaviour of a sexual nature, including jokes, touching, and assault, within the last year. 8.82 per cent of staff reported at least one incident from patients, service users, their relatives or other members of the public, an increase from last year (8.79 per cent). From staff and colleagues, this figure has seen a slight decrease, from 3.85 per cent in 2023 to 3.66 per cent in 2024. These figures starkly differ across sectors: around one in ten nurses and midwives said they have been the target of unwanted sexual behaviour at work, with ambulance staff most likely to experience this: incidents here were more than one in four (28.79 per cent).
Racism is the culprit of two thirds of discrimination incidents
The survey revealed a diversity and equality sub-score of 8.08, which although higher than its ‘We are compassionate and inclusive’ rating (7.28), is the lowest diversity score in five years (8.1 in 2021). In a similar vein, less than six in ten (55.93 per cent) of staff in 2024 felt that the NHS acts fairly towards career progression or promotion, regardless of protected characteristics like gender, religion or ethnic background. Discrimination among staff has also increased to its highest level in five years, with almost one in ten staff reporting discrimination within the last twelve months from patients, service users, their relatives, or other members of the public (9.25 per cent) and from managers, team leaders or colleagues (9.22 per cent). The latter has seen a steady climb over the years, from 8.37 per cent in 2020, with 66 per cent citing discrimination on the grounds of their ethnicity.
Again, ambulance staff have reported the most incidents of workplace discrimination, (18.60 per cent), although nursing and healthcare assistants have been the biggest jump, from 14.38 percent reporting discrimination in 2023, to a concerning 16.44 per cent reporting discrimination in 2024.
“…there is still a long way to go for the NHS”
On the staff survey, NHS Providers interim chief Saffron Cordery said: “It is really worrying to see from these findings that staff experience of discrimination at work has increased, with much of it based on ethnicity.
“The gap in discrimination and bullying, harassment or abuse from patients, their families and the public is growing compared with white colleagues.
“Clearly, there is still a long way to go for the NHS in its vital work to tackle racism.”
Sexual misconduct policy framework
In response, NHS England launched a new sexual misconduct policy framework in October 2024 which built upon the sexual safety charter published in 2023 which committed to a zero-tolerance approach to inappropriate sexual behaviours towards staff. The framework was released alongside additional policy and an e-learning module, and is the first-ever public sector national guidance in tackling and responding to sexual misconduct at work.
The aims of the framework are to support NHS colleagues in recognising, reporting and preventing sexual misconduct in the workplace, and offer anonymous reporting to make it easier for staff to report any issues they experience or see. The framework additionally provides information and guidance on internal and external support that staff can access should they experience or witness sexual misconduct.
In addition, the Worker Protection (Amendment of Equality Act 2010) Act 2023, passed in October 2023, came into force in October 2024, and dictates that employers have a duty to prevent the sexual harassment of employees, and must have steps in place to protect their workers. NHS England’s sexual misconduct policy is informed by this new law, and sets out a rubric for employers to follow in the case of sexual misconduct, giving guidance should a member of staff disclose, witness, or wish to report and instance of sexual harassment or misconduct.
Looking towards the 2025 Staff Survey
How NHS staff feel about their job has huge impacts on the care they give. Working in functioning teams with compassionate, supportive leadership is essential to care quality, staff retention, staff wellbeing, financial performance, less violence towards staff, lower error and infection rates, and avoidable patient mortality. Climbing levels of discrimination and sexual conduct not only have huge impacts on staff morale, but also the care they are able to give, and feeling unable to report incidents or seeing no tangible results from reporting only serve to make this problem worse.
Aside from care and performance targets, NHS staff are people too, and it is paramount they feel safe, respected and protected in their workplaces, especially groups more vulnerable to sexual misconduct and discrimination, like women and ethnic minorities. Although positive news can be extracted from the survey results, like the highest number of people looking forward to coming to work since 2020, the high levels of discrimination and sexual harassment cases are unacceptable. The implementation of sexual misconduct framework is a welcome response from the NHS, but more needs to be done about protecting the 26.4 per cent of black and minority ethnics (BAME) from harassment and racism, both from patients and managers.
