comment: Survey shows managers' high morale but their staff are dissatisfied

Published: 07/06/2002, Volume II2, No. 5808 Page 17

The factors contributing to NHS employees' happiness have remained reassuringly the same despite all the reorganisations. They include a sense of doing something worthwhile, clarity about their role, adequate pay, a degree of autonomy, a sensible work/life balance and freedom to get on with the job in decent conditions.

So it is disappointing that human resources is only now being given proper attention by the UK's largest employer. It is to be hoped that the raft of new employment policies will genuinely concentrate organisations on the quality of working lives and that retention will be given as much attention as recruiting staff.

Employees' needs are not complicated - though they are difficult to deliver in a context beset by targets, high turnover of chief executives, constant staff shortages and volatile political attitudes towards the public sector. But who goes into management if not to affect the lives of others? And the best, at all levels of the service, know one of the greatest testaments to their skills is the good practice of those they have influenced.

The requirement for all NHS organisations to conduct annual surveys of staff morale (see feature, pages 22-24) is a good starting point. Analysis of these surveys showed that except for managerial staff, there was widespread dissatisfaction with pay and some conditions of service, particularly among technical, works, maintenance and clerical staff.

In contrast, staff reported that relationships with managers were usually good. This should provide managers with some satisfaction. Managers, for their part, are the only group to rate all aspects of their job positively. As the authors of the study point out, this could be because their jobs involve a degree of autonomy, good financial rewards and clear targets.

But neither of these findings should encourage complacency. There is limited value in taking an organisation's temperature unless you intend to do something about the diagnosis. Managers' power to influence individuals' working lives will be crucial.

However rewarding their own jobs may seem, they are not being effective for their organisation, or the NHS as a whole, if their staff always go home with a sense of being unappreciated and preoccupied with finding a way out.

If - and this is a big if - employing organisations are given some of the autonomy the government promises, and locally determined pay becomes a reality, managers should sense a freer hand to tackle these issues.

However, further research among primary care trusts and strategic health authorities is likely to reveal similar levels of dissatisfaction. This will highlight how effective human resource management in the NHS still has a long way to go, however happy the managers.