Nearly one third of NHS employees do not agree that they would feel secure raising concerns about unsafe clinical practice, according to the 2014 NHS staff survey.

The survey, published today, paints a picture of increasing pressure on those who work within the health service.

Of the survey’s 29 “key findings”, 15 have deteriorated since last year, 11 have improved, one has remained the same, and two cannot be compared due to changes in the questions.

Sixty-four per cent of staff surveyed said if a friend or relative needed treatment they would be happy with the standard of care provided by their organisation, a slight decrease on the 65 per cent recorded in 2013.

Picker Institute Europe, which carried out the survey, said the fall was “concerning” because the measure is strongly related to patient experiences of care.

Fifty-six per cent of staff said they would recommend their organisation as a place to work, down from 58 per cent in 2013.

There was a marked decrease in the number of staff satisfied with their level of pay, from 38 per cent in 2013 to 33 per cent this year, representing the first drop in pay satisfaction since 2011.

Only 29 per cent felt there are enough staff for them to do their jobs properly, down 1 percentage point on the previous year.

In a new question introduced to the survey, only 68 per cent of staff agreed with the statement that they would feel secure raising concerns about unsafe clinical practice. Only 57 per cent said they would be confident that their organisation would address their concern.

Nearly one quarter of staff (24 per cent) said they had experienced bullying, harassment or abuse from a line manager or another colleague, a slight increase from 23 per cent the previous year.

More positively, 67 per cent of staff said patient care was their organisation’s top priority, compared to 66 per cent in 2013 and only 62 per cent in 2012.

The proportion of staff reporting they felt pressure to work while feeling unwell fell markedly, from 68 per cent in 2013 to 65 per cent in 2014.

Neil Churchill, director of patient experience at NHS England, said the national averages masked “striking differences in staff experience between different hospitals and other NHS employers”.

Writing on today, Chris Graham, Picker Institute Europe’s director of research and policy, described the survey’s findings about whistleblowing as “worrying”.

“Scaled up, they suggest that more than 100,000 NHS employees would not feel secure raising concerns about unsafe clinical practice,” he said.

“This is astonishing, and conclusively demonstrates that there is a very widespread fear – justified or not – about the personal consequences of whistleblowing.”