Only a quarter of health service staff in Scotland think their NHS board handles change effectively, according to a survey published last week.
Less than a third think communication between management and staff is effective and just 43 per cent believe senior managers are focused on the needs of patients or clients.
More than 58,000 responded to the survey sent to staff in October and November last year. It is the first biennial NHS staff survey published since the Scottish National Party formed its government in 2007.
The survey showed that staff think there have been some improvements. Some 55 per cent would recommend their organisation as a good place to work, up from 43 per cent in 2006, and staff feel more involved in decision making than they did two years ago.
Other findings were that 85 per cent of staff said they would be prepared to go the extra mile in their jobs, and 76 per cent were satisfied with the support of colleagues.
Health secretary Nicola Sturgeon said: "I know that NHS boards will be listening to the views of their staff, which are reported through the survey published today, and working to address those areas where they can improve."
Speaking at a seminar for NHS managers and staff representatives in Clydebank, Ms Sturgeon also launched a new workforce strategy, which includes five key ambitions. These include having all staff as ambassadors for health improvement, safety and quality and making NHS Scotland an employer of choice.
The strategy is being backed with a new£1.5m fund to support staff wellbeing.
WHAT SCOTS STAFF THINK
85 per cent of staff say they would "go the extra mile" for work
26 per cent think their NHS board handles change effectively
39 per cent think their pay is reasonable, considering their duties and responsibilities
43 per cent think senior managers in their board are focused on meeting patient needs
73 per cent think their job makes good use of their skills and abilities
77 per cent still intend to be working within their NHS board in 12 months