Nearly three-quarters of NHS workers in England are regularly doing overtime, much of it unpaid, according to the annual Healthcare Commission staff survey.

Fifty-seven per cent of acute trust staff and 59 per cent of primary care trust workers said they regularly worked unpaid overtime in the survey, published last week.

The proportion of staff who said they were satisfied with their jobs has dropped across all types of trust compared with previous years. Sixty-eight per cent of staff in acute trusts expressed satisfaction with their job (down from 69 per cent), three-quarters of PCT staff were satisfied (down from 77 per cent), and 56 per cent of ambulance trust staff were satisfied (down from 58 per cent).

Among the more than 128,000 staff in 326 English trusts who gave their views in October 2006, large numbers are not receiving regular appraisals or performance development reviews. Most of those who do are not finding it helpful: just 18 per cent of ambulance trust staff found appraisals useful.

NHS Employers deputy director Alastair Henderson said his organisation was working to ensure 'annual well-structured appraisal' for all NHS staff. 'We need to work hard locally and nationally to make sure the NHS remains a place people want to work.'

He said employers would be pleased with the fall in the proportion reporting work-related stress, down from 39 per cent in 2003 to 33 per cent, and injuries, down from 22 per cent to 17 per cent.

The proportion of staff reporting violence or abuse from patients or their relatives has remained steady - at 31 per cent compared with 30 per cent last year.

UNISON national secretary for health Karen Jennings said: 'Following today's report, it is even more important for the government to rethink its paltry annual pay award.'

Less than half (45 per cent) of staff. questioned said that they believed patients were the top priority for their trust and only 39 per cent thought they would be happy with the standard of care at their trust if they were a patient.

View the survey here