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Relationship between employee engagement scores and service quality ratings: analysis of the National Health Service staff survey across 97 acute NHS Trusts in England and concurrent Care Quality Commission outcomes (2012–2016)

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posted on 29.07.2019, 16:44 by Mark Wake, William Green
Objective This research explores measures of employee engagement in the National Health Service (NHS) acute Trusts in England and examines the association between organisation-level engagement scores and quality ratings by the Care Quality Commission (CQC). Design Cross-sectional. Setting 97 acute NHS Trusts in England. Participants 97 NHS acute Trusts in England (2012–2016). Data include provider details, staff survey results and CQC reports. Hybrid Trusts or organisations affected by recent mergers are excluded. Outcome measures Analysis uses organisation-level employee engagement and CQC quality ratings. Results Employee engagement is affected by organisational factors, including patient bed numbers (β=−0.46, p<0.05) and financial revenue (β=0.38, p<0.05). CQC ratings are predicted by overall employee engagement score (β=0.57, p<0.001) and financial deficit (β=−0.19, p<0.05). The most influential employee engagement dimension on provider ratings is ‘advocacy’ (λ=0.54, p<0.001). Analysis supports the notion that employee engagement can be predicted from advocacy scores alone (eigenvalue=4.03). Better still, combining advocacy scores from the previous year’s survey or adding in motivation scores is a highly reliable indication of overall employee engagement (95.4% of total variance). Conclusions NHS acute Trusts with high employee engagement scores tend to have better CQC ratings. Trusts with a high financial deficit tend to have lower ratings. Employee engagement subdimensions have different associations with CQC ratings, the most influential dimension being advocacy score. A two subdimension model of engagement efficiently predicts overall employee engagement in NHS acute Trusts in England. Healthcare leaders should pay close attention to the proportion of employees who would recommend their organisation as a place to work or receive treatment, because this is a proxy for the level of engagement, and it predicts CQC ratings.

Funding

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Publication costs were met by the University of Leicester.

History

Citation

BMJ Open 2019;9:e026472

Author affiliation

/Organisation/COLLEGE OF SOCIAL SCIENCES, ARTS AND HUMANITIES/School of Business

Version

VoR (Version of Record)

Published in

BMJ Open 2019;9:e026472

Publisher

BMJ Publishing Group

issn

2044-6055

Acceptance date

10/06/2019

Copyright date

2019

Available date

29/07/2019

Publisher version

https://bmjopen.bmj.com/content/9/7/e026472

Notes

Survey data are available from http://www.nhsstaffsurveys.com and https://www.cqc.org.uk.

Language

en

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