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LiA Scatter Map for Acute and Community Trusts based on National Staff Survey 2017-2018

Fri 9th March, 2018
LiA Scatter Map for Acute and Community Trusts based on National Staff Survey 2017-2018

Well, the trend from the 92 Acute-only sector Trust cohort sustains it seems for their peers in the combined Acute and Community Sector.

Listening into Action’s analysis of the 2017-2018 NHS National Staff Survey (NSS) results are in and it tells a fairly depressing tale. Staff it seems, are fed up with how things are and – apart from those leaving the Service for sunnier climes – are quite happy to record their displeasure this year more than any other, if the results to date are anything to go by.

Everything it seems ending in ‘i’ isn’t making a blind bit of difference to how they feel locally: NHSI, SI, QI…you get the picture. But still the jungle drums beat the same tune, the tune that’s failed to turn things round for years now. There’s a very clear – and obvious - reason for this, if anyone is interested? Maybe yes? Maybe no? Maybe Maybe?

Bottom line? The ‘National medicine’ of more command and control, more central dictat, more targets and pressures, and more unhelpful ‘interventions’ from regulators and ‘over-seers’, has resulted in the worst set of NSS results we have seen since starting this analysis eight years ago.

As a reminder, the Scatter Maps show an analysis of the 32 Key Findings from the latest National Staff Survey (NSS) results – produced by Picker Europe for the NHS. Each Trusts' results are reflected at a grid reference on a 32 by 32 ‘Scatter Map’ that shows how staff have rated the Trust’s leadership and culture over the past year. It's simple to understand:

• The higher up you are, the better your Trust is performing against your peers in the eyes of your staff
• The further to the right you are, the more positive your trend, year-on-year.

So, the best quadrant to find your Trust in is 'top right': an above average performance and a positive trend. Second best is 'top left': a positive relative performance according to staff, but they are less positive than the same time last year. The second worst quadrant is 'bottom right': below median performance with some encouraging positivity from staff to soften the blow. The worst quadrant is 'bottom left', with staff views on leadership and culture resoundingly negative.


Download a PDF copy of the Scatter Map 

Those of you familiar with our Scatter Maps from previous years will recognise some changes:

• Gone are the yellow and blue boxes that highlighted whether your organisation was a Foundation Trust or not – this was not proving to be useful or relevant
• They are replaced instead by red and green boxes, reflecting whether an individual Trust’s results are better or worse than last year; red for worse, green for better, and a more visual sense of ‘Whose results are going the wrong way?’
• Trust identifiers are shown only for the best and worst performing Trusts at this stage, for a couple of reasons: 1) We don’t want the named Trust Scatter Map to detract from the wider messages staff are giving national and local leaders; and 2) We want Trust leadership to reflect on where they think they are before we release the results.
• If you want to find out your Trust’s position according to your staff, please call Gordon on 07734 812311 or email to and we will happily share this with interested CEOs and HRDs.

And so to the results...

There are 37 Acute and Community Trusts this year whose results bear strict comparison. There are another four or five new or existing Trusts whose results can’t be assessed against 2016-2017 for several different reasons, so they are not included here.

The ‘movement’ on the Scatter Map is clear, as it was with the Acute-only sector, and it is downwards and leftwards.

You know something big is happening when National leaders on staff well-being indicators – such as Guy’s and St Thomas’ FT or The Newcastle-Upon-Tyne Hospitals FT – have vacated the top performing quadrant. These Trusts, and others like them have been fixtures in the ‘top right’ since we started assessing the NSS results; but they ain’t there anymore! Sound the alarm and make sure it is working in Richmond House!

The rate of decline is stark.

In 2016-2017, there were 14 Trusts in the ‘top right’ quadrant. This year it’s down to 6. Yep. SIX. That’s a 43% reduction in Trusts where staff rate leadership and culture above average and better than last year. 6 out of 36! In 2016-2017, there were 9 Trusts in the ‘bottom right’ quadrant – trying to get better – and now there are only 5. That’s a 56% shift away from trending positively. And they’ve all mostly landed up in the ‘bottom left’ quadrant, which has seen a rise from 5 Trusts last year to 14 in 2017-2018. A huge jump in staff saying things are going wrong, quickly.

On top of the general shift, if you look at last year’s Scatter Maps, you’ll see a far more even distribution across all quadrants and within quadrants than the current year’s ‘clustering tendency’ which is further left and further down the overall grid. On top of that, the red/green colour-coding shows that 16 out of 37 Trusts have improved, whilst 20 out of 37 Trusts have seen worse results (one has stayed right where it was in 2016-2017, in itself, no mean feat).

And so to individual Trusts…

Top Dog this year is Northern Devon Healthcare NHS Trust – a non-FT no less – so congrats to all for the continued improvement from 2016-2017.

Not faring so well is Lewisham and Greenwich who have dropped four places from 2016-2017 to claim bottom spot in the Acute and Community league table, shifting from a positive trend last year to a heap of trouble in the year ahead.

We’re also really big on ‘Quadrant Shifters’ – those Trusts whose staff see them go from ‘bottom-left’ to ‘top-right’, or from ‘top-right’ in the other direction. These results highlight a fairly stark change going on locally: sometimes good, sometimes bad.

Nobody has managed to go from ‘bottom left’ to ‘top right’ – or vice versa – but some whose improvement is noteworthy in other ways are Sandwell and West Birmingham, and South Tyneside. Well done to them. In reverse, moving in the wrong direction, are: Great Western, Wye Valley, and York Teaching. Work to do, and a different approach perhaps?

Time for a different drum beat, for the whole NHS.

Next up, Mental Health and Learning Disability Trusts. Breathe.


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