Staff satisfaction and organisation performance: Evidence from the NHS staff survey

It has long been claimed that staff are an organisations most important resource, and that job satisfaction and employee attitudes are likely to be associated with better organisational performance, on the basis that good employers can attract and retain better workers, and that satisfied workers are likely to work harder than dissatisfied workers. In academic terms, this is known as the Human Resources Management (HRM) Model.

While much has been written on this model, there are three main problems with the model from the perspective of the NHS. First, some of the studies have problems with their methods. Second, no clear consensus arises from the studies. Third, most of the studies relate to business in the USA, and there are few studies on the British NHS.

In addition to representing an interesting academic issue, the topic has important practical relevance for the NHS. The NHS has made commitments to its workforce to be a model employer through the Improving Working Lives standard of 2000 and more recently through the staff pledges of the NHS Constitution of 2009. The NHS also has legal obligations such as in the area of equality and diversity as seen in the Equality Act of 2010.

For example, male and white staff should not be getting a better deal than female or black and minority ethnic staff in terms of training opportunities. In addition to the moral and legal case, there is the important issue of the business case of improving organisational performance.

We aim to identify important policy levers (e.g. which elements of staff engagement, well being or satisfaction are most important to organisational performance?) The project will use existing, available sources of data to answer these questions. In particular, data from the NHS national staff survey the largest annual workforce survey in the world will be explored extensively, both in total and broken down into specific groups of staff, and this linked with other sources of data. This will allow the researchers to analyse statistically the links between job satisfaction and employee attitudes and organisational performance (eg overall performance as gauged by the Care Quality Commission; patient experience; mortality rates; hospital infection rates).


Powell, M., Dawson, J., Topakas, A., Durose, J. and Fewtrell, C. (2014) Staff satisfaction and organisational performance: evidence from a longitudinal secondary analysis of the NHS staff survey and outcome data. Health Services and Delivery Research; 2(50).


January 2012-January 2014


NIHR Service Delivery and Organisation (NIHR SDO) programme


Professor Martin Powell and Dr Jeremy Dawson