Informing our third leadership report, we surveyed NHS professionals to understand their views on the quality of patient care and leadership in delivering improvements.

1. Leadership survey 2013
May 2013

2. Fieldwork
Survey ran through February and March
More than 900 responses
Promoted in partnership with:
– Faculty of Medical Leadership and Management
– Managers in Partnership
– NHS Confederation
– NHS Professionals
– Royal College of GPs
– Royal College of Midwives
– Royal College of Nursing
– Royal College of Physicians

3. WHO RESPONDED

4. Who answered the survey?
Respondents were:
– approximately a third non-clinical and two thirds
clinical
– 87% of respondents have worked within the NHS for
10 years or more
– 78% manage people
– majority of respondents from hospital setting (63%
acute trusts, 9% mental health trusts). The survey
focussed on providers.

5. Q. Is your role primarily:
Clinical
64%
Non-clinical
37%

6. Q. How long have you worked in health care?
less than 5
years
3%
5-10 years
10%
more than 10
years
87%

7. Q. Do you manage staff?
Yes
78%
No
22%

8. Q. Which type of organisation do you work
for?
Acute
62%Mental health
9%
Primary care
6%
Community
7%
Independent
sector providing
NHS services
3%
Commissioning
3%
Other (please
specify)
10%

9. Q. How would you describe your role?
Executive
(Board)
4%
Senior
management
eg, director
17%
Manager
20%
Nurse
36%
Doctor
7%
Allied health
professional
2%
HCA/auxilliary
staff
2% Other
(please
specify)
12%

10. THE RESPONSES

11. Q. Who do you think has the greatest impact on
the quality of care?
Respondents asked to rank 1 to 5, with 1 being most
important
Ranking as follows:
– Clinicians
– Managers
– Government/DH
– Board
– Patients
– Regulators (eg, CQC, Monitor)
– Professional bodies (eg, GMC, NMC)

12. Q. Which of these factors has the biggest impact
in creating the right culture in an organisation to
deliver high-quality care?
Asked to rank top three
Top four were:
– appropriate resources and adequate staffing levels
– authentic leadership setting clear objectives and priorities
– trust boards seeing safety and quality as a priority
– clear focus on the perspective of patients.

13. Q. As a manager, which of the following do you
think is the biggest obstacle to you in improving
care?
40.1% said time and/or resources
There was a split between clinical (46%) and non (30%)
(and 51% nurses)
27.5% said organisational culture (this was higher with
non-clinical (33%) than clinical (24%) (board: 48%,
managers: 21%)
11.8% said externally set performance measures
(clinical: 11%, non-clinical: 14%)

14. Q. As a manager, which of the following do you
think is the biggest obstacle to you in improving
care?
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Time and/or
resources
Organisational
culture
Externally set
performance
measures
Professional
silos
Administration Other (please
specify)
Training or
development
needs

15. Q. Do you think enough priority is given to the
quality of care? (by level)
in the NHS? in your organisation? in your service/team? by your commissioner?
don't know 5% 4% 3% 37%
no 73% 48% 20% 43%
yes 23% 47% 78% 21%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%

16. Q. Do you think enough priority is given to the
quality of care in the NHS? (by role)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Clinical Non-clinical Executive
(Board)
Senior
management
e.g. Director,
Head of....
Manager Nurse Doctor
Yes
No
Don't know

17. Q. Do you think enough priority is given to the
quality of care in your organisation? (by role)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Clinical Non-clinical Executive
(Board)
Senior
management
e.g. Director,
Head of....
Manager Nurse Doctor
Yes
No
Don't know

18. Q. Do you think enough priority is given to the
quality of care in your service/team? (by role)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Clinical Non-clinical Executive
(Board)
Senior
management
e.g. Director,
Head of....
Manager Nurse Doctor
Yes
No
Don't know

19. Q. Do you think enough priority is given to the
quality of care by your commissioner? (by role)
0%
10%
20%
30%
40%
50%
60%
70%
Clinical Non-clinical Executive
(Board)
Senior
management
e.g. Director,
Head of....
Manager Nurse Doctor
Yes
No
Don't know

20. Q. What do you think of the quality of
leadership? (by level)
in the NHS in your organisation? in your service/team?
Don't know 2% 1% 1%
Very poor 13% 7% 4%
Poor 27% 19% 7%
Average 45% 37% 23%
Good 13% 29% 48%
Very good 1% 7% 17%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%

21. Q. What do you think of the quality of leadership
in the NHS? (by role)
Clinical Non-clinical
Executive
(Board)
Senior
management
e.g. Director,
Head of....
Manager Nurse Doctor
Don't know 2% 2% 0% 3% 3% 3% 2%
Very poor 14% 10% 11% 11% 6% 18% 15%
Poor 31% 19% 14% 18% 24% 31% 32%
Average 41% 51% 50% 50% 50% 40% 45%
Good 10% 17% 25% 18% 17% 8% 7%
Very good 0% 1% 0% 1% 0% 0% 0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%

22. Q. What do you think of the quality of leadership
in your organisation? (by role)
Clinical Non-clinical
Executive
(Board)
Senior
management
e.g. Director,
Head of....
Manager Nurse Doctor
Don't know 1% 0% 0% 0% 0% 1% 0%
Very poor 9% 4% 0% 4% 2% 14% 8%
Poor 21% 15% 7% 13% 22% 21% 15%
Average 38% 34% 18% 38% 38% 35% 42%
Good 25% 37% 57% 32% 34% 23% 32%
Very good 6% 9% 18% 13% 4% 5% 3%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%

23. Q. What do you think of the quality of leadership
in you service/team? (by role)
Clinical Non-clinical
Executive
(Board)
Senior
management
e.g. Director,
Head of....
Manager Nurse Doctor
Don't know 0% 1% 0% 0% 0% 0% 0%
Very poor 5% 3% 0% 0% 3% 7% 3%
Poor 9% 4% 0% 5% 4% 11% 10%
Average 25% 19% 14% 18% 22% 21% 30%
Good 45% 53% 57% 53% 58% 45% 43%
Very good 16% 20% 29% 24% 13% 15% 13%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%

24. Q. Which of the following leadership qualities do
you see most regularly in your organisation?
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%