1. the institute for employment studies The NHS Context for Engagement

2. Diverse staff groups and locations Many different groups ● Clinical professionals ● Technicians ● Support staff ● Managers Patient-facing and ‘back office’ ● Hands-on daily contact ● Administrative and managerial ● ‘Corporate’ can seem very distant Different locations ● Multi-hospital acute Trusts ● Many locations for delivering community & mental health services Mergers and restructuring ● Hospitals and services changing hands ● Trusts reconfiguring and changing names

3. Engagement with what? Clinicians may owe more loyalty to their profession than the organisation they work for Support staff often care deeply about where they work (their hospital or clinic) but don’t identify with their Trust Patient-facing staff are often very engaged with their patients but might not care about wider Trust issues Senior managers have high levels of organisational engagement because they are making strategic and business decisions

4. NHS Staff Survey

5. Constant pressure Ever-increasing demand for services Cost restraint Public and press scrutiny Frequent ‘reforms’ due to changes in Government Targets → strain on staff, stressful jobs

6. Positives about the NHS Belief in NHS ethos Desire to help patients Rewarding work Patient/public appreciation Interesting jobs, often with considerable autonomy Career and development opportunities Clarity of core purpose