GUIDANCE FOR CONTRACTORS - NHS STAFF SURVEY 2018 NHS STAFF SURVEY COORDINATION CENTRE - NHS Staff Surveys
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NHS STAFF SURVEY 2018 GUIDANCE FOR CONTRACTORS NHS STAFF SURVEY COORDINATION CENTRE
Contacts
NHS Staff Survey Coordination Centre
Picker Institute Europe
Buxton Court
3 West Way
Oxford
OX2 0JB
Tel: 01865 208141 (9.30am – 4.30pm, Monday to Friday)
Fax: 01865 208101
E-mail: nhsstaffsurvey@surveycoordination.com
Website: www.nhsstaffsurveys.com
Key personnel
Jenny King
Caroline Killpack
Rory Corbett
Firona Roth
Mariann Novak
Steve Sizmur
Page 2
Contents
1 Introduction .............................................................................................................. 3
2 Key changes to the NHS Staff Survey for 2018 ...................................................... 4
2.1 Eligibility criteria .......................................................................................................... 4
2.2 Changes to variables to be submitted ......................................................................... 4
2.3 GDPR responsibilities ................................................................................................. 4
2.4 Online survey websites ............................................................................................... 4
2.5 Providing list of participating organisations ................................................................. 4
2.6 New guidance sections ............................................................................................... 4
2.7 Clarifications to the guidance ...................................................................................... 4
3 Summary of minimum survey requirements .......................................................... 5
4 Survey timetable....................................................................................................... 6
5 Mandatory minimum fieldwork period .................................................................... 8
6 Online or mixed mode eligibility criteria ................................................................. 9
6.1 Criteria for organisations that want to run the survey online or mixed mode ............... 9
7 Improving response rates ...................................................................................... 11
7.1 Confidentiality concerns............................................................................................ 11
7.2 Incentives ................................................................................................................. 11
7.3 Online surveys: email deliverability ........................................................................... 12
8 The Questionnaire .................................................................................................. 13
8.1 Core Questions ........................................................................................................ 13
8.2 Optional values question .......................................................................................... 14
8.3 Additional Question Modules .................................................................................... 14
8.4 Local questions ........................................................................................................ 15
9 Questionnaire specifications................................................................................. 16
9.1 Paper........................................................................................................................ 16
9.2 Envelopes................................................................................................................. 16
9.3 Online ....................................................................................................................... 16
10 Covering letters / emails and reminders ............................................................... 19
10.1 Paper covering and reminder letters ......................................................................... 19
10.2 Online covering and reminder emails........................................................................ 19
10.3 Email subject lines .................................................................................................... 20
10.4 Chief Exec letters / emails ........................................................................................ 20
11 Breakdown of results by directorate / department / site...................................... 21
12 Preparation of Staff Lists ....................................................................................... 22
12.1 Who should be on this list? ....................................................................................... 22
12.2 Who should not be on this list? ................................................................................ 22
12.3 Format of the staff list spreadsheet ........................................................................... 23
13 Creating the staff sample or census file ............................................................... 25
13.1 The size of the basic sample .................................................................................... 25
13.2 Instructions for preparing the sample / census file. ................................................... 25
14 Final sampling inspection by the Coordination Centre ....................................... 29
Page 115 Distribution and receipt of questionnaires, and prompting non-respondents... 30
15.1 Distribution timing ..................................................................................................... 30
15.2 Taking receipt of completed questionnaires .............................................................. 30
15.3 Recording Responses: outcome codes .................................................................... 31
15.4 Calculating the response rate ................................................................................... 34
15.5 Weekly monitoring .................................................................................................... 34
16 Data entry and data transfer to the Coordination Centre .................................... 35
16.1 Data fields to be included in file submitted to Coordination Centre ........................... 35
16.2 Questionnaire data ................................................................................................... 36
16.3 Data cleaning ........................................................................................................... 37
16.4 Data checking........................................................................................................... 38
16.5 Transferring the data ................................................................................................ 38
16.6 Data transfer for organisations who change contractors ........................................... 38
17 Reports of the survey findings .............................................................................. 39
17.1 Embargo on results .................................................................................................. 39
17.2 Reporting free text comments ................................................................................... 39
Appendix 1 Eligibility criteria: why are certain groups excluded? ............................ 41
Page 21 Introduction
The NHS Staff Survey provides an opportunity for organisations to survey their staff in a
consistent and systematic way. This makes it possible to build up a picture of staff
experience and, with care, to compare and monitor change over time and to identify
variations between different staff groups. Obtaining feedback from staff and taking account of
their views and priorities is vital for driving real service improvements in the NHS.
All NHS trusts (foundation trusts, acute and specialist hospital trusts, ambulance service
trusts, mental health, community and learning disability trusts) are required to participate in
this survey. Clinical Commissioning Groups, Commissioning Support Units, Social
Enterprises and other NHS bodies may choose to undertake the NHS Staff Survey on a
voluntary basis. This requirement to participate may be subject to change.
Page 32 Key changes to the NHS Staff Survey for 2018
Below you will find a summary of the key changes and clarifications made to the guidance
this year.
2.1 Eligibility criteria
Suspended staff have been removed from the exclusion criteria for the survey. Please note
that because of this change relevant outcome codes have also been adjusted.
In addition, several amendments have been made to the eligibility criteria for the survey to try
and reduce confusion among trust staff that have to draw the staff list. Please read the
instructions in section 12 carefully.
2.2 Changes to variables to be submitted
Disability and pay band information will not be collected for the 2018 survey. These variables
should not be included in the sample sent to the Coordination Centre.
See section 14 for the full list of variables required to be submitted to the Coordination
Centre for each organisation.
2.3 GDPR responsibilities
Due to the introduction of the GDPR, the legal basis under which staff data is processed for
the purpose of the Staff Survey must be documented. Participating organisations are
responsible for ensuring their compliance with the GDPR. A summary of how to manage the
NHS Staff Survey in line with the GDPR is available on our website here.
2.4 Online survey websites
The Coordination Centre is now recommending that all contractors use HTTPS enabled
websites to host the Staff Survey – see section 9.3.
2.5 Providing list of participating organisations
The survey timetable has been updated to give organisations a deadline to appoint a
contractor and for contractors to provide a list of participating organisations they are working
with to the Coordination Centre – see section 4.
2.6 New guidance sections
There are three new sections to the guidance this year covering requirements around
envelopes for postal surveys (section 9.2), the embargo on organisations sharing results
prior to the publication of the survey results (section 17.1), and requirements on reporting
free text comments (section 17.2).
2.7 Clarifications to the guidance
We have amended the wording that outlines when to code staff that leave an organisation or
become ineligible before the first mailing is distributed as ‘LE’ or ‘EXCL’ (section 15.3).
We have added a sentence to clarify that surveys must be distributed to staff by the start of
the mandatory minimum fieldwork period. This applies to both online and postal surveys – so
postal surveys must be delivered to the trust before the start of the mandatory minimum
fieldwork period to allow trusts time to distribute them internally (section 15.1).
Page 43 Summary of minimum survey requirements
All participating organisations must follow a standard methodology as described in these
guidance notes, and must fulfil the following minimum requirements:
An external organisation must be appointed to act as a survey contractor. As a
minimum, this organisation should be responsible for receipt of completed
questionnaires, data entry and editing, and delivery of this data to the Coordination
Centre. The deadline for appointing a contractor is 24 August 2018. Each
contractor must provide a list of participating organisations to the Coordination
Centre by 3 September 2018.
A self-completion questionnaire. Online, mixed mode and paper questionnaires
must contain the full set of core questions (see section 8 for more details on the
questionnaire).
As a minimum, all participating organisations are required to survey a random
sample of staff (see section 12 for more details on sampling).
Questionnaires (each labelled with a unique staff ID number) must be distributed to
selected staff with two reminders (if a paper survey) or six reminders (if online) being
sent to non-responding staff (see section 15 for more details on the questionnaire
distribution process).
Minimum fieldwork period. Organisations and contractors must ensure that their
survey has a fieldwork period of at least eight weeks.
The closing date for the survey is Friday 30 November 2018.
The data submission deadline is Friday 7 December 2018. Contractors must
ensure that all data is submitted to the Coordination Centre by this deadline.
There are a number of ways in which the survey can be adapted for local needs.
Organisations may:
Conduct a survey with a larger staff sample or a census (section 13).
Select and add additional question modules (section 8.3).
Include their own local questions on other topical issues (section 8.4).
Please note that it is the responsibility of each participating organisation to comply with their
responsibilities under the GDPR. The legal basis for processing personal data for the NHS
Staff Survey is “for the performance of a task carried out in the public interest or in the
exercise of official authority vested in the controller” (Article 6(1)(e)). The legal basis for
processing sensitive personal data (e.g. ethnicity) is ‘covered in article 9(2)(h) under ‘the
management of health or social care systems’. A document is available on our website, here,
which contains further details about complying with the GDPR whilst participating in the NHS
Staff Survey.
Page 54 Survey timetable
Please note, survey contractors may set earlier deadlines for organisations than those set
out below. Contractors should liaise with the participating organisations regarding any such
requirements.
Section in
Date (2018) Step of survey implementation By whom?
guidance
Contractors running the online survey must send a
By 24 August Contractor 9.3
test link to the Coordination Centre.
Agree with your contractor which survey mode Organisation
By 31 August 6
(online, paper or mixed mode) is to be used and contractor
Provide a list of participating organisations to the
3 September Contractor N/A
Coordination Centre
Contractors submit first weekly monitoring data
20 September sheet. These should then be submitted every Contractor 15.5
Thursday for the remainder of fieldwork.
Contractors should aim to submit all samples to the
By 21 September Contractor 14
Coordination Centre by this date.
Pre-approach letter/email. If you are using a pre-
By 1 October approach letter or email, send these to staff one to Contractor 10
two weeks before the first mailing.
Paper surveys
The following dates are for the mandatory fieldwork
10 and 15
period. It is strongly recommended that fieldwork Contractor
is started earlier.
By 8 October Initial mailing (including questionnaire)
Page 6Section in
Date (2018) Step of survey implementation By whom?
guidance
2-3 weeks after
First reminder
initial mailing
2-3 weeks after
Second reminder (including questionnaire)
first reminder
Online surveys
The following dates are for the mandatory fieldwork
period. It is strongly recommended that fieldwork
is started earlier. Time between mailings must
always adhere to that specified in section 10.
By 8 October Initial mailing
By 22 October First online reminder
Contractor 10 and 15
By 29 October Second online reminder
By 5 November Third online reminder
By 12 November Fourth online reminder
By 19 November Fifth online reminder
By 26 November Sixth (final) online reminder
30 November Close of fieldwork Contractor N/A
7 December Data submitted to Coordination Centre Contractor 16
Page 75 Mandatory minimum fieldwork period
To increase the quality of data provided to organisations, a minimum mandatory fieldwork
period exists. Organisations receive a greater number of responses with increased fieldwork
time, as this allows for more time to notify staff and allow them to respond.
In 2018, the survey closing date is 30 November 2018. Initial mailings must therefore be
completed by 8 October 2018, which allows for the mandated eight-week fieldwork period.
While the Coordination Centre understands that sampling queries and technical issues can
slow the process of sample approval and survey mailing, the initial mailing must allow for a
minimum of eight weeks of fieldwork. Survey contractors should work with participating
organisations to ensure they receive the staff lists early enough to meet this requirement,
allowing time for the necessary sample checks by contractors and the Coordination Centre.
Organisations running the paper survey must ensure that questionnaires are distributed to
staff by the start of the mandatory minimum fieldwork period.
Please note: the eight week period is mandatory as a minimum, but, where possible, it is
strongly recommended that organisations start their survey earlier in order to have a
fieldwork period longer than eight weeks.
There are two very important reasons to adhere to a minimum mandatory fieldwork period:
Representativeness. It is crucial that all organisations have data that represents the
actual demographic make-up of their staff. Shorter response periods are known to
have a particular negative impact on response rates from certain groups, such as
black and minority ethnic (BME) staff. Additionally, in relation to online surveys, staff
members who do not ordinarily work at a computer as part of their day job may find it
challenging to find time to complete the survey.
Comparability. Due to seasonal variation and the length of time between the sample
date and the survey date, any organisation that goes into field late will risk being
rendered incomparable with other organisations that have adhered to the fieldwork
dates. Delays can also cause higher rates of staff ineligibility, as more staff sampled
on 1 September may have since left the organisation, impacting on the number of
responses received as well as data quality, representativeness and usefulness.
Page 86 Online or mixed mode eligibility criteria
Organisations participating in the NHS Staff Survey are able to conduct a paper survey, an
online survey or a mixed mode survey, combining paper and online options. If an
organisation has staff with active email addresses, that organisation can, but is not obliged
to, run the survey online.
Organisations are encouraged to target paper and online surveys to the staff groups they
deem most appropriate for each mode. This will allow staff groups that are known to respond
better on paper or have limited access to their email to be sent a paper survey, even if they
have an active email address. Each staff member must still receive only one type of survey.
Organisations making use of this flexible mixed mode approach will need to provide
mode information (i.e. paper or online) to their contractor along with their staff list.
Organisations that wish to implement this approach are encouraged to engage with staff
groups with lower response rates to find out which method is preferred, prior to drawing their
staff list. Contractors may also be able to advise organisations on which staff groups typically
respond better on paper.
All surveys must still conform to the minimum sample requirements (see section 12);
extended samples and census data will be accepted by the Coordination Centre providing
the organisation adopts and adheres to a consistent approach. The Coordination Centre
reserves the right to reject additional data which follows a different methodology to the basic
sample.
6.1 Criteria for organisations that want to run the survey online or mixed
mode
Organisations must meet all the criteria below in order to be allowed to run the online or
mixed mode option and have their data included in national reporting. Before undertaking an
online or mixed mode survey, contractors must confirm with organisations that all the criteria
have been met. If an organisation does not meet all the criteria, then they will be required to
run the survey using a paper-based approach, as in previous years.
The organisation must:
Have accurate, up-to-date and active organisation email addresses for all staff groups
to whom they intend to administer the online survey or online element of the mixed
mode survey. Organisation email addresses should be used where possible, but it is
acceptable for non-work email addresses to be used if necessary, for example for
staff on parental leave, provided that staff have given permission for their non-work
email to be used.
Check the staff email addresses are up to date for 2018, even if they ran an
online or mixed mode survey in 2017.
Be confident that all staff access these email addresses on a regular basis and
therefore it is feasible to expect to get responses to the survey from these email
addresses.
Be able to extract e-mail addresses from their Electronic Staff Record (ESR) system
with ease. If the organisation has to cross-reference records or enter email addresses
manually then they should not run the online or mixed mode option.
Be confident that they can extract their staff list, with accurate up-to-date email
addresses, as of 1 September 2018 and provide this information to contractors by 14
September 2018.
Allow staff time to complete the survey in work time on a work computer (for staff who
wish to do this).
Be able to implement a communications plan to ensure that staff are aware that they
will be receiving a link to the survey by email.
Page 9 Commit to providing their contractor with updates to email addresses throughout
fieldwork.
Send written confirmation to their contractor, signed by their survey lead, that they
meet all of the above eligibility criteria for running an online survey.
Please note that staff should be assigned to one type of questionnaire only (i.e. online or
paper).
Contractors are required to provide the Coordination Centre with data throughout the
fieldwork period identifying the number of staff who have so far never received a survey
email (staff coded as ‘UN’ – see section 15.3 for further details). The Coordination Centre will
monitor this data to identify organisations that have a high level of undelivered surveys. Data
quality can be substantially impacted by an organisation having a high proportion of staff who
never receive a survey email. Therefore, if organisations do not act to resolve this issue by
providing their contractor with updated email addresses they may be required to run a mixed-
mode, or paper only, survey the following year.
The Coordination Centre will only accept data from organisations that issue the correct
number of reminders to non-responding staff and follow all other requirements of the
methodology set out in this guidance.
Page 107 Improving response rates
Achieving a high response rate to the NHS Staff Survey is very important for the quality and
utility of the findings, as the higher the survey response rate, the more confident we can be
that the survey findings are representative of NHS staff as a whole, and the more use can be
made of the data at trust level. Non-responding staff may have different characteristics and
views from staff who do respond, so the higher the proportion of staff who respond, the
higher the probability that the survey findings are a true reflection of staff views as a whole.
Some information about increasing response rates is provided below, and further resources
are available in the ‘improving response rates’ section of the NHS Staff Survey website at
www.nhsstaffsurveys.com/Page/1058/Survey-Documents/Survey-Documents/.
7.1 Confidentiality concerns
One of the key barriers to achieving good response rates is concern among staff members
about the confidentiality of the survey and the need for the bar code on the questionnaire. It
is therefore recommended that all organisations include information about the following in
their communications to staff, and that managers are encouraged to discuss this with staff
using the template responses below:
Q: If I fill in the questionnaire, will my response be kept confidential?
A: Yes. You will post your completed questionnaire directly to the independent survey
contractor appointed by . does not have access to the questionnaires or to any personal data
(including names and addresses). The report that is sent back to presents the survey findings in summary form, and does not reveal the
identity of the staff surveyed.
Q: Why does the questionnaire need an identification number and bar code?
A: You have been given a unique identification (ID) number so that your name and
work contact details are not on the questionnaire. Survey contractors use the ID
numbers to ensure that reminder letters are only sent to staff who have not returned a
questionnaire.
As staff return their completed questionnaires directly to an external survey
contractor, there is no way that anyone in a NHS trust/organisation will be able to link
data with a particular ID number or individual. Organisations will only receive reports
of the summary survey findings. If a questionnaire is returned with the ID number
obscured or removed, data cannot be included in the survey findings as, without the
ID number, it is not possible to assign data to the correct NHS trust/organisation.
For further information, see the FAQs at http://www.nhsstaffsurveys.com/ or contact the
Coordination Centre on 01865 208141.
7.2 Incentives
Incentive schemes can be used by organisations to encourage staff to complete the survey,
and good incentive schemes can be a successful way of increasing response rates. The use
of such schemes is at the discretion of the organisation, but organisations must fully
consider the possible risks of any incentive scheme prior to implementation.
Most importantly, if an organisation wishes to use an incentive scheme linked to survey
completion by specific members of staff (e.g. a prize draw that rewards a specific member of
staff for completing the survey) they should be aware this can sometimes undermine the
perceived confidentiality and anonymity of the survey, as they can be taken to suggest that
the organisation has access to the survey data. All organisations running incentive schemes,
particularly those linked to individual survey completion, must take care that their
communications to staff regarding the scheme do not undermine staff confidence that their
responses are confidential and anonymous. Please note, prize draws MUST be handled by
the contractor, and it is recommended that communications to staff note that this is the case.
Page 11In some organisations staff have particular concerns or suspicions about confidentiality in
general and in such cases incentive schemes that link to individual survey completion can
increase these concerns and lead to reduced response rates and less accurate responses. If
this is considered likely, the organisation should not run such an incentive scheme.
An alternative to incentive schemes that identify specific respondents is to use a scheme that
rewards groups, rather than individuals. For example, incentives could be given to
departments who reach a certain response rate, or to the department with the highest
response rate.
7.3 Online surveys: email deliverability
One of the key factors in attaining a high response rate if running an online or mixed mode
survey is ensuring that the survey emails are actually received by staff.
Email accuracy
It is vital that organisations ensure the accuracy of email addresses they provide to their
contractor for use in the survey mailings, and make sure that only active email addresses are
provided. This checking process should be started in good time before the survey
commences and should be repeated each year, even if an online survey was run the
previous year.
Following the initial survey mailing, there will be a two week gap before the first reminder is
sent out. Organisations must use this time to provide correct email addresses to their
contractor for any staff members whose email addresses did not work in the initial mailing
(i.e. a bounceback was received).
Please note, when survey email addresses are updated, it is strongly recommended that the
organisation also updates this in their ESR (Electronic Staff Record) system. This can save a
substantial amount of time in future surveys and also help with other organisation activity
such as the Staff Friends and Family Test.
Mailbox space
Staff should be encouraged through internal communications to ensure they have sufficient
space in their mailboxes to actually receive the email. This is likely to be particularly an issue
for groups of staff who do not use their email accounts as part of their day to day work.
Firewalls and spam filters
To avoid survey mailings being stopped by firewalls and spam filters, organisations should
liaise with their IT departments about these prior to the survey and make all possible
efforts to ensure the survey emails are allowed through. To help with this process, it is
recommended that contractors confirm relevant details including the email subject lines and
sender email address that will be used with all organisations prior to the start of the survey.
Page 128 The Questionnaire
Please note that the following points apply to paper, online and mixed mode surveys.
The questionnaire has three components, one of which is compulsory:
A set of core (compulsory) questions, which must be asked in all organisations.
Additional question modules (optional).
Local questions (optional).
If further additional optional or local questions are added, the questionnaire must be limited
to a maximum of 16 A4 sides, although it is recommended that no more than 12 A4 sides are
used. A questionnaire that is longer than this will have an adverse effect on response rates.
The same logic should be applied to online or mixed mode surveys; introducing too many
questions may adversely affect the response rate.
All participating organisations must include the full set of core questions in their
questionnaire, but also have the option of selecting the additional question modules. These
can be put together using the Questionnaire Compilation Tool available on the Coordination
Centre website (www.nhsstaffsurveys.com). Typically, creating a questionnaire should be
done by the contractor appointed by the organisation.
8.1 Core Questions
The core questionnaire is broken down into the following categories:
YOUR JOB
Questions about the respondent’s experiences of working at their organisation
and in the NHS, including: team working, involvement in decision making, job
satisfaction and how engaged staff are in their jobs.
YOUR MANAGERS
Questions relating to immediate managers, senior managers, feedback from
management, communication and support from management.
YOUR HEALTH, WELL-BEING AND SAFETY AT WORK
Questions about the impact of job role on health, pressure to come to work
when feeling ill, working hours, witnessing incidents and errors, raising
concerns at work, physical violence, and harassment/discrimination.
YOUR PERSONAL DEVELOPMENT
Questions about the type and quality of the training, learning and development
respondents have received and the quality of appraisals respondents have
received.
YOUR ORGANISATION
Questions relating to the organisation as a whole, including whether staff
would recommend their organisation for treatment or as a place to work, and
whether patient experience feedback is used.
BACKGROUND INFORMATION
Questions about the respondent’s age, gender, ethnic background, sexual
orientation / identity, religious cultural beliefs, occupational group, how long
they have worked at their organisation, whether they have contact with
patients, and line management responsibilities. This information is used to
help understand whether different groups of people have different experiences
of working in the NHS.
Page 138.2 Optional values question
As in 2016, organisations have the option of including an extra question on values which can
be tailored to the organisation using the questionnaire compilation tool:
Organisations can substitute more effective wording in place of the “your organisation’s
statement of values” part of question 32a (the text surrounded by the red box in the example
above). Parts b and c of this question are not editable. ONLY the text in the red box may
be edited. If organisations want to edit this question further, or add any other questions on
values, this cannot be included in the main body of the questionnaire, but should instead be
done by adding a local question, which will appear at the end of the questionnaire.
It is recommended that all organisations choosing to use this question do change the
editable text, to ensure this is understood by staff, and to help make sure they are thinking
about the correct set of organisation values, rather than professional or other values
statements they may be aware of.
If your organisation’s values statement has a name, it is recommended you include this. For
example, if an imaginary organisation called Town Hospital NHS Trust had a publicised list of
values that staff are expected to adhere to called the RESPECT values, they could edit the
text so question 32a asks: “Are you aware of Town Hospital NHS Trust’s ‘RESPECT’
values?”
Due to the variation in context and question wording between organisations, the findings
from this question will not be benchmarked. Organisations will need to agree with their
contractors the exact wording of this question and where it is to be placed in the
questionnaire.
8.3 Additional Question Modules
The Additional Question Modules can be added to the questionnaire. These cover:
LEADERSHIP AND CAREER DEVELOPMENT
This module focuses on a number of the principles found in the NHS Leadership
Framework. This framework has been designed by the National Leadership Council to
help NHS organisations develop the leadership skills of their healthcare staff, with the
primary objective of improving patient care and outcomes. Questions relate to career
progression, becoming a leader, and feeling part of the organisation’s vision for the future.
The module was expanded in 2014 to include questions on “potential and development”.
HEALTH AND SAFETY
Promoting a healthy and safe work environment is an important domain in the NHS
Outcomes Framework: ‘treating and caring for people in a safe environment and
protecting them from avoidable harm’ (Domain 5). Questions relate to respondents’
working environment, safety culture, and the implementation of safety processes.
Page 14 PATIENT EXPERIENCE
This module provides a different approach to looking at staff and patient experience.
Instead of exploring links between survey data sets, this module takes questions from the
NHS patient survey programme and adapts them for use with NHS staff. Questions look
at whether respondents believe patients are treated with respect and dignity, have
confidence in the staff treating them, and are included in decisions.
8.4 Local questions
Organisations can create additional local questions to add to the end of their questionnaire.
These should be discussed with their contractor.
For example, one area in which organisations may want to consider adding additional
questions is health and well-being. There is a large drive across the NHS to improve the
health and wellbeing of staff. Additional health and wellbeing questions may allow
organisations to better understand the type of support required by their staff, the impact and
the reach of their current initiatives and help to shape their thinking on what sort of initiatives
and interventions to deliver in the future. They may also allow organisations to compare and
contrast the impact and access across different staff groups, departments and demographics
within their organisation.
The Coordination Centre has created some guidance on constructing questions on health
and wellbeing, as well as a number of recommended questions. This guidance can be found
at: http://www.nhsstaffsurveys.com/Page/1058/Survey-Documents/Survey-Documents/
Page 159 Questionnaire specifications
9.1 Paper
The questionnaire compilation tool described in section 8 should be used to create a PDF
document containing the core and any additional question modules for a particular
organisation. Any local questions should be designed on separate pages, and added to the
end of the pages of the PDF document before printing to form a single document.
The questionnaire has been designed in black, white and NHS Light Blue, and should
therefore be printed in colour. Experience has shown that the overall look of a questionnaire,
including the use of colour, helps to raise survey response rates.
The NHS Light Blue colour used in the questionnaire is Pantone 300, or R:0 G:114 B:198.
The light blue used for the bands at the top of each question is a 25% tint of the same colour
(Pantone 290 R:196 G:216 B:226).
Questionnaires should be printed as A4 booklets (i.e. an 8-side questionnaire would be 2
folded A3 sheets, stapled in the centre).
All selected staff within an organisation should receive an identical questionnaire, in terms of
content and format. The only difference between questionnaires distributed to different
individuals should be in the ID number assigned during the sampling procedure (see section
13.2). If the ID (or barcode) is printed at the top of the questionnaire as opposed to the
bottom, may alter the text on the front of the questionnaire to read “The barcode/number
above is only used…”.
It is a requirement that all paper used in the publication of the NHS Staff Surveys, including
questionnaires and corresponding letters, must conform to government requirements for the
use of 100% recycled paper with a minimum post-consumer waste content of 80%. It is
further recommended that the paper used is uncoated and of standard A4 size (except for
the questionnaires, which should be printed as A4 booklets on A3 paper).
9.2 Envelopes
Contractors must use either C4 or C5 envelopes to post paper questionnaires.
A concise printed message on the envelope is permitted in order to identify that it contains a
staff survey.
9.3 Online
Online questionnaire templates will be set up by contractors for organisations running the
online survey. The templates will contain the questions from the core questionnaire along
with any additional question modules and local questions that the organisation has
requested.
All selected staff within an organisation should receive an identical online questionnaire,
these will be distributed using staff email addresses at the organisation. Each member of
staff should be able to login and complete the survey from the workplace (or a computer
elsewhere if they wish).
Online surveys must remain open to staff throughout the fieldwork period if the staff member
is eligible and has not responded, even in cases where a response is very unlikely (i.e.
someone has left an organisation and further mailings have been stopped).
All contractors running an online survey must provide the Coordination Centre with a test link
by 24 August 2018. Contractors must receive approval of their online questionnaire from the
Coordination Centre before survey mail-out.
It is vital that online questionnaires follow the paper questionnaires as closely as possible
and adhere to the following requirements:
Page 16 The appearance of the questionnaire is very important. It should appear neat and
professional. Colours should match those used in the paper questionnaire.
o The NHS Light Blue colour used in the online questionnaire is Pantone 300, or
R:0 G:114 B:198. The light blue used for the bands at the top of each question
is a 25% tint of the same colour (Pantone 290 R:196 G:216 B:226).
The front page should contain all the information featured on the paper questionnaire
(except for the information on returning the questionnaire), including the NHS logo.
o If desired, contractors may include their email address for queries, as well as
their helpline number.
o Any technical support information should direct queries to the contractor, as
the Coordination Centre cannot assist with technical queries (e.g. passwords,
new links). The contractor’s support phone number should appear on the front
page, and, if possible, at the bottom of every other page of the online
questionnaire.
It is not permitted for contractors to include their own organisation’s logo anywhere on
the survey.
Fonts should be easy to read and consistently sized, with no special formatting other
than that featured in the paper questionnaire. Use of underline, bold and italics must
match that in the paper questionnaire.
The buttons allowing respondents to move between pages should be sufficiently
obvious.
All response options and headings included in the paper questionnaire must be
included online.
Response options should appear in the same order and layout as presented in the
paper questionnaire.
Response options should be evenly spaced, with no category given more space than
others.
Response radio buttons/tick boxes should be sized with the font – i.e. if a large-print
font is selected, the response buttons/boxes should also be large-print.
If possible, the area around the radio buttons/tick boxes should be “clickable”, so that
the response option is selected if the respondent clicks slightly outside the
button/box.
Question series should be on the same page and within the same formatted section,
e.g. questions 4a to 4j should all be on the same page and together in the same box,
as appears in the paper questionnaires.
o This also applies to questions that are routed or filtered.
Questions should be arranged in such a way so as to avoid placing too few or too
many on one page. Too many questions on one page can cause non-response if
respondents do not see them; conversely too few questions on one page can cause
response fatigue as respondents become bored with too many pages.
For questions that feature the “Other” response with a response text box, ensure that
the text box is logically placed with the “Other” response selection, so respondents
understand the two items go together.
Any notes featured in the paper questionnaire (e.g. “Please include paid overtime,
bank shifts, and additional paid hours on-call” on question 10b) should be similarly
placed in the online version.
Online questionnaires can utilise automatic routing, so that respondents are
automatically directed to the next relevant question where the paper questionnaire
includes instructions to do so. If automatic routing is not used, then the text and
placement of routing instructions must match that featured in the paper questionnaire.
Page 17 Respondents must be able to leave questions blank.
Respondents must be able to go back to previous pages while in the process of
completing the questionnaire.
The online questionnaire must contain a free text comment box at the end. This
should be preceded by the instruction: “If you have any additional comments about
working in this organisation, please write them below. Written comments you provide
will be passed to your organisation, so do not include any personal details in your
comments if you want them to remain anonymous:”
Online questionnaires should be hosted on HTTPS-enabled websites
It is crucial that contractors receive signoff from the Coordination Centre before
fieldwork begins, as the questionnaire cannot be used without approval.
All efforts should be made to meet the above requirements. If any of these are not possible
within the limitations of contractors’ survey software it is essential that contractors discuss
this with the Coordination Centre and agree on a suitable approach in good time before the
beginning of fieldwork.
Page 1810 Covering letters / emails and reminders
10.1 Paper covering and reminder letters
There are four different types of letter designed for use in the survey:
A pre-approach letter (optional): this should be sent out one to two weeks before
the first mailing to inform people that they will be taking part in the survey.
A covering letter, which will accompany the questionnaires and a reply-paid
envelope (which should be printed with the contractor’s return address) in the first
mailing.
A first reminder letter to be sent to non-respondents two to three weeks later.
A second reminder letter, which will accompany a second copy of the
questionnaire and another reply-paid envelope sent to non-respondents a further
two to three weeks later.
The text for these letters has been prepared by the Coordination Centre and is downloadable
from the survey documents page of the Coordination Centre website
http://www.nhsstaffsurveys.com/Page/1058/Survey-Documents/Survey-Documents/
Certain parts of these letters require or allow editing by organisations and/or contractors.
These are indicated on the template letters in blue text. A contractor helpline number must
be inserted in the correct location. In addition, it is possible to:
Use personal salutations in covering letters - i.e. addressing staff by name (‘Dear Dr
Smith’). Please note that the decision to use personal salutations should only be
made if the organisation is certain that ESR records are complete and allow for the
use of staff names without error.
Add a short paragraph to explain how the organisation has used results from previous
surveys. It is very important you publicise the action you have taken; otherwise staff
cannot appreciate how the survey can improve working conditions.
Add information about incentives, if applicable.
The final version of each letter must completely fit on to one side of A4. This includes all text
added by an organisation and the signatures of the organisation chief executive and the Staff
Survey Coordination Centre Chief Research Officer.
All letters should be printed on paper headed with the NHS and participating organisation
logos. The inclusion of the organisation logo assures staff that the organisation is supporting
the survey, and provides clarity for any staff working in multiple organisations about which
organisation they should be answering questions about.
A first class reply-paid envelope must be sent with every paper questionnaire. These
envelopes should be printed with the address to which questionnaires are to be returned (i.e.
that of the survey contractor).
It is a requirement that all paper used in the publication of the NHS Staff Surveys, including
questionnaires and corresponding letters, must conform to government requirements for the
use of 100% recycled paper with a minimum post-consumer waste content of 80%. It is
further recommended that the paper used is uncoated and of standard A4 size (except for
the questionnaires, which should be printed as A4 booklets on A3 paper).
10.2 Online covering and reminder emails
Eight email templates have been created for use with the online survey:
A pre-approach email (optional): this should be sent out one to two weeks before
the first mailing to inform people that they will be taking part in the survey.
An initial email, which will be sent out with a survey link.
Six reminder emails to be sent with a survey link to non-respondents.
Page 19o The first of these should be sent two weeks or more after the initial email.
This gap allows time for the correction of email addresses found to be
incorrect through bouncebacks received following the initial email.
o The following reminders should be spaced at least a week apart.
o The final email reminder should be sent on the 26 November at the latest.
The text for these emails has been prepared by the Coordination Centre and is
downloadable from the Coordination Centre website
(http://www.nhsstaffsurveys.com/Page/1058/Survey-Documents/Survey-Documents/).
Certain parts of these email templates require or allow editing by organisations and/or
contractors. These are indicated on the templates in blue text. A contractor helpline number
must be inserted in the correct location. In addition, it is possible to:
Use personal salutations in emails - i.e. addressing staff by name (‘Dear Dr Smith’).
Please note that the decision to use personal salutations should only be made if the
organisation is certain that ESR records are complete and allow for the use of staff
names without error.
Add a short paragraph to explain how the organisation has used results from previous
surveys. It is very important you publicise the action you have taken; otherwise staff
cannot appreciate how the survey can improve working conditions.
Add information about incentives, if applicable.
Emails should be as concise as possible. Contractors may use links within the body of the
email to provide further information for staff.
10.3 Email subject lines
Organisations and contractors are encouraged to carefully consider the subject lines used for
all of the above emails which are sent to staff. It is important to make sure that these are
easily understood by staff. Possible subject lines include: NHS Staff Survey 2018, or
[Organisation Name] Staff Survey, or NHS Staff Survey: Invitation. Similarly, it is important to
consider the email address from which the survey gets sent to staff, as if this does not look
relevant, some staff may not open the email.
Consideration should be given to the possible impact of subject lines and email addresses on
the likelihood of emails getting stopped by spam filters and firewalls.
Organisations may also wish to notify staff of the subject line and sender email address
through internal communications, so that staff know what to look out for.
10.4 Chief Exec letters / emails
In previous years, some organisations have opted to include an additional letter / email from
their CEO or other high-level management. Such communications can be beneficial if they
emphasise the importance of the staff survey to the organisation’s management and discuss
the impact the survey can have. If such a letter or email is to be used, the following guidance
must be followed:
If a chief executive letter is sent along with paper survey mailings, the envelope
must be packed such that the official covering letter is seen first when the respondent
opens the envelope.
If a chief executive email is sent along with online survey mailings, this must be
accessed via a link embedded in the official survey email. It is not acceptable for
the chief executive letter to be added to the bottom of the official email, as this
makes the email too long. It is also not acceptable for the letter to be included as
an attachment to the official survey emails, as including attachments increases
the file size of the email and risks reducing email deliverability.
Page 2011 Breakdown of results by directorate / department / site
The feedback report produced by the Coordination Centre can include up to two breakdowns
by directorate, department, location or any other staff categorisation the organisation wishes
to include. For simplicity, these categorisations are usually referred to by the Coordination
Centre as ‘directorates’.
In order to have directorate breakdowns included in an organisation’s report, sufficient
information needs to be included on the staff lists supplied to the contractor and the
Coordination Centre.
Section 12 outlines how to prepare a staff list for the survey. If directorate breakdowns are
used, each staff member must be included in one, and only one, of the categories in
each breakdown. It is not permissible to leave this field blank for any staff members in the
sample, if a staff member does not fit into any of the groups, then an ‘other’ category should
be created.
The Coordination Centre does not report results from any group if there are 10 or fewer
responses in that group Therefore, it is important that enough staff are included in each
directorate to ensure that there are a sufficient number of responses for results to be
displayed. Organisations should take into account their response rate when making these
decisions. Directorates submitted to the Coordination Centre must have a minimum of 11
staff.
In general, we recommend a limit of 12 categories to a breakdown (e.g. 12 directorates,
12 locations). If there are substantially more than this, we suggest combining some of the
smaller categories. This will ensure that less data is suppressed due to low numbers, and the
organisation still receives useful staff group breakdowns.
The maximum number of categories permitted in each directorate breakdown is 24, but this
number would only be suitable for very large organisations.
Care must be taken by the organisation and contractor to provide the Coordination Centre
with only those directorate breakdowns the organisation wishes to be included in the
benchmark report, which will be publically available.
As part of the data submission, organisations/contractors must provide the Coordination
Centre with the name of the directorate in question. The length of these should be sufficiently
short to fit into the report format as it is; see the below image for an example. Due to the
format of the reports, directorate category names should be 36 characters or fewer
(including spaces). Longer names may be cut off or obscure other directorate names.
Page 2112 Preparation of Staff Lists
One of the first steps in conducting the Staff Survey is to compile a list of all staff that are
eligible to participate. Please note that preparation of this staff list is the responsibility
of the organisation, not of the contractor. This section is provided to contractors to enable
you to help organisations in the event you are contacted with queries, and to enable
contractors to run the appropriate checks on staff lists submitted to them by organisations.
If an online or mixed mode survey is being administered a valid staff email address will be
required for each member of staff. Preparation of the staff list needs to be carried out by a
staff member who is familiar with both the structure of staff records and Microsoft Excel. We
advise that organisations ensure that staff lists are comprehensive and up to date by 17
August 2018.
12.1 Who should be on this list?
All full time and part-time staff who are directly employed by the organisation on 1
September 2018 (even if the sample is drawn after this point);
Staff on fixed term contracts;
Staff on secondment to a different organisation, but only if they are still being paid
by the participating organisation and have been out on secondment for less than
one year;
Hosted staff (staff seconded to the participating organisation from elsewhere, e.g.
social care staff seconded from the local authority) who have a substantive contract
with the organisation, but only if they are on the participating organisation’s payroll,
are currently being paid by the participating organisation;
Any staff member meeting the above criteria who is on parental leave (maternity or
paternity leave).
12.2 Who should not be on this list?
Staff who started working at the organisation after 1 September 2018;
Staff who are on long-term sick leave (at least 90 days) on 1 September 2018;
Staff on unpaid career breaks;
All staff employed by sub-contracted organisations or outside contractors;
Bank or locum staff (unless they also have substantive organisation contracts)
Seconded staff who are not being paid by the participating organisation (e.g. social
care staff who are on the payroll of the local authority and are not being paid by the
participating organisation);
Student nurses (please note, other ‘student’ staff, such as student health visitors
and midwives should be included, as long as they are on the payroll and not
classified as student nurses);
Non-executive directors (e.g. typically “Chair”, “Chairman” are in this category);
Staff who work under a ‘retention of employment’ (RoE) model – these are staff who
hold a contract with an organisation, but are paid and managed day to day by an
independent contractor.
For detail on the reasons some of these staff groups are excluded from the survey, please
see Appendix 1.
Please ensure that:
Page 22 No eligible staff members have been omitted from the list. This could potentially
happen if, for example, staff records are kept separately for different departments or
sites within the organisation. The Chief Executive should be included if they meet all
other eligibility criteria.
The list does not contain duplicate or redundant names and email addresses.
All ineligible staff have been excluded from the list.
In previous years, a surprisingly large number of surveys have been sent to staff no longer
working for or not known at the organisation and to those on long-term sick leave. These
surveys can upset the staff who receive them and will cost the organisation both time and
money. It is vital that organisations ensure that staff lists are accurate and up-to-date before
sampling.
If human resources provision is shared between multiple organisations, then it is important
that separate staff lists are created for each organisation, not one overall sample for the
provision. The staff list for each organisation should be consistent with the instructions
above.
Please note: commissioning support units (CSUs) running the survey on behalf of clinical
commissioning groups (CCGs) must submit separate staff lists for each CCG rather than
submitting one staff list as the CSU. Staff lists submitted as the CSU should only include
eligible employees of the CSU itself.
12.3 Format of the staff list spreadsheet
The staff list should be in Excel spreadsheet format, with one employee per row. The first
row should be used for column headings (Name, Staff Group, Address etc.) and there should
be no blank rows. Each employee should appear only once on the spreadsheet with the
following information:
Organisation ID (NHS trust/organisation code).
Staff ID (generated from organisation records or assigned by contractor).
Full name.
Sufficient address details – this needs to be sufficiently detailed to enable a
questionnaire to be sent to each individual via the internal mail. As in previous
years, it is permissible to send questionnaires to home addresses of staff who do
not have a permanent work address.
Email address (online only) – for delivery of the online or mixed mode survey.
Directorate, department or division (or whatever breakdown or breakdowns are
required for the report). Up to two directorate breakdowns can be submitted to the
Coordination Centre for use in national reporting (and contractors may permit more
for use in local reporting). This information is not mandatory.
Location (if the questionnaires are to be separated into batches for different post
rooms).
Ethnic background – as in previous years, this information is collected so responses
from different ethnic groups can be monitored. As usual, the following coding should
be used:
White
A British
B Irish
C Any other White background
Mixed
D White and Black Caribbean
E White and Black African
F White and Asian
G Any other mixed background
Asian or Asian British
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