Directors of Nottinghamshire’s main operator of mental health hospitals have admitted its culture is ‘not where we want it to be’ after new staff survey results were poorer than in 2024.
Nottinghamshire Healthcare NHS Foundation Trust runs Highbury Hospital and Sherwood Oaks in Mansfield.
The trust published the results of its 2025 staff survey earlier in March.
There was only an increase in one of nine elements in which staff were asked to score, compared with the average of the previous year.
In three of the categories, the average score decreased.
The trends were discussed at a meeting of the authority’s bosses on Thursday, 26 March.
Presenting the results, Jennifer Guiver, the trust’s executive director of people and culture, said: “In terms of the results, we are absolutely not where we want to be. They have largely stayed the same.”
In the survey, which ran over the autumn period, staff were asked to score between 0–10 how much they agreed with seven statements.
The statements form the NHS’s ‘People Promise’ – a basis for how the organisation is expected to operate as a whole.
The seven statements are: “We are compassionate and inclusive”, “we are recognised and rewarded”, “we each have a voice that counts”, “we are safe and healthy”, “we are always learning”, “we work flexibly”, and “we are a team”.
For compassion and inclusivity, safety and health, working flexibly, and teamwork, the trust’s average scores all equalled those of 2024 – 7.2, 6, 6.6 and 6.8 respectively.
But the averages for “recognised and rewarded” and “voice that counts” both decreased, from 6 to 5.9 and from 6.5 to 6.4, respectively.
Only for “we are learning” did the trust register an increased score, of 5.3, compared with 2024’s 5.2.
Staff were also asked to score staff engagement and morale on the same 0–10 scale.
The score for staff engagement dropped from 6.5 in 2024 to 6.4 in 2025, while morale remained the same at 5.6.
In all nine categories, the trust scored worse than the average for mental health trusts across the country, with the 6.79 average score for “we are a team” actually being the worst score among all 61 mental health trusts in England.
Around 48% of staff – 4,480 employees – responded to the survey, which was a 2% increase on the previous year, when 4,259 responses were recorded.
In Thursday’s board meeting, non-executive director Dawn Leese raised her concerns about the results.
She said: “One of the things I have reflected on, which has been informed by lots of visits that I’ve done, is that some of the things people are really bothered about aren’t necessarily reflected in this. Some of them are really basic things like: have we got enough people to do the job?
“How many of those are temporary staff? Have we got a substantive leader in place? What’s the environment like? Lots of really fundamental things that drive people. They’re just not happy about that, and it makes it really difficult to do their job.
“And most people want to do a great job. I went to a ward the other day that was 100% established with substantive (permanent) staff. It was a joy. They were such a well-functioning, high-performing team with a set of values and aspirations to do great things. You can’t do that if you’re running on 25% or 50% temporary staff.”
Responding, Ms Guiver said: “I agree, culture is as much about the tone of the emails you receive from your manager, whether you’re welcomed in the morning, and whether we recognise that it’s somebody’s big birthday or a big celebration. That’s culture and what makes you want to come to work.”
In a financial update, executive director of finance Alison Wyld said the trust was spending 34% less on bank and agency staff in 2025/2026 compared with the previous financial year.
But also noted at the meeting were the continued levels of staff sickness, which sit at around 7% at any one time, and vacancies, which sit at around 11% at any one time.
Non-executive director Nigel Smith said: “Adding those figures (7% + 11%) together with annual leave, we’ve got about a fifth of staff missing. I’m trying to compute all this. At the same time, we are reducing bank and agency staff. I’m not sure it’s all working without putting pressure on operational teams.”
Ms Guiver pointed out that the vacancy numbers included positions in the trust’s “offender health” sector – the provision of healthcare to prisons in Nottinghamshire, as well as in Leicestershire and Lincolnshire, which the trust previously offered.
The trust began decommissioning its services to offender health in 2025, and around 400 staff were transferred to Northamptonshire Healthcare NHS Foundation Trust.
Ms Guiver added that, excluding offender health, turnover had reduced from 8% to 7% across the trust for the financial year.
She also told the board that the trust’s People & Culture committee had discussed sickness absences at its last meeting and said it had agreed: “We do need to address them, and we still need to reduce them as a top priority.”
Speaking on the staff survey, Ifti Majid, chief executive of Nottinghamshire Healthcare, said: “The NHS Staff Survey is one of the most important ways for colleagues to share their views about working at the trust, and we’re grateful to everyone who took part.
“Our trust-wide scores have remained in a similar position to the previous survey and, whilst we had hoped for improved results, we also appreciate that the environment we have been working in has had an impact on the progress we have made.
“We know how important it is to patient care that our colleagues have a good experience at work, and it is for this reason we are committed to continuing to work with colleagues to listen and act on their feedback to improve their working lives.”
Regarding staffing levels, a spokesperson for the trust added: “The therapeutic relationships we build with people using our services are fundamental to providing safe, compassionate, person-centred care.
“This can be affected by a lack of consistency, which can happen when temporary staff are used. This is why we have worked hard to reduce the use of agency staff, with a focus on recruitment and retention alongside the implementation of Safe Wards, Culture of Care, and quality improvement initiatives.
“Temporary staff are used only in exceptional circumstances to maintain patient safety, and only following a clear approval process.”
