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Fit for the future? Rethinking the public services workforce Contents

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Chapter 3: Experiences in the workforce

77.Public services employers have a responsibility to ensure the wellbeing and job satisfaction of their staff. This is important to recruitment and retention. Positive experiences in the workplace make employers more attractive and means people are less likely to leave. As noted by the Police Foundation: “a healthy, happy and motivated workforce needs to be seen as a strategic capability”.120

78.We set out to establish what could make people want to join—and stay in—the public service workforce. Addressing some common cultural issues could have a significant impact. First, though, we examined the impact of staffing shortfalls on staff.

Impact of staffing shortfalls

79.Staffing shortfalls increase pressure on public services workers in post. With no reduction in the amount of work, an increase in vacancies creates overwork and burnout. “Intense pressure” and “suffering” was widely acknowledged, including by government officials.121 Healthcare workers were reported as being “exhausted and overstretched”,122 and the Police Foundation reported “low morale, poor wellbeing, and unmanageable workloads”.123 Similar comments were made about staff working in children’s social work,124 adult social care,125 education,126 and prisons.127

80.Overstretch is a key cause of staff turnover; creating more vacancies and exacerbating the problem. The Local Government Association said: “Many health and care staff are now struggling with burnout, leaders are delivering services with increasing vacancies, and retention rates are at an all-time low.”128 Lloyds Bank Foundation for England and Wales stated:

“The level of unfilled vacancies … adds pressure to an already overstretched workforce, as services are forced to operate at lower capacity, reducing the number of people who can access support. In many cases, existing staff have to step in to fill the capacity gap and meet demand for services, which in turn can lead to burnout or further staff turnover”.129

81.We were told that this was a “vicious circle”130 which “constrain[s] further progress”.131 Skills for Care referred to “impossible decisions about care delivery that frontline staff are having to make daily due to workforce shortages”.132 This leads to negative impacts on people using services. In May 2022, the Auditor General for Wales, Adrian Crompton, reported that it could take seven years to bring NHS Wales waiting lists back to 2020 levels, leaving many unable to access treatments.133

82.A contributor who worked with vulnerable children provided an example of the human impact of a churn of staff on individual children and young people. They said service users:

“… face frequent changes of the key people supporting them … This creates instability and disjointed care and support in their lives, contributing to and exacerbating feelings of abandonment, and undermining their emotional wellbeing”.134

83.Many of those who deliver crucial public services feel overworked. This has a direct impact on staff turnover and creates a vicious circle which ultimately affects service users.

Disempowerment

84.Lack of staff empowerment and autonomy was a common complaint in services including the police and local authorities, in both senior and frontline roles.135 When reflecting on leadership in public services, contributors from Brunel University argued that there was “a focus on compliance, performance and efficiency that often overrides empowerment, care and compassion”.136

85.Empowering staff can also enhance innovation. Those staff on the front line know the changes that are needed to reduce bureaucracy and provide the best service possible. Ian Jones from Volunteer Cornwall, and his co-contributors, emphasised this point:

“… leadership has to be distributed downwards and allow for the emergence of new ideas to build on innovative practice that works. It also requires an understanding of when to call in the necessary professional to undertake distinct pieces of work and yet not allow the dominance of the professional to govern from the top down. We have to draw down the expertise from the bottom up when required.”137

86.Tom Surrey, the DHSC’s Director for Adult Social Care, linked staff empowerment with boosting retention.138 When gathering evidence of effective workforce management in the private sector, we heard from Richard Lee, Chief People Officer at Willmott Dixon, a construction and property development company. He attributed low people turnover (6%) to a focus on empowerment: “Our people feel valued and trusted, and they feel trusted because we empower them. We give them autonomy to take local decisions to improve efficiency and to serve our customers better.”139

87.Similar comments were made by Andrew O’Brien, who stated: “Social enterprises have very high rates of retention and happiness, because the workers and staff feel empowered about the services they are delivering”. However, he went on to say that such empowerment was often lost when services were delivered by government bodies rather than by partner organisations.140

Bullying

88.We received reports of a bullying culture in certain public services. The General Medical Council (GMC) stated that bullying was an important factor in doctors leaving the NHS.141 Reflecting on challenges in the care sector, other contributors noted that “the public sector reports exceedingly high levels of managerial bullying”.142 In the Civil Service People Survey, 7% of respondents reported having been bullied in the last 12 months. Reports include staff being humiliated in front of colleagues, excessively controlled and intimidated.143

89.Gavin Larner acknowledged that bullying was an issue in the NHS: “Pre-pandemic, our primary focus was on things like bullying, harassment, [and] workplace culture.”144

Discrimination

90.We heard some evidence of direct and indirect discrimination in the workplace against staff from minority backgrounds. NHS Providers wrote, “whilst the NHS is the UK’s largest employer of Black, Asian and minority ethnic people, it is not always a good employer of people from minority communities”.145 The General Medical Council went into more detail, stating that despite increases in the number of BAME doctors, “these doctors are more likely to face barriers around indication, career progression, and to end up in disciplinary or regulatory processes”.146

91.Similar concerns were raised by the NASUWT, the Teachers’ Union, who in their 2017 report Invisible Teachers found that 31% of teachers from black and minority ethnic backgrounds reported experiencing discrimination in the workplace.147

92.Discrimination linked to ethnicity was also experienced by service users. The Maternal Mental Health Alliance referred to disparities in health outcomes, including the finding that “maternal mortality is more than four times higher for Black women, two times higher for mixed ethnicity women and almost twice as high for Asian women compared with white women.”148

93.Academics from Brunel University London highlighted evidence that women faced barriers to accessing training and career progression if they took career breaks or moved to part-time working, for example due to childcare responsibilities. They argued this was caused by “organisational values that prioritise full-time working as the desire and preferred form of working”.149

94.Disability discrimination was also reported. The Department for Health and Social Care stated that disabled staff “face greater challenges when it comes to violence and abuse, bullying and harassment, and career progression.”150 The GMC highlighted similar concerns, reporting that doctors with a disability “were less likely to feel supported by colleagues and senior staff and were nearly twice as likely as non-disabled doctors to have taken ‘hard steps’ towards leaving the medical profession.”151 Outside the health service, trade union Unison said that disabled workers fear resistance from managers when requesting reasonable adjustments such as flexible working.152

95.These findings are supported by various Government documents. In the 2021 Civil Service People Survey, 7% of civil servants said that they had been discriminated against at work in the previous 12 months, including discrimination on the basis of disability, gender or ethnicity.153

96.Discrimination, in the form of increased barriers to promotion and a lack of support for staff, remains at unacceptable levels in the public service workforce. This will continue to act as a barrier for the recruitment and retention of talented people.

Recognition

97.While the work of the NHS received national appreciation during the pandemic, we were told that there is relatively little public recognition of workers outside the NHS. This was particularly highlighted in relation to adult social care. Sarah McClinton commented:

“Our staff have shown huge commitment and compassion. They do very skilled jobs that support people to live the lives that they want to lead in crisis and in the longer term … but care staff often feel they are forgotten, undervalued and not always recognised.”154

98.A lack of public recognition was not restricted to social care. The Education Policy Institute’s Director of Schools Workforce saw a need to improve the status of teaching as a profession,155 while the Chief of Corporate Services at the Metropolitan Police, Robin Wilkinson, suggested that work in the public sector is “less valued, less respected … than it was 30 years ago.”156 Similar concerns were raised about social work157 and children’s homes.158

99.Political challenges in recognition in the civil service were highlighted, with the Trades Union Congress stating that anonymous criticism of civil servants by government ministers undermines “the careers and lives of individuals who are constitutionally unable to defend themselves”, “lead[s] to a demoralised workforce and act[s] as a deterrent to anyone considering a career in the civil service”.159

100.There are also concerns about whether public services and the public sector recognise the value of their own staff. We were told that staff expertise or specialism is not always recognised, with the civil service trade union Prospect arguing that public servants face “a fragmented career landscape that fails to adequately recognise the value of specialist knowledge, skills and experience”, and stating that specialists need to be “regarded as integral elements in multidisciplinary teams rather than the ‘hired hand’ or ‘technical support’”.160 Lack of recognition of workers’ capabilities also leads to disempowerment, covered earlier in this chapter.

101.The public service workforce cannot be sustainable until the experiences of staff are broadly positive. Due to chronic overstretch and cultural issues which include persistent discrimination and a lack of recognition, this is not currently the case.

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