title: Staff perceptions of quality of care: an observational study of the NHS Staff Survey in hospitals in England.
abstract: BACKGROUND
  There is some evidence to suggest that higher job satisfaction among healthcare staff in specific settings may be linked to improved patient outcomes. This study aimed to assess the potential of staff satisfaction to be used as an indicator of institutional performance across all acute National Health Service (NHS) hospitals in England.
  
  
  METHODS
  Using staff responses from the NHS Staff Survey 2009, and correlating these with hospital standardised mortality ratios (HSMR), correlation analyses were conducted at institutional level with further analyses of staff subgroups.
  
  
  RESULTS
  Over 60 000 respondents from 147 NHS trusts were included in the analysis. There was a weak negative correlation with HSMR where staff agreed that patient care was their trust's top priority (Kendall τ = -0.22, p<0.001), and where they would be happy with the care for a friend or relative (Kendall τ = -0.30, p<0.001). These correlations were identified across clinical and non-clinical groups, with nursing staff demonstrating the most robust correlation. There was no correlation between satisfaction with the quality of care delivered by oneself and institutional HSMR.
  
  
  CONCLUSIONS
  In the context of the continued debate about the relationship of HSMR to hospital performance, these findings of a weak correlation between staff satisfaction and HSMR are intriguing and warrant further investigation. Such measures in the future have the advantage of being intuitive for lay and specialist audiences alike, and may be useful in facilitating patient choice. Whether higher staff satisfaction drives quality or merely reflects it remains unclear.
authors: Department of Primary Care and Public Health, Imperial College London, London, UK. richard.pinder@doctors.org.uk
authors: Richard J
authors: RJ
authors: Pinder
authors: Felix E
authors: FE
authors: Greaves
authors: Paul P
authors: PP
authors: Aylin
authors: Brian
authors: B
authors: Jarman
authors: Alex
authors: A
authors: Bottle
mesh_terms: D001291:Attitude of Health Personnel; D004739:England; D017052:Hospital Mortality; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007588:Job Satisfaction; D008505:Medical Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D009313:National Health Programs / Q000592:standards*; D036301:Qualitative Research; D019984:Quality Indicators, Health Care / Q000592:standards; D011787:Quality of Health Care / Q000592:standards*
keywords: Attitudes; Health services research; Performance measures; Quality measurement; Surveys