“Needs Healthier Staff”: An Essential Strategy for Fixing NHS Performance

 


The UK spends billions every year training, developing, and recruiting staff for the NHS. This eye-watering amount grows year on year. So, are we getting value for money for this huge investment and is the NHS performing well?

When we think of NHS performance, we tend to look at metrics such as waiting times or access to treatments. These numbers make for grim reading. In Accident & Emergency, for example, only 70% of patients in Scotland are currently seen and sorted within four hours—down from 95% a decade ago. But what do we mean by ‘high performance’ in healthcare? Is it hitting a target, or is it delivering safe, compassionate care day after day?

Trending upwards however is NHS staff sickness absence. Scottish Government data show that 6.4% of NHS Scotland staff are currently off sick—that’s over 10,000 people. So, we have a more expensive service, with deteriorating performance, delivered by sicker staff. Performance, it seems, is inseparable from staff wellness.

The Human Cost Behind the Numbers

Government figures and subsequent investment largely focus on patient outcomes. But what about the staff delivering the service? Are we measuring the human cost to them in anything beyond absence rates?


The picture is bleak. A 2024 Royal College of Nursing survey reported 1.67 million sick days taken by nurses in a single year due to “stress-related conditions.” A 2025 GMC survey revealed that one in five doctors are considering leaving the NHS altogether. Staff in today’s NHS aren’t thriving — many are barely surviving.

Before staff reach the point of sick leave, they often display “presenteeism”—turning up but disengaged—or “quiet quitting,” emotionally checked out and just going through the motions. Multiply this many thousands of times across the NHS and it becomes clear why performance, and public confidence, are crumbling.

Why Current Approaches Fall Short

Wellbeing initiatives in the NHS are too often treated as “nice extras” rather than essentials. Project ideas like yoga or mindfulness sessions may offer short-term relief but rarely touch the deeper, systemic issues that undermine wellbeing.

The NHS remains locked in a target-driven culture, mistaking busyness for performance. But true high performance in healthcare is not about squeezing more out of exhausted staff — it’s about creating the conditions where they can flourish.


Contrast with some large corporations who have recognised that employee wellbeing is not a luxury but a performance strategy. Tony Schwartz, CEO of The Energy Project, showed that rising demand cannot be met by simply increasing targets or hours—exhausted staff quickly disengage. Instead, companies that prioritise employee “energy” through physical and psychological support see productivity improve. Deloitte, employing more than 28,000 people, acknowledged this in its 2024 Mental Health and Employers report which makes a clear case for investing in staff wellbeing.

A Better Model for the NHS

The NHS would do well to learn from such approaches. There is no quick fix—no magic bullet—but there are proven models. Kent & Medway Health & Care Academy, for instance, use a wellbeing framework based on Maslow’s Hierarchy of Needs.


Meeting basic workplace requirements first, and then addressing psychological and self-fulfilment needs, allows staff not just to cope but to thrive. Thriving staff are more creative, take fewer sick days, engage better with teams, and show greater resilience under pressure.

It starts with senior NHS leaders modelling healthy work habits, while ensuring that fundamental workplace needs are met for all. Mentoring, coaching, and psychological support—both individual and group—should be routine, not remedial. Wellbeing metrics must be standardised and tracked alongside traditional performance parameters.

A Case Example

A senior nurse was struggling to get to the end of her shift without feeling physically and mentally shattered. By her own admission, her productivity tailed off dramatically in these hours, preferring to re-check tasks rather than start anything new. She hadn’t called in sick, but she was starting to lose her spark.


After engaging with some coaching that I organised within our department, we addressed several issues around getting adequate sleep, food preparation, making time for exercise, taking regular breaks during her shift, pacing herself and working a more regular shift pattern.

In time, she was much happier at work and productive right to the end of her shift. She was thriving — and her patients and colleagues noticed the difference.

The Urgency of Now

The NHS simply can’t afford to slide further. Urgent action is needed to ensure employees are thriving, not just surviving.

It will never deliver high performance on the back of exhausted, disengaged staff. If we want healthier patients, we must first create healthier staff.


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