The 10 most common causes of NHS staff disengagement

NHS staff disengagement is a battle most internal communicators will face at some point in their NHS career. This blog addresses the 10 most common causes of NHS staff disengagement.

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How internal communications can help to fix the 10 most common causes of staff disengagement

Internal comms within the NHS is a huge job, particularly since the arrival of COVID. But, with evidence from Bain proving that an employee who feels engaged and inspired is 125% more productive, it is clear that internal comms plays a huge part in keeping the NHS going.

There are however a lot of plates that need to keep spinning for your internal communications to achieve their maximum impact. This blog explores the factors that hold internal communications back and how to overcome these challenges.

Three core problems

The most common challenges facing internal communicators can be categorised into three groups:

1) Staff

Each of your staff work differently and think differently. With such an array of different minds, it can be very difficult to engage with everybody. But for those who are less engaged, there are a number of reasons that directly impact how they feel that could be holding them back.

2) Your organisation

The nature of your organisation and the leadership team all impact the effectiveness of your internal communications. It is here that there will be numerous variables, such as a managerial change, that could rock your perfectly aligned internal communications strategy at any time.

3) Your way of working
How you deliver your internal communications strategy is often overshadowed by the two points above. But your processes and tools are just as important to the smooth running of your internal communications strategy than the other two points.

Now let’s look in more detail at these factors and how, as an internal communicator, you can help to resolve them.

Your staff

Your staff are the very reason that you have an internal communications strategy. They keep the NHS running but there are various factors that can prevent your internal communications from resonating.

1) A lack of recognition or development opportunities

If an individual doesn’t feel appreciated, they will rapidly become disengaged. Everyone needs to feel like they are contributing value.

Recognition will come in various forms but a simple “thank you” can go a long way. Encouraging peer-to-peer appreciation and acknowledging exemplary performance consistently across departments can be a great morale boost.

Closely linked to recognition is the opportunity for progression. Career development is the number one reason why employees leave their job. If they cannot see an avenue for personal growth, they will become unmotivated and disengaged.

The solution: While policies are in place they may not be well known across all your staff. Your first step will be to ask a cross-section of people whether they know about the relevant policies and what they know about them. This will give you an indication as to how great the education process will need to be. From here you can build awareness campaigns into your internal comms. That could be simply making people aware of recognition schemes or it could be a regular ‘recognition’ feature in the staff newsletter.

In addition to educating your staff, you may also need to educate line managers so they know when recognition is warranted. That will help to ensure consistency across all teams.

2) Day-to-day frustrations

A standalone frustration is barely given a thought but a frustration experienced day-in-day-out soon grows into something much bigger.

This could be a laborious process or a disrespectful colleague. No matter how severe the frustration, if nothing is done about it, in time, it will cause disengagement.

The solution: A frustration can only be solved if the individual shares that frustration. There are various ways this could be done – via their line manager, staff surveys, staff unions, staff forums or suggestion boxes. By reminding staff of the different outlets available to them you will encourage them to have a voice.

Of course, the other essential factor is to then help remove the frustration. Depending on the nature of it, as an internal communicator that is likely to go beyond your scope and require various other departments, but you can play a role in communicating any resolutions. Particularly if the resolution impacts multiple people. Acknowledging a problem and then demonstrating how it will be resolved is a brilliant morale booster. Consider presenting this as a mini case study – highlight the problem, the way in which the issue was discussed, what the resolution was and what it feels like to now have a resolution. By painting the entire picture your staff will be reminded that it is worth raising their frustration.

3) A lack of collaboration

With so many employees this is a major challenge for the NHS. If your staff lack interaction with colleagues it is likely to impacts how well they can do their job.
The more you can connect your staff the more they will take accountability, the more they will learn and the more they will achieve.

Ultimately, a collaborative way of working drives empowerment. An empowered workforce will feel able to make their own decisions, contribute more and achieve more. All of which breeds satisfaction.

The solution: How you encourage collaboration will depend upon the tools your staff have available to them. For example, if you have an intranet with an employee directory you could both encourage staff to keep their profiles up-to-date and promote the location of the staff directory. You could also promote different individuals or departments in a ‘getting to know you’ feature. Include examples of how they support other teams or pitch it as a mini CV. You could also run some mini webinars or podcasts in which different services talk about something they have learnt that could benefit other teams too.

It may also be beneficial to remind staff of certain procedures to help them connect with their colleagues. For example, the process for contacting the IT department, or where to find a form to request PR support.

When you have such a large workforce there are many opportunities to collaborate and learn from each other. With your input, you can help to facilitate these interactions.

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Your organisation

Just as with any large organisation, the processes and way the NHS is run can lead to disengagement. Here are five problems that frequently hamper employee engagement:

1) Not having leadership buy-in

Your internal communications strategy will only be successful if your leadership team believe in it. Our‘State of UK Employee Engagement’ survey found that 17% of UK organisations state a lack of leadership buy-in as their greatest challenge when undertaking employee communications.

On a similar vein, you may have the backing of your senior leadership but the approach they want you to take may differ to the strategy you think will be most appropriate.

The solution: Depending on the level of scepticism it may be beneficial to discuss your strategy with them one on one. To help them listen to your point of view, use as many statistics as possible to cement the value in what you are doing. The stats in our infographic may help you with this.

You might also want to pitch to them some tests in which you do some A/B testing of both approaches to see which is most effective. That way you aren’t telling them they are wrong, you are just proposing you test two options!

2) A non-inclusive strategy

An organisation is only successful because of its people. That includes everyone from a porter to the chief executive. Every individual needs to be considered when executing an internal comms strategy. The famous John F Kennedy interaction with the NASA janitor is a perfect case in point. When asked what he did for NASA the janitor responded with “I’m helping put a man on the moon”.

This is an organisation that had very effectively communicated with the janitor. He knew his purpose and how he was contributing to the business goals.

For many organisations, the NHS included, the logistics of including everyone often get in the way. Depending on their job role some staff can be “hard to reach” and subsequently get forgotten about or receive information secondhand.

The solution: First of all do you know which of your staff you don’t currently reach? If not, this is the first step. You need to understand which of your staff you can’t reach before you can see a resolution. You might be able to tell this through existing data or you may need to do a survey to explore further.

Once you know the answer to that you can explore ways to better reach them. Could a more formal distribution process ensure communications reach them through their line managers for example? Could you record information via video? Could you run a campaign to promote your social media channels to those individuals? Could software such as an employee engagement app be a consideration? Whatever your solution, if you engage with additional people, it is worth it.

3) Significant change

As COVID has shown us, change is a certainty. But change takes many forms; from a change in direction, to a new policy, to a change in management, to the introduction of a new system. Whatever the change it is likely to unsettle some of your staff. It is human nature to resist change so this is to be expected. Therefore, during any period of change, we must work particularly hard to maintain staff engagement.

The solution: it’s important to understand the reasons behind people’s fear of change. This article neatly summarises the emotions people may be feeling and helps to put their reactions into perspective. By taking a moment to appreciate how your staff may feel during a time of change you can then create a communication plan that supports them step-by-step through the change. 

For every change communication you create remember to include information about what is changing, how that change will affect them, what is expected of them and what the next steps will be. By following this pattern with every communication you will help your staff adjust quicker and reduce the risk of disengaging them. 


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Your way of working

There are a number of aspects within the internal communications team that could be inhibiting your staff engagement efforts. When you are working so hard to communicate effective with your staff you need to ensure that your ship is sailing at full throttle. The most common challenges our customers come to us with are:

1) Unrealistic expectations

These unrealistic expectations could be on yourself or your team.
Often this is an unrealistic expectation of time; trying to squeeze too many tasks into not enough time. This is a very common challenge with 38% of internal communicators stating time as their biggest challenge in our recent State of UK Employee Engagement survey.

The survey also found that over half of those responsible for internal comms spend less than 25% of their time on this function. With so many plates to spin at any given time, it is easy to see how expectations can increase beyond capability.

The solution: You may find value in reviewing everyone’s roles within your team. Does everyone understand the part they play? Do they know what their responsibilities are and the deadlines that sit alongside their duties? Do they agree that these are attainable? Are you utilising all their skills effectively or would it be beneficial to switch some of the responsibilities?

If time is particularly tight with no immediate solution, could you recruit some advocates from outside of your team? Even if it is to help promote a single campaign, their passion for what you do could be really beneficial.

2) Silo working

Silos are very common within internal communication teams, particularly if you have a large team or dispersed workforce.

As such, tasks may be owned by just one individual or data may only be accessible by a single team that has multiple other priorities that sit above your request.

Whatever the silo you experience, it will be causing inefficiencies, and frustrations.

The solution: Collaboration! By introducing a more collaborative way of working you will no longer have a need for silos.

If multiple people work on different tasks consider adopting a task management system in which everyone in the team can view all of the tasks and who is responsible for them. This will give you a single source of truth that will provide confidence and a more efficient way of working.
If certain skills sit with just one person explore training and development opportunities for other individuals so you always have at least two people capable of any given task.

If you experience silos within your processes, such as a bottleneck when accessing data, is there another way this could be done? Are there alternative systems or integration options that would simplify the process? Are there other teams or colleagues that could support with the project? Or do you just need a formalised process to ensure you receive the information in a timely fashion?

3) The wrong tools for the job

Due to the budget & resource implications and fear of change, it can be easy to stick with a tool even if it isn’t meeting all your needs. You may customise the system to get it doing what you need but there are inevitably always workarounds or compromises. These workarounds open greater possibilities for human error and over time the workarounds become more and more cumbersome.

If you have an established internal communications strategy you may also be suffering from having too many solutions. Jumping from one system to another will have a knock-on effect on productivity. You may also find it difficult to compare data from two systems because of the way the information is collated or displayed.

The solution: As a team, audit your processes and systems. It’s important to take this step back from your day-to-day roles and consider if the systems you use are providing the best outcome. While they may have been the best tools for the job five years ago there may be better solutions available to you now. Likewise, five years ago one of your solutions may not have had the same level of capability it has now. Upon review, you may find that you could easily consolidate your systems and reduce your expenditure.

Once you have carried out an evaluation, schedule in the next one. By keeping these review sessions regular you will keep on top of your needs and encourage your team to stay curious, always exploring how improvements could be achieved.

4) A lack of valuable insight

Our recent study found that 48% of UK organisations do not monitor the effectiveness of their internal comms.

That’s approximately half of UK organisations that are running internal comms tactics without any insight into to how effective they are. If you too lack useful insight, this is a quick win that could transform your internal comms efforts.

The solution: If you have unused data your first step is to study that information to identify what it tells you. Based on this research you can identify any data gaps; considering what information would really help inform your strategy.

If the data you have available is limited you may want to look at a software tool that could help you collate and interpret more information. Tools such as NewZapp Trusted Delivery will enable you to send visually appealing internal communications whilst also collating data on how effective each communication was. This could save you significant time and give you greater confidence in your decision making. It will also help you to evidence your success and drive future initiatives.


Internal communications and staff engagement are intrinsically linked, now more so than ever before. As an internal communicator for the NHS you have a huge opportunity to influence engagement levels. By taking a moment to consider what you can do differently, you could make significant improvements in staff engagement.

If you would like to explore more about how NewZapp Trusted Delivery can help you with your internal communications strategy, get in touch today and we’ll show you our internal communications software in action.

darren hepburn

Darren Hepburn

Operations Director

Passionate about using my 30 yearsof owning my own businesses to help create better workplace environments.  A Bon Jovi loving TikTok junkie. I spend most of my time thinking about the impact technology is having on our society. And my pug Winston…

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