The relationship between leader support, staff influence over decision making, work pressure and patient satisfaction: a cross-sectional analysis of NHS datasets in England



West, Thomas HR, Daher, Pascale ORCID: 0000-0001-7277-5153, Dawson, Jeremy F, Lyubovnikova, Joanne ORCID: 0000-0003-0710-3929, Buttigieg, Sandra C and West, Michael A
(2022) The relationship between leader support, staff influence over decision making, work pressure and patient satisfaction: a cross-sectional analysis of NHS datasets in England. BMJ OPEN, 12 (2). e052778-.

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Abstract

<h4>Objective</h4>To explore the relationships between leader support, staff influence over decisions, work pressure and patient satisfaction.<h4>Design</h4>A cross-sectional study of large National Health Service (NHS) datasets in England in 2010.<h4>Setting and participants</h4>158 NHS acute hospital trusts in England (n=63 156) from all staff groups.<h4>Primary and secondary outcome measures</h4>Survey data measuring leader support, staff influence over decision making, staff work pressure and objective outcome data measuring patient satisfaction.<h4>Results</h4>Multilevel serial mediation analysis showed a significantly positive association between leader support and staff influence over decisions (<i>B</i>=0.74, <i>SE</i>=0.07, <i>p</i><0.01). Furthermore, staff influence over decisions showed a negative association with staff work pressure (<i>B</i>=-0.84, <i>SE</i>=0.41, <i>p</i><0.05) which in turn was negatively linked to patient satisfaction (<i>B</i>=-17.50, <i>SE</i>=4.34, <i>p</i><0.01). Serial mediation showed a positive indirect effect of leader support on patient satisfaction via staff influence over decisions and work pressure (<i>B</i>=10.96, <i>SE</i>=5.55, <i>p</i><0.05).<h4>Conclusions and implications</h4>Our results provide evidence that leader support influences patient satisfaction through shaping staff experience, particularly staff influence over decisions and work pressure. Patients' care is dependent on the health, well-being, and effectiveness of the NHS workforce. That, in turn, is determined by the extent to which leaders are supportive in ensuring that work environments are managed in a way which protects the well-being of staff.

Item Type: Article
Uncontrolled Keywords: health services administration & management, quality in health care, organisational development
Divisions: Faculty of Humanities and Social Sciences > School of Management
Depositing User: Symplectic Admin
Date Deposited: 02 Feb 2022 15:56
Last Modified: 18 Jan 2023 21:14
DOI: 10.1136/bmjopen-2021-052778
Open Access URL: https://bmjopen.bmj.com/content/12/2/e052778.full
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3148031