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17 July 2018
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Evidence: The value of medical engagement

NHS staff are central to the delivery of good quality patient care. Therefore, medical engagement fundamentally alters NHS performance, including patient experience and patient mortality. An engaged workforce is motivated, satisfied, committed, finds meaning to their work, and has advocacy for the organisation. At the other end of the spectrum, poor medical engagement leads to burnout and stress resulting in cynicism, exhaustion, and inefficiency.

In trusts with high medical engagement, employees benefit from increased job satisfaction and well-being, and are more committed to improve outcomes (Organ, 1988). The organisation benefits are numerous, including higher levels of patient safety, improved performance, improved financial management and decreased absenteeism and staff turnover. An organisation with 1 standard deviation higher medical engagement compared to similar providers, typically improves its mortality rate by 2.4%. An average NHS trust with 1 standard deviation improvement in medical engagement will have lower staff turnover and can expect to save over £150 000 in salary costs (West & Dawson, 2012).

These benefits are acknowledged across the healthcare system and are enshrined in the NHS Constitution’s 3rd principle:

“Respect, dignity, compassion and care should be at the core of how patients and staff are treated – not only because that is the right thing to do, but because patient safety, experience and outcomes are all improved when staff are valued, empowered and supported”

Conversely, organisations with poor medical engagement will find it more challenging to improve quality of patient care and organisational outcomes (Keogh, 2013; Francis, 2013; Berwick, 2013).

A number of strategies have been proposed for how to improve medical engagement. These include well-structured appraisals with clear objectives, organising work around well-structured teams with shared objectives, and supportive line management which enables employees to become involved in decisions making.

For junior doctors, 8 high impact actions to improve the working environment currently have system-wide support. Implementation of these actions will improve medical engagement and help trusts achieve the subsequent benefits to operational performance and patient outcomes.

Further reading: what is medical engagement?

Medical engagement is defined as “the active and positive contribution of doctors within their normal working roles to maintaining and enhancing the performance of the organisation which itself recognises this commitment in supporting and encouraging high quality care” (Spurgeon, Barnwell & Mezelan, 2008). Medical engagement is measurable and has a consistent correlation with a number of positive organisational attributes.

Job satisfaction and job commitment are recognised necessary components of medical engagement. However, a third essential factor, working in a collaborative, has also emerged in recent years. Spurgeon suggests that:

“Since team-working and co-operation have always been considered critical to effective patient care it is perhaps no surprise that collaborative working has been found to be the “3rd pillar” in supporting effective medical engagement.”

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