Employee engagement, learning and development in an NHS organization

Abstract

This NHS based case study examines the meanings, purposes, attitudes and behaviours attached to the concept of employee engagement (EE) in a health service setting where, although there is increasing interest in its measurement and introducing practices to enhance it, there has been limited research. The study also explores the factors which act as driving and restraining forces to its practical realisation including in particular the contribution of learning and development (L&D). Adopting a broadly social constructionist position the study incorporates critical management and discourse perspectives. Theory building evolved through a process of abductive, inductive and deductive reasoning, cycling between the data and the literature. The review of academic and practitioner literature draws on research into EE, work engagement, motivation, commitment, human resource development, and health service management. The empirical study explores staff perceptions of EE, in a shared experience of developing insights into multiple experiences of the social world at work. Semistructured interviews were held with health service learning and development professionals, and 10 focus groups with 52 staff. These were mainly nurses and allied health professionals and some administrative and support staff. The research contributes a number of insights into the conceptualization of EE, its application within a health service context, and the contribution of L&D. It finds that EE is a contested construct that is subject to multiple meanings and interpretations; but that neither academic nor practitioner literature fully capture the nuances of individual staff experience. These included experiencing feelings of engagement and disengagement at the same time, and being more engaged with day-to-day work and patient care than with the wider organization. Understanding EE from an employee perspective provides insights into the complexity of engagement and the impact of different contexts. For example drivers for and barriers to EE are seen as complex, situational and personal. L&D can be a driver for engagement, and a number of L&D interventions and practices were identified which contribute to EE, and general and specific factors which support and inhibit L&D are revealed. Given that current conceptualisations of EE focus overly on staff engagement with the organization, a framework is presented for understanding the locus of engagement with other foci such as patients and a profession. The team or work group is identified as a particular locus of engagement. The impact of different contexts on individual engagement emerges as a significant factor. The frameworks and findings may be of relevance to health service and other organizational contexts.