The annual NHS Staff Survey has raised concerns over the wellbeing of the NHS workforce, demonstrating the toll that the COVID-19 pandemic has taken on front-line staff.

The survey, based on almost 600,000 responses, is reportedly the largest ever undertaken, and was conducted from October to November 2020.

Among the results, there was some positives – including an increase in the number of staff who would recommend their organisation as a place to work, from 63.3% in 2019 to 66.8% in 2020.

However, the survey also found that 44% of staff reported feeling unwell due to work-related stress in the last 12 months, reflecting a 3.7% increase from last year.

Among front-line staff, 46.6% reported stress compared to 41.7% in 2019, with almost half – 49.6% – of staff working on COVID-19 wards or areas reporting stress.

The survey also provided some insight into NHS staff pay, despite being undertaken before the government’s proposal of a 1.0% pay increase for most NHS staff.

The survey results reveal a small decrease of 1.3% in the proportion of staff who were ‘satisfied’ or ‘very satisfied’ with their pay, from 38.0% in 2019 to 36.7% in 2020.

However, this differed between staff groups, with non-patient-facing staff’s pay satisfaction increasing from 40.7% to 42.4% and medical and dental professionals increasing from 55.0% to 56.9%.

For registered nurses and midwives, pay satisfaction has dropped from 36.4% to 32.5%. Among nursing and healthcare assistants, there was also a decrease from 24.5% to 22.0%.

“Results from the NHS Staff Survey illustrate the profound impact of the Covid pandemic on the NHS workforce – and the strength and resilience it has shown in maintaining services throughout the crisis,” said Chris Graham, chief executive officer of the Picker Institute, which managed the survey for NHS England and NHS Improvement.

“Incredibly, morale has remained high and measures related to staff engagement show the deep commitment of NHS personnel. At the same time, results around work-related stress and pay satisfaction show the toll that 2020 has taken on front-line staff, particularly in front-line and non-medical roles,” he added.