With the launch of the 2025 10-Year NHS Plan, the NHS embarks on a decade of transformative change. The plan sets out a bold vision to shift services from hospital to community, adopt digital-first care, and prioritise prevention over treatment. Workforce reform underpins all of this—making staff engagement not just a workforce issue but a strategic enabler of system-wide reform.

As part of my MSc in Occupational Psychology, I completed my thesis by exploring staff engagement across 201 NHS provider organisations which found statistically significant correlations between engagement scores and key organisational performance metrics—namely CQC ‘Well-led’ ratings and NHS England’s System Oversight Framework segmentation. These findings were reinforced by qualitative interviews with senior finance and HR leaders, many of whom described engagement as “crucial” to sustainable performance, patient safety, and staff retention.

Key Findings Relevant to the 10-Year Plan

• Stronger engagement = stronger performance

Organisations with higher staff engagement scored significantly better in both CQC and SOF ratings.

• Engagement is often undervalued in strategic planning

Despite recognising the value of engagement, senior leaders acknowledged that under financial or regulatory pressure, engagement efforts are often deprioritised in favour of compliance or cost control.

• Engagement drives autonomy and accountability

Finance leaders described engaged teams as more willing to act with ownership and deliver improvements proactively—critical traits as the NHS moves towards more devolved models of care.

• Cultural and structural barriers persist

Hierarchical structures, inconsistent leadership behaviours, and underinvestment in development were highlighted as ongoing challenges to building a fully engaged workforce.

Why This Matters Now

The 10-Year Plan’s ambition to deliver care closer to home, digital transformation, and preventative services depends on workforce buy-in and adaptability. Yet these goals will be difficult to achieve without sustained, system-wide attention to staff experience and voice.

As the NHS seeks to reduce overseas recruitment, build domestic capacity, and roll out personalised development plans for all staff by 2035, there is a clear opportunity to place engagement at the heart of workforce strategy.

Implications for NHS Finance Leaders

Finance leaders will play a pivotal role in delivering value across integrated care systems. Several practical implications emerge:

• Strategic Investment: Business cases for development, wellbeing, and leadership training must account for the return on engagement—improved quality, productivity, and retention.
• Data Integration: Staff engagement metrics (e.g. National Staff Survey scores) should be triangulated with financial and operational KPIs in performance dashboards.
• Board-Level Insight: Understanding the psychological drivers of engagement—not just the tactical activities—will support better decision-making at board level.
• Cultural Change Support: Finance leaders, often seen as system stewards, can help shape cultures that balance performance with compassion and transparency.

A Call to Action

The next decade will test the NHS’s ability to transform sustainably and equitably. In this context, staff engagement is not a “nice to have”—it is a strategic enabler of clinical, operational, and financial performance.

Embedding engagement into business planning, performance monitoring, and system leadership will help realise the ambitions of the 10-Year Plan—ensuring that transformation is delivered with, not just to, the NHS workforce.

For further discussion or support please don’t hesitate to get in touch with us in MIAA: Gayle Wells, Director of Operations or Andy Maloney, Director of Delivery – Workforce and fellow leaders and networks such as HFMA.