3:32am UK, Wednesday April 09, 2008

Less than half of NHS staff (46%) believe patient care is the top priority at their health trust, a survey has showed.

'Trust are not prioritising care'

One in four do not think their trust sees it as most important, while a further 29% neither agree or disagree.

The poll also found wide variations between hospitals on measures to fight infections such as Clostridium difficile and MRSA.

There have been some improvements, with 82% of NHS staff saying their trust does enough to promote handwashing with hot water, soap or alcohol rubs, up from 70% in 2005.

But only 61% said handwashing equipment was always available when they needed it. A further 30% said it was available most of the time.

The survey of 155,922 NHS staff did reveal some positive results, with many feeling supported by colleagues.

But more than one in 10 (13%) of those questioned had suffered physical violence at the hands of a patient or their relatives in the last year, the same as in 2006 and up 1% on 2005.

Among those working in ambulance trusts, the number attacked was 29%, while in mental health trusts it was 22%.

Around half (51%) of those working in ambulances also thought the vehicles were in a poor state of repair while 42% thought they did not offer a safe working environment.

The Healthcare Commission published the results from an annual poll - one of the largest staff surveys in the world.

Responses were received from all 391 NHS trusts, with an overall staff response rate of 54%.

Anna Walker, the Commission's chief executive, said: "The results show that there are a lot of reasons to work in the NHS? But there are challenges to making the NHS a better place to work.

"Some of those will be tough to crack because they are about the environment that the healthcare system operates in."