TWO-thirds of NHS staff in Scotland say they can't do their job properly because of staffing shortages.
An official survey found just a quarter of nurses and less than a fifth of ambulance personnel felt there were sufficient staff to allow them to work well.
Even senior managers believe the service is too stretched, with just 38% saying there are enough staff.
The same survey revealed 43% of NHS employees do not feel it is safe for them to speak up if they are concerned about quality or safety issues - a figure medical body the British Medical Association Scotland called "disappointing".
Across the workforce, 15% indicated to the researchers they had been bullied or harassed by colleagues in the previous year.
More than 55,000 NHS Scotland staff took part in the survey at the end of this summer, more than the previous year. Health boards which do not directly look after patients, such as health promotion organisation NHS Health Scotland, had the highest response rates - up to 90%. Participation in NHS Greater Glasgow and Clyde was lower than anywhere else, at 25%.
The Scottish Government, who released the findings today, said the data showed staff were increasingly positive about working for the health service.
They highlighted that 12% more staff agreed the care of patients was their health board's top priority and 61% would recommend their workplace as a good place to work - up 10% on 2013.
The Royal College of Nursing Scotland also said the survey showed steps had been taken in the right direction.
Theresa Fyffe, director of the RCN Scotland, said health boards were perhaps
"finally starting to listen more to their staff and taking actions to prioritise the needs of their patients."
However, she also reflected that when it comes to pressure on staff, just 38% of nurses feel they have enough time to deal with all the conflicting demands they face at work.
Ms Fyffe said: "We cannot continue to ask nurses to juggle all the demands they face trying to deal with more and more patients, without enough staff. Budgets are very tight and likely to become more so over the next years, so we must look at how we can do things differently..."
Dr Peter Bennie, chair of the BMA in Scotland, said it was "deeply concerning" that a third of staff had experienced abuse from patients or members of the public.
He noted there had been some improvements since the 2013 survey and said it was a credit to staff that 90% were happy to go the extra mile, but continued: "Despite public statements by Government and the NHS that they are working to improve how NHS staff can raise concerns, it is disappointing that this does not seem to have delivered the cultural change that gives confidence to staff to speak out - 43% of staff do not feel that it is safe to do so, and this reflects our own survey of members, where doctors feel that speaking out can hinder their career progression or expose them to bullying."
Health Secretary Shona Robison said: "This annual feedback from staff throughout the organisation is extremely important in letting us know what is going right and where we can make improvements."
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