Nearly half of NHS employees feel overstretched and undervalued, a Healthcare Commission survey has found.
The study showed that 47% of staff felt there were not enough staff to "do the job properly" and 31% felt undervalued – an improvement on the figure in 2007 of 36%.
The study, which included responses from 160,000 workers at all 390 trusts, also showed that 35% of staff had witnessed an incident that "could have hurt staff or patients" in the month before the survey.
Standards of cleanliness appeared to have improved, with almost three quarters of people saying that handwashing materials were available when needed – a 10% improvement on 2007.
Christine Beasley, the government's Chief Nursing Officer, said: "The significantly higher ratings on the availability of handwashing materials, on training and promotion of infection control shows the NHS is serious in tackling the spread of hospital infections and we are improving year on year."
Anna Walker, Chief Executive of the Commission, praised the NHS for making "real progress" in tackling the "tough nuts" of infection control, work-related stress and harassment and abuse from patients.