NHS staff sickness absence

Estimates from Public Health England put the cost to the NHS of staff absence due to poor health at £2.4bn a year – accounting for around £1 in every £40 of the total budget. This figure is before the cost of agency staff to fill in gaps, or the cost of treatment, is taken into account (NHS England).

To address this issue, NHS England's Chief Executive announced a major drive to improve the health and wellbeing of health service staff, in a bid to benefit both staff and taxpayers (September 2015).

How have NHS staff sickness absence rates changed?

The national absence rate demonstrates marked seasonal fluctuation, with a peak in the late autumn/winter months and subsequent reductions. The peak absence rate shows a decline in recent years: 4.96% in December 2010, 4.72% in January 2013, and 4.44% in January 2014. It did increase again in December 2014 to 4.79% but this did not reach the high observed in December 2010. Average annual absence rates for the past five years are lower compared to the baseline 2009/10 year (4.40%): 4.16% in 2010/11, 4.12% in 2011/12, 4.24% in 2012/13, 4.06% in 2013/14 and 4.25% in 2014/15 (data not shown).

How did NHS staff sickness rates vary by trust type?

Sickness absence rates by type of organisation demonstrate the same marked seasonal fluctuation as the rate at a national level and no organisation type shows a marked difference over the time period. Absence rates in ambulance trusts have been consistently higher than all other types of organisations and mental health & learning disability trusts and community provider trusts also are consistently higher than the national average.

How did NHS staff sickness rates vary by staff type?

Rates of sickness absence vary markedly between staff groups. Nursing, midwifery and health visitor learners have the lowest sickness absence rate (average 1.13% from January 2010 to January 2016). However, this group comprises students who do not spend all their time rostered onto shifts, and who have markedly different working conditions.

Medical and dental staff have the second lowest absence rate (average 1.21% from January 2010 to January 2016), and there is almost no seasonal variation.

In contrast, ambulance staff and healthcare assistants have the highest absence rates (both with an average of 6.2% from January 2010 to January 2016), with the largest seasonal fluctuations also being observed in ambulance staff.

How has the proportion of staff who feel under pressure to attend work while ill changed over time?

For comparison, the proportions of staff feeling pressure to attend work despite feeling unwell, as reported by the annual Survey of NHS Staff, are also included.

A substantial proportion of NHS staff have felt under pressure to attend work when ill. In 2009 just over one fifth of staff reported that they felt pressure to attend work despite having felt unwell. This was followed by year on year increases in 2010, 2011 and 2012 when it reached a peak of 27% of staff reporting pressure to attend work despite feeling unwell. This subsequently decreased in 2013 and 2014, when 23% of staff felt pressure. In 2015, this indicator was changed to ask not only whether the staff member felt under pressure from colleagues to come to work while unwell but also whether they additionally put themselves under pressure to come to work. Once this was included, the percentage of staff feeling under pressure to go to work when unwell doubled. Of the staff who attended work while unwell, 92% reported they had put themselves under pressure to attend, 25% felt pressure from a manager and 19% from colleagues (data not shown).

About this data

The data presented relate to sickness absence rates for staff at NHS organisations on the Electronic Staff Record (ESR). ESR is a payroll and human resources system which, since April 2008, has contained staff records for all NHS employed staff with the exception of GPs and those employed at the two foundation trusts which are not on the system. It replaced over 30 separate HR and payroll systems which were previously in use.

The figures published include the following components:

- Numerator: Full Time Equivalent (FTE) Days Lost to Sickness Absence (including non-working days)

- Denominator: Full Time Equivalent (FTE) Days Available (including non-working days)

- Rate: Sickness Absence Rate

The term FTE in this context means that if a full-time member of staff is off sick for five days (including any non-working days), the numerator=5 and denominator=365; however if a half-time member of staff is off sick for five days (including any non-working days), the is numerator=5 and denominator=182.5.

It should be noted that lower rates can also indicate under reporting of sickness absence.

More information can be accessed from the Health and Social Care Information Centre


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