Lies and Damned Lies - Interpreting Sickness Absence Rates of NHS employees
The recent publication of the NHS Health and Wellbeing Review(1)
provides a thoughtful overview of possible future approaches to improve
the health of NHS employees. On a less positive note the associated media
reports have focused on references within the report to an apparent excess
of sickness absence among NHS, and other public sector employees, compared
to the private sector(2,3). These comparisons, which are reported
periodically in the national media, arise from regular surveys undertaken
by employer related bodies such as the Chartered Institute of Personnel
and Development (CIPD) and CBI/AXA. There are multiple confounding factors
that make simple comparison of public and private sector absence rates
unreliable. The Health and Safety Executive have reanalysed a similar
survey to control for other factors known to be associated with absence,
particularly organisational size, and found this reduced the observed
average difference in absence between public and private sector in the
study from 2.5 to 0.3 days per employee per year (4).
There is much that can be done to improve the health of public sector
employees. Implementation of appropriate workplace health interventions,
and subsequent systematic assessment of outcomes, will hopefully
demonstrate a benefit not only on the valuable outcome of improved
employee health but also increased effectiveness in delivery of health
care to the general population. In the meantime public sector workers are
unlikely to find their widespread and repeated presentation as
substantially more ‘work shy’ than private sector workers as demoralising
and counter productive in achieving these desired outcomes.
Rapid Response:
Lies and Damned Lies - Interpreting Sickness Absence Rates of NHS employees
The recent publication of the NHS Health and Wellbeing Review(1)
provides a thoughtful overview of possible future approaches to improve
the health of NHS employees. On a less positive note the associated media
reports have focused on references within the report to an apparent excess
of sickness absence among NHS, and other public sector employees, compared
to the private sector(2,3). These comparisons, which are reported
periodically in the national media, arise from regular surveys undertaken
by employer related bodies such as the Chartered Institute of Personnel
and Development (CIPD) and CBI/AXA. There are multiple confounding factors
that make simple comparison of public and private sector absence rates
unreliable. The Health and Safety Executive have reanalysed a similar
survey to control for other factors known to be associated with absence,
particularly organisational size, and found this reduced the observed
average difference in absence between public and private sector in the
study from 2.5 to 0.3 days per employee per year (4).
There is much that can be done to improve the health of public sector
employees. Implementation of appropriate workplace health interventions,
and subsequent systematic assessment of outcomes, will hopefully
demonstrate a benefit not only on the valuable outcome of improved
employee health but also increased effectiveness in delivery of health
care to the general population. In the meantime public sector workers are
unlikely to find their widespread and repeated presentation as
substantially more ‘work shy’ than private sector workers as demoralising
and counter productive in achieving these desired outcomes.
1.http://nhshealthandwellbeing.org
2.BMJ 2009;339:b3406.
3.BMJ 2009;339:b3628
4. http://www.hse.gov.uk/press/2006/e06073.htm
Competing interests:
None declared
Competing interests: No competing interests