Intended for healthcare professionals


NHS absenteeism is a “festering sore,” study says

BMJ 2011; 343 doi: (Published 18 August 2011) Cite this as: BMJ 2011;343:d5327
  1. Oona Mashta
  1. 1London

Managers in the UK health services are failing to tackle staff absenteeism, which costs millions of pounds in lost productivity every year, a new study concludes.

Healthcare has the highest levels of absenteeism levels of any sector, and a reduction of just 1% could save the NHS in England more than £34.2m a year, say the authors, Vivienne Walker and David Bamford, from Manchester Business School (Health Services Management Research 2011;24:142-50, doi:10.1258/hsmr.2011.011004).

Sickness absence costs the UK economy £12bn each year, and the rate of absenteeism is much higher among public than private sector workers, they say.

To reach their findings the researchers reviewed 140 previously published studies on absenteeism and carried out an in-depth investigation into absenteeism in two trusts in Northern Ireland.

Overall the most common health problems reported were work related injuries, such as musculoskeletal disorders, including upper back pain, but also depression.

Studies showed that as much as 20% of absence was not genuine and that less than half of organisations measure the cost of absence.

The researchers concluded, “Absence merits rigorous attention as it affects quality of care, wastes manager and occupational health service time and bleeds resources away from core services. It is a persistent festering sore that is the single biggest cause of lost productivity in the NHS. A systematic change programme is needed for a fundamental improvement, otherwise the healthcare sector will continue at the top of the league of absenteeism.”

Gill Bellord, director of employment relations and reward for NHS Employers, said, “This is an important issue. We are working with the NHS and health unions to provide advice and guidance to support a fit and healthy workforce that can deliver first class care to patients.”

The researchers used quantitative surveys, interviews, and secondary data to analyse absenteeism from September 2005 to March 2007 at the two trusts in Northern Ireland, where absenteeism is generally higher than in the rest of the UK.

Just under a third of 294 managers and just under a half of 40 occupational health service staff interviewed at the two trusts responded to the surveys.

Nearly all the occupational health staff but only about half the managers believed that absenteeism could be reduced. Three quarters of the managers believed that they were responsible for managing absence, yet the research indicated that a half were inactive.

The researchers concluded that occupational health staff who strongly supported rehabilitative returns to work could be better used in reducing staff absenteeism.

One of the authors, Vivienne Walker, said, “At a time of significant financial constraints in the NHS, if we can be releasing money we should be doing so.

“The NHS needs a higher level of audit to ensure managers are tackling absenteeism. We also need to be explicit about how we expect managers to tackle absenteeism in their induction.

“Professional managers also need to introduce more rigour in the system so that they can reduce absenteeism. There should also be early intervention to get the long term absentees back to work.”

A BMA spokesman said that NHS staff were more at risk than the general population of particular types of health problems. “Effective occupational health services are essential to ensure that all NHS staff work in safe ergonomic environments so that disorders like chronic backache can be minimised,” he said.

“Working for the NHS can be very stressful, and it is therefore essential that staff feel confident to seek help early on for anxiety related illnesses—this can help prevent long periods of absenteeism.

“Managers need to ensure that their staff know about occupational health services and how to seek help.”