Absence in the NHS: Why the health service is finding it hard to reduce sickness absence

摘要

Absence data for the NHS England in 2012-13 reveal that workers took an estimated 9.5 working days off sick in the 12 months to the end of March 2013. The figures, published by the Health and Social Care Information Centre (HSCIC), show a slight rise in sickness absence compared to the previous 12-month period (2011-12), when an estimated 9.3 working days were lost to sickness. The latest figures mean the national annual sickness absence rate across England rose from 4.12% in 2011-12 to 4.24% in 2012-13. Rates of absence have also increased marginally in both Scotland and Wales.The sickness absence rate in 2012-13 for NHS Scotland was 4.80%, up from a 4.63% in 2011-12, while the quarterly absence statistics for Wales for the three months to the end of March 2013 reveal a sickness absence rate of 5.5%, compared with 5.4% for the same period in 2012. The latest statistics suggest that, almost four years after the previous government - and later the coalition government - accepted the recommendations of the Boorman review4 of staff health and wellbeing,the NHS is struggling to bring down absence levels significantly. Dr Steve Boorman, who carried out the independent review for the government, concluded that the NHS could reduce the then (2009) rate of sickness absence, which overall was running at 4.48% (an average 10.7 days a year per worker), by a third. Achieving a reduction on that scale would result in 3.4 million additional available working days a year for NHS staff- equivalent to an extra 14,900 whole-time equivalent staff. The review estimated the direct annual cost to the NHS of staff sickness absence at £1.7 billion, and said reducing it by a third will save the service £555 million a year. A 2011 study by the Audit Commission estimated that savings of £290 million could be achieved if all primary care trusts (PCTs), NHS trusts and foundation trusts (FTs) in England reduced their sickness absence rates to the lower quartile - that is, doing as well as the best 25% of trusts in managing sickness absence. So, with the government demanding that the service delivers financial savings of £20 billion by 2015 and the potentially significant savings from reducing absence levels, why are rates remaining stubbornly high? Here, we examine some of the main reasons.