Topic analysis: Workforce sickness absence

We requested data from NHS Digital on NHS sickness absence rates by reason, staff group and organisation. The organisations were mapped to their corresponding integrated care system (ICS). We gained insights on the overall sickness absence rate and the top 5 reasons for absence among nursing staff. 

What we learnt

Sickness absence increases during certain months of the year across all ICS. On average, it’s highest between October and March and lowest between April and September. It begins to go up in around October to November each year and peaks around December to January.

This has been a consistent pattern each year, apart from at the start of the COVID-19 outbreak in April 2020 and in July 2022, when we saw an increase in sickness absence in all ICS. 

We will repeat this analysis in winter 2024 to analyse any new trends.

Reasons for absence

Between 2018 and 2022, the top reasons for sickness absence overall were:

• anxiety
• stress
• depression
• other psychiatric illnesses

During 2018 and 2019, the top reasons for sickness absence were:

• anxiety
• stress
• depression
• other psychiatric illnesses
• other musculoskeletal problems
• cold, cough, flu-influenza
• gastrointestinal problems
• injury fracture

From 2020, the top reasons changed slightly due to the pandemic. Infectious diseases and chest and respiratory problems became a more prominent reason for sickness, replacing injury fracture. 

It’s concerning that sickness absence due to mental health reasons such as anxiety, depression, stress and burnout is increasing across all regions.

The North East and North Cumbria ICS had the highest rate of sickness absence due to mental ill health, at 29.6%. North West London ICS had the lowest at 10.2%.

Overall, the London region had lower levels of sickness due to mental health reasons. But 4 out of 5 London ICS have a higher sickness absence rate now than in 2018, indicating that sickness due to mental health reasons may be increasing in the region.

This overall increase indicates that nurses are experiencing higher levels of stress and burnout. This could be linked to increased workloads, staffing shortages and the ongoing impacts of the pandemic. It’s vital that nursing staff receive sufficient mental health support from their employers, and that workforce supply issues are urgently addressed by ICS to alleviate pressure on the existing workforce. 

The effects of the pandemic continue to be felt in the nursing workforce, through stress and burnout, as well as the persistently increased rates of respiratory illness.

This may be due to increased exposure to the virus in the workplace, or to a lack of appropriate PPE. In many clinical settings, for example, wearing face masks is no longer a requirement.

Sickness absence both contributes to, and is a symptom of, wider issues facing the nursing workforce. Recruiting staff to address acute workforce shortages may be hampered by high rates of stress and burnout, and more staff absences due to illness exacerbates existing staff pressures.

This can cause issues during the winter particularly, as seasonal trends in sickness combine with increased demand for services. We urge ICS to urgently prioritise actions to increase workforce supply. This will help to ensure that safe staffing levels are met, staff aren’t overstretched and levels of burnout and illness reduce. 

Integrated Care System leaders should: 

• Analyse the local factors leading to sickness absence and take measures to address them 
• Implement data collection and monitoring to track rates of sickness absence across an ICS. This will help to identify local and seasonal trends and factor these into workforce planning and the provision of targeted wellbeing support.

Service providers should:

• Analyse data to understand local challenges and work with staff groups to design interventions to reduce sickness rates.
• Adhere to legal requirements around adequate welfare and safety facilities.
• This includes:
• access to breaks, changing facilities and personal lockers
• access to sufficient, well-maintained and high-quality resources (including PPE), moving and handling equipment.