NHS in England grappling with difficult new normal as staff sickness soars post-pandemic

New analysis from the Nuffield Trust explores sickness absence in the NHS in England.

Press release

Published: 29/06/2023

The NHS in England is facing a new normal of sickness absence in hospitals and community services having seen a 29% jump in the most recent calendar year compared with the year before the pandemic (an average of 5.6% in 2022 vs 4.3% in 2019), equating to an average of 17,000 additional staff off sick each day, according to new Nuffield Trust analysis for the BBC.

Analysis of staff sickness data published by the NHS shows that there were more staff off sick on any given month in 2022 than at the worst point in the year before the pandemic: even the month with the lowest rates of sickness in 2022 (May 2022 at 4.9%) was higher than December 2019, the worst month that year (4.86%).

In total across 2022, some 27 million days were lost to sickness absence, equivalent to 74,500 full-time staff, including some 20,400 nurses and 2,900 doctors. This increasing burden of sickness absence is thought to be contributing to higher costs and disruption for NHS providers, fuelling additional stress for remaining staff, and is a major push factor for staff leaving, leading to further disruption for patients and services.

While the increase in respiratory and infectious conditions is not surprising given Covid-19, there has also been a stark rise in staff who need to take sick days for anxiety, stress and burnout, which now account for a quarter of sick days. In total across 2022, some 6 million working days were lost in total to mental health and wellbeing reasons.

The analysis, All is not well: Sickness absence in the NHS in England, covered exclusively by the BBC, also found:

  • The level of sickness absence is not equal around the country. By the end of 2022, the reported sickness rate in the North West stood at 7.4%, above the national average for hospital and community services, while London was 5.4%.
  • All types of NHS trusts saw a substantial increase in sickness absences, but ambulance services have seen a particular spike with three ambulance trusts seeing one in 10 staff off sick on average every day in 2022.
  • Ambulance staff (2.3 percentage point increase), ambulance support staff (3.2) and midwives (1.9) saw the largest rises in sick days in 2022 compared to the pre-pandemic year.
  • The sickness absence rate in the NHS in England remains well above the public sector average despite a national target to bring them down to this level.

The analysis of NHS data adds to further evidence that NHS staff are increasingly suffering from work-related stress. Over half (57%) of staff reported in the NHS annual staff survey going into work despite not feeling well.

Nuffield Trust Senior Fellow Dr Billy Palmer said:

“The health service is grappling with a difficult new normal when it comes to staff sickness leave. The increasing numbers taking time away from work feeds into a seemingly unsustainable cycle of increased work leading to burnout and then more people choosing to leave.

“Monthly sickness absence rates last year never once fell below even the worst point pre-pandemic. These sustained, higher rates of sickness absence are equivalent to taking some 17,000 staff out of the NHS.

“There has been a lot of focus on recruitment and bringing staff in or back, but we need more endeavour to improve the working conditions of existing staff and protect them from illness. The NHS workforce plan needs to have concrete support to enable employers to improve NHS staff experience if the service is to break this cycle of staff absences, sickness and leaving rates.”

Notes to editors

  • We have compared NHS Digital sickness absence data for NHS hospital and community service staff for the calendar year (Jan-Dec) for 2022 and the calendar year of 2019 as the pre-pandemic year.
  • Our analysis of the changes in reasons for leaving over time is limited to April to December in 2019 and in 2022, due to lack of data covering the entire calendar years.
  • The NHS’s sickness absence rate is calculated by dividing the total sickness absence days (including non-working days) reported by the sum total days available per month for each member of staff (also including non-working days). This will tend to underestimate sickness absence rates as short-term sickness on or overlapping with non-working days will not always be fully recorded.
  • Our analysis uses the above approach, while the BBC has calculated annual NHS sickness absence rates taken as an average of the monthly sickness absence rates in a given year.
  • The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate www.nuffieldtrust.org.uk
  • For all queries or to arrange an interview, contact: Simon Keen: 07780 475571 / simon.keen@nuffieldtrust.org.uk; or Eleanor Martin: 07920 043676 / eleanor.martin@nuffieldtrust.org.uk