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The Management of Sickness Absence by NHS Trusts

Note: this project commences in September 2024.


A recent paper by the Nuffield Trust noted a rise in the number of days NHS staff were taking off work due to illness. The reported rate of sickness absence for NHS staff across 2022 was 29% higher than in 2019 with anxiety, stress and depression making up a quarter of the cases (25.5%).

The scale of sickness absence is further highlighted by recent studies tracking the negative impact of the Covid pandemic on the wellbeing of healthcare staff. Evidence suggests that employee decisions to leave acute healthcare are related to a recent period of sickness absence. The NHSE Long Term Workforce Plan (LTWP) points to evidence on the positive impact staff well-being policies can have on employees’ quality of (working) life. They also impact productivity, engagement, commitment and the quality of care delivered.


The proposed study aims to look at Trusts in terms of their pattern and level of sickness absence and to undertake in-depth studies in selected Trusts to explore similarities and differences in their management of sickness absence.

Figures suggest some variation in sickness absence depending on region, staff occupation, care setting, and individual Trust. This suggests the value of exploring organisation specific factors and whether they influence sickness absences and what choices NHS employers make in managing them.

  • We will look at how and why Trusts vary in their rates and patterns of sickness absence.
  • We will consider the policy and practice choices made by Trusts to manage sickness absence.
  • We will look at the systems developed and used by Trusts.
  • We will consider the impact of policies and practices to manage staff sickness absence and worker well-being, on various employee and patient outcomes.


  • We will use publicly available data looking at each Trust. We will categorise and group them by their sickness absence profile (e.g. the distribution and levels of sickness absence across their workforce).
  • We will identify case studies sites in three to five Trusts from each of the high, medium and low sickness absence rate Trusts (a possible maximum of 15 Trusts), looking at why these variations exists.
  • We will map policies and practices used to manage sickness absence and staff wellbeing in each case study Trust, looking at how and why they were used.
  • We will gather the views of different stakeholders, (e.g. senior trust and ward managers, employees from different occupational groups), through interview, focus groups and data from different sources.
  • We will look at different approaches to the management of sickness absence and its impact on employee and patient outcomes (for example staff turnover and expenditure on agency staff).


September 2024 – February 2026


NIHR Policy Research Programme: NIHR206121(07)

Policy relevance

Sickness absence results in many lost working days, undermining NHS capacity to address current service demands and the backlog of demand since the Covid pandemic. There are also cost consequences from staff sickness absence, with the increased use of agency staff. As noted, sickness absence is often an indicator of deeper well-being issues and an early warning sign for staff departure, leading to reduced staffing levels, undermining continuity of care and adding yet further cost. Thus, identifying factors influencing good practice in supporting employee well-being and the management of sickness absence is of importance.


The main output from this study will be a report of findings. All participants will receive a copy of the summary and recommendations. The full report will be published online on the Unit’s website. We will also prepare further outputs, working with local partners (Applied Research Collaboration South London and Making Research Count) and national stakeholders, particularly those with an interest in occupational health. We will present findings at academic conferences and publish at least one article in a peer reviewed journal.

Project status: Starting