Sickness absence rates across the NHS

Moberly, Tom

doi:10.1136/bmj.k2210

Cited by 34 publications

(14 citation statements)

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“…For the numbers of patients, we did the same but with different distributions for each day of the week. Current national sickness rates for nursing staff are 4.5%, 36 so we assumed rates of unanticipated absence through short notice sickness of 4% for assistants and 3% for registered nurses, approximating known differences in sickness absence between these groups. 37 The probability of bank and agency staff requests being fulfilled was based on different assumptions regarding the availability of these staff (see table 1).…”

Section: Model Parameters Run Length and Replicationsmentioning

confidence: 99%

Costs and consequences of using average demand to plan baseline nurse staffing levels: a computer simulation study

et al. 2020

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BackgroundPlanning numbers of nursing staff allocated to each hospital ward (the ‘staffing establishment’) is challenging because both demand for and supply of staff vary. Having low numbers of registered nurses working on a shift is associated with worse quality of care and adverse patient outcomes, including higher risk of patient safety incidents. Most nurse staffing tools recommend setting staffing levels at the average needed but modelling studies suggest that this may not lead to optimal levels.ObjectiveUsing computer simulation to estimate the costs and understaffing/overstaffing rates delivered/caused by different approaches to setting staffing establishments.MethodsWe used patient and roster data from 81 inpatient wards in four English hospital Trusts to develop a simulation of nurse staffing. Outcome measures were understaffed/overstaffed patient shifts and the cost per patient-day. We compared staffing establishments based on average demand with higher and lower baseline levels, using an evidence-based tool to assess daily demand and to guide flexible staff redeployments and temporary staffing hires to make up any shortfalls.ResultsWhen baseline staffing was set to meet the average demand, 32% of patient shifts were understaffed by more than 15% after redeployment and hiring from a limited pool of temporary staff. Higher baseline staffing reduced understaffing rates to 21% of patient shifts. Flexible staffing reduced both overstaffing and understaffing but when used with low staffing establishments, the risk of critical understaffing was high, unless temporary staff were unlimited, which was associated with high costs.ConclusionWhile it is common practice to base staffing establishments on average demand, our results suggest that this may lead to more understaffing than setting establishments at higher levels. Flexible staffing, while an important adjunct to the baseline staffing, was most effective at avoiding understaffing when high numbers of permanent staff were employed. Low staffing establishments with flexible staffing saved money because shifts were unfilled rather than due to efficiencies. Thus, employing low numbers of permanent staff (and relying on temporary staff and redeployments) risks quality of care and patient safety.

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Section: Model Parameters Run Length and Replicationsmentioning

confidence: 99%

Costs and consequences of using average demand to plan baseline nurse staffing levels: a computer simulation study

et al. 2020

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“…Obesity increases the risk of diseases including diabetes, heart disease, osteoarthritis and cancer [10], and increases the risk of musculoskeletal (MSK) problems. MSK is a leading cause of sickness absence [9,11] and is prevalent in nurses [12,13], but could be improved with lifestyle changes such as exercise [14]. A recent secondary analysis of nationally representative cross-sectional data from the United Kingdom (UK) has suggested an upward trend in the health-related behaviours of nurses relative to the general working population.…”

Section: Introductionmentioning

confidence: 99%

“…Mental ill-health is a serious concern in the nursing profession [19][20][21][22]; it is one of the leading causes of sickness absence in the UK National Health Service (NHS), incurring a significant financial burden to healthcare services [11]. Rates of work-related stress, emotional exhaustion and burnout are high [23,24], and the prevalence of depression may be higher in nurses than in the general population [25].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Lifestyle Health Promotion Interventions for Nurses: A Systematic Review

Stanulewicz

Knox

Narayanasamy

et al. 2019

IJERPH

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Background: Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention most likely to have positive outcomes are unknown. Objective: To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses. Methods: A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9–3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed. Results: Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group (n = 51, 37.5%). The majority of interventions focused on education, physical activity, mindfulness, or relaxation. Thirty-seven (27%) studies had a multimodal intervention approach. On average, studies had relatively small samples (median = 61; mode = 30) and were conducted predominantly in North America (USA/Canada, n = 53). The findings were mixed overall, with some studies reporting benefits and others finding no effects. Dietary habits was the most successfully improved outcome (8/9), followed by indices of body composition (20/24), physical activity (PA) (11/14), and stress (49/66), with >70% of relevant studies in each of these categories reporting improvements. The lowest success rate was for work-related outcomes (16/32). Separate analysis of RCTs indicated that interventions that focus solely on education might be less likely to result in positive outcomes than interventions targeting behavioural change. Conclusions: Interventions targeting diet, body composition, PA, or stress are most likely to have positive outcomes for nurses’ health and/or wellbeing. The methodologically strongest evidence (RCTs) is available for body composition and stress. Interventions relying solely on educational approaches are least likely to be effective. Organisational outcomes appear to be more challenging to change with lifestyle intervention, likely requiring more complex solutions including changes to the work environment. There is a need for more high-quality evidence since many studies had moderate or high risk of bias and low reporting quality.

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“…The sickness absence rate for all those working in the health sector amounts to 3.5%, considerably higher than the rate of 2.9% for the public sector as a whole and 1.7% for private sector workers 13. Public Health England estimates that the cost of sickness absence by NHS staff is £2.4bn a year: reducing absences by one day per person a year would save around £150m (roughly the cost of 6000 full time staff) 14…”

Section: What Can Help To Increase Productivity?mentioning

confidence: 98%