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PROFESSIONAL


Thara Raj MSc


Public Health Manager NHS Newham


NHS heal thyself: managing long-term sickness and


incapacity for work Dealing with long-term sickness and incapacity for work should be a priority for the NHS, especially in these times of budget cuts


P


oor management of long-term sickness places a substantial burden on NHS resources. With over 1.3 million staff, the NHS suffers when staff become unwell and are not properly managed back to work. Added to this is the cost of treating working age people who are sick, ranging from GP consultation to specialist care. The additional


cost of treating health conditions that keep people out of work is estimated to be £5-11 billion per year.1 The great news is that the NHS has the knowledge and owns


many of the resources needed to manage long-term sickness and incapacity for work effectively.


POLICY CONTEXT The problems were highlighted in 2008 when the government published Dame Carol Black’s Review of the health of Britain’s working age population. It showed that the annual economic costs of sickness absence and worklessness associated with working age ill-health are estimated to be over £100 billion - greater than the current annual budget for the NHS. According to Dame Carol Black (who is the National Director for


Health and Work at the Department of Health), two-thirds of sickness absence and long-term incapacity is due to mild and treatable conditions, often with inappropriate ‘medicalisation’, needing vocational rehabilitation: Depression, anxiety, stress-related mental health problems (with an estimated cost of £28.3 billion in 2008). Musculoskeletal conditions: mild and often soft tissue (with an estimated cost of £7 billion in 2007).


The review made a strong case for the NHS being involved in


the provision of work-related health interventions to reduce long-term sickness and incapacity for work. The Department of Health (DH) went further by commissioning an independent review of the health and wellbeing of NHS staff2


-


the Boorman review. It found important associations between better staff health and wellbeing and patient outcomes, including reduced MRSA rates and lower standardised mortality rates. He also found that the direct cost of staff sickness absence at the time was £1.7 billion. Marmot3


warned that plans to raise the retirement age to 68 will


cause hardship for millions because three-quarters of people could be too ill to work.


SICKNESS ABSENCE RATES IN THE NHS Sickness absence rates are being monitored quarterly by the NHS Information Centre, through the Electronic Staff Record (ESR), on an experimental basis. This has made it easier to monitor sickness absence rates by organisation and region, rather than relying on surveys. The Audit Commission4


analysed this data and found that


between July 2009 and June 2010: PCTs and trusts in the North East had, on average, the highest rates compared to London, which had the lowest. Sickness absence rates ranges from 1.6% to 6.8% nationally. Staff groups with the highest sickness absence rates are nursing, midwifery and health visitors (5.2%), ambulance staff (6.3%), and healthcare assistants (6.8%).


After allowing for these factors, the Audit Commission


estimated that the NHS could save £290 million if they reduced their sickness absence rates to the lower quartile and found that some PCTs and trusts have already achieved this.


GOOD PRACTICE Various bodies, including the Health and Safety Executive and Chartered Institute of Personnel Development (CIPD) have published good practice. The National Institute for Health and Clini- cal Excellence’s (NICE) added to this body of knowledge and published guidance for NHS and non-NHS audiences, Manage-


30 Nursing in Practice March/April 2012


www.nursinginpractice.com


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