The NHS is losing the equivalent of 80,000 staff to sickness absence costing taxpayers £4.6billion a year, a damning report reveals.
Exceptionally generous sick pay is fuelling a ‘sick leave epidemic’, often to the detriment of patients on waiting lists, the Policy Exchange think tank warns.
Its new analysis found sickness absences have soared by more than a fifth within the NHS over the past ten years.
And the crisis is now so severe that the absent workers could fully staff 80 additional hospitals, the ‘NHS: Heal Thyself’ report says.
It concludes: ‘Sickness management in the NHS is financially unsustainable, operationally damaging and ultimately unfair to both patients and staff.’
Policy Exchange researchers examined responses to Freedom of Information requests, NHS workforce data and interviews with occupational health and HR professionals.
They found the NHS in England – which employs over 1.5million people and is the country’s biggest employer – offers up to six months sick leave on full pay, followed by a further six months on half pay.
Meanwhile, people working in the private sector typically receive only two to four weeks on full pay, with almost a third on statutory sick pay alone.
Exceptionally generous NHS sick pay is fuelling a ‘sick leave epidemic’, often to the detriment of patients on waiting lists, the Policy Exchange think tank warns.
It is thought to explain why the NHS recorded a sickness absence rate of 5.15 per cent in 2024, which is almost three-times higher than the UK private sector average of 1.8 per cent and higher than the public secure average of 2.9 per cent.
Over the past decade, sickness absence rates within NHS trusts and integrated care boards have increased by 21 per cent, with long-term sickness over 28 days rising by 43 per cent between 2019 and 2024.
Furthermore, the number of staff going on long-term sick leave and not returning to work in NHS organisations increased by 42 per cent over this period.
Report author Gareth Lyon, head of health and social care at Policy Exchange, said: ‘Our findings show a system which is clearly not working either for NHS staff or for patients.
‘The health service should be an exemplar of how to support people to stay in work and to return to work.
‘Instead we are seeing tens of thousands of people being paid to be off work for months or even years at a time.
‘In order for the NHS to become more productive, to reduce waiting lists and to increase patient satisfaction levels we urgently need to address this systemic failure.’
Sickness absence levels are higher among some groups of managers and administrators than frontline clinicians but more than 8 million days of clinician time are still lost each year.
Is NHS sickness absence now a bigger problem than staffing shortages?
Report author Gareth Lyon, head of health and social care at Policy Exchange, said: ‘Our findings show a system which is clearly not working either for NHS staff or for patients.’
The report identifies ‘exceptionally generous’ sickness pay arrangements, weak management accountability, and inadequate occupational health provision as ‘key drivers of persistently high absence rates’.
It also finds strong correlations between high sickness absence and poor staff morale, weak leadership, stress and burnout.
The think tank is calling for an ‘overhaul’ of NHS sickness policies and practices to bring them in line with the private sector.
Recommendations include reducing the period in which staff can receive full sick pay from six months to 28 days and introducing a ‘day-one’ clinical assessment for NHS staff calling-in sick.
There should be expanded use of alternative duties and remote working to support return-to-work pathways and more accountability measures for senior managers in poorly performing trusts that fail to reduce absence rates to a target of 2.7 per cent.
Regular medical certification and work capability reviews for long-term absence and a new specialist occupational health service across all NHS organisations would also help, it adds.
Former Tory chancellor Nadhim Zahawi said: ‘People are struggling to get appointments and waiting lists are out of control.
‘It is clear that large parts of the NHS are not working as productively as they should to serve patients or to deliver value for the taxpayer.’
Lord Carter of Coles, a member of the House of Lords finance committee, said: ‘We cannot afford for so many people to be off sick in an organisation which is meant to be tackling illness.
‘Instead of paying people to be off work for months at a time – which amounts to a form of benign neglect – NHS managers should be incentivised to bring people back into work quickly and to help them stay there.’
Around 36,000 of the 80,000 are clinical staff. Poor mental health accounts for around a third of NHS sick leave.
