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What the doctor ordered: ‘Sickness rates are far too high’

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At this time of year, the NHS and its staff rise to magnificent heights. Epidemics of flu and norovirus sweep the nation, resulting in high rates of admission, opening of extra inpatient beds and enormous pressure on primary care, at a point when many frontline staff have got the dreaded lurgy themselves.

And in the trenches, where valiant members of staff drag themselves into clinical work areas to treat their patients, morale is further battered by Ermintrude who rings in sick, same as she did last time there was a bit more pressure in the system. And the time before that.

And the previous time as well. Though she is well enough to attend an all-night party for her friend who is getting married at the weekend.
On the whole, clinical staff in the health service are relatively robust. Sometimes colleagues come to work smiling but bearing burdens most of us cannot possibly imagine.

NHS sickness policies are generous to a fault, primarily to accommodate this sort of scenario. However, there is a small group of people who take more sick leave than one might expect.

We speculate about domestic pressures, young children and elderly relatives. Sadly, some are simply abusing the system when it comes to sick leave, and this is evident mainly among nurses.

There are distinctions within the profession. For example, registered nurses have lower sickness rates than unqualified staff, and clinical nurse specialists have lower rates than any other nursing role. Why is this?

Interestingly, sickness rates are very low among doctors. Perhaps one reason is that it would clearly hamper their careers if others felt they were always off sick. This is changing though and sickness among junior doctors is growing.

So what should we do about this problem, which adds to the pressures on colleagues just when the camel cannot carry any more straws? As managers, we can plan for enhanced winter staffing to reduce the burden.

We need to consider the reasons why doctors have low rates of sick leave, as there are probably lessons to be learnt. Their higher visibility, smaller numbers and personal supervision may be very relevant. I suggest that we take a more proactive approach to managing sickness. This would involve telephone follow-up of the staff members in question, visiting them and active pursuit of a return to work, so long as it is handled with sensitivity.

This will allow support to be channelled where it is needed, and those who should be working can be deployed without fuss or delay.

Martin Sandler is a consultant physician at Heart of England NHS Foundation Trust

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