Despite the progress that has been made in tackling levels of sickness absence in the NHS over the past decade, more remains to be done, as Jeremy Orr explains

Figures from the Information Centre for health and social care show that the national sickness absence level for the health service in 2005 was 4.5 per cent, while the average for the nation as a whole was only 3.5 per cent.

Through the improving working lives initiative and other efforts, we have tackled some of the major causes of short-term absenteeism. While this has gone some way to improving the situation, it is clear that there is still work to do in managing long-term absence and supporting staff to return to work.

Retiring on grounds of ill-health is a drastic step many workers would prefer not to take, and it is up to employers to offer suitable options to make remaining in the workforce a real possibility.

A successful reduction in numbers of absent staff or those retiring early would mitigate risks to the service and reduce future cost pressures on the NHS pension scheme.

Research by the Work Foundation found that among staff educated to degree level, the average length of time off sick due to stress was 22.7 days a year. Average time absent for musculoskeletal problems is roughly six weeks but in many cases persists far longer.

Way forward

Proposals launched by NHS Employers and the NHS trade unions last month aim to improve the management of long-term absence and ill-health retirement, not only by encouraging the prevention of staff sickness and injury, but also by supporting staff to return to work after a period of absence through, for example, phased return or redeployment to another role.

Under the proposals, line managers would be responsible for recognising potential health problems early on and taking appropriate steps to minimise their impact, including access to services such as physiotherapy and cognitive behavioural therapy.

As an added incentive for good practice, employers should be charged the cost of ill-health retirement, currently shouldered by the NHS pension scheme.

As things stand, if a member of staff is unable to return to their original position, the pension scheme does not take into consideration whether or not the individual is likely to find alternative employment.

Under the new proposals, ill-health retirement benefits would be based on a two-tier approach - one for those who are likely to be able to find alternative employment and another for those permanently unable to work at all, which would provide a higher level of benefit.

The proposals aim to reduce the numbers of staff absent on grounds of ill-health and to encourage them back into work as soon as they are able, through improved management techniques and the provision of occupational health services.

Given that the normal retirement age for new members of the NHS pension scheme is rising to 65 from April next year, it is likely that numbers of staff on long-term absence or retiring through ill-health will also increase in the future. By tackling these issues head-on and ensuring we have laid the grounds for best practice sooner rather than later, we will be best placed to help fulfil our responsibilities towards NHS employees and to face the likely demands that will be made on the service and the NHS pension scheme in the years ahead.

A three-month consultation on the review proposals is currently under way. Full details of the proposals can be found in the consultation document, Partnership Review of Ill-Health Retirement, NHS Injury Benefit Scheme and Sickness Absence: joint proposals for consultation and the accompanying questions and answers. They are available on the NHS Employers website at