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02.09.15

Stevens blames ‘altruism gene’ for high NHS staff sickness

NHS England chief executive Simon Stevens says some sickness absence in the NHS can be “designed out” if more support is given to staff with musculo-skeletal problems and stress, but that NHS workers have to look after their own health too.

In his speech and Q&A session at the Health & Care Innovation Expo this lunchtime expanding on the “major drive” launched this week to improve staff health and wellbeing, Stevens said: “The jobs that most frontline health professionals do are as demanding – probably more so – than just about any other walk of life.

“Secondly, the ‘altruism gene’ runs strong in the National Health Service, and so [staff] always put other people before themselves or their own health, but actually if we don’t look after the people providing the care, they’re not going to be able to do that as well.

“Thirdly, the reality is that in some places, they need leadership, to listen, and to take new ideas seriously, and creates the kind of environment where people feel they can flourish in their careers.”

Event chair Mishal Husain, a presenter on BBC Radio 4’s Today programme, pressed Stevens on whether there was a specific target on cutting sickness absence.

Stevens replied: “We aim to cut it by as much as we can. Obviously if you’re involved in a physically demanding job, then your sickness absence often tends to be higher.

“There are two principal causes of sickness absence in the NHS: musculoskeletal problems, and stress/mental health problems. Some of that can be ‘designed out’ in the way that we arrange work, and by getting people the support they need early on – so access to a physio, or access to mental health services that have been shown to work.”

Sick days taken across the NHS tend to total about 14 to 15 days a year, with the latest figures (January-March 2015) showing a sickness absence rate in England of 4.44%. This was a slight rise on the previous year, when the figures hit their lowest rate ever.

The average sickness absence rate across all sectors of the UK economy is more like four to five days a year, but the Health & Social Care Information Centre says such comparisons are not useful: “These [NHS] figures are best compared with business areas that involve infectious conditions, traumatic situations and assaults on employees. It is possible that higher rates may be the result of good management systems and lower rates may be due to under-recording.”

Paramedics’ sickness absence rates are significantly higher than other groups, with a percentage rate more than five times higher than those in the ‘nursing, midwifery and health visiting learners’ category.

Stevens’ speech focused on demolishing what he called three “either/or myths” – the idea that the NHS has to choose between either health or care, either today or tomorrow, and either local or national. In all of these cases, the answer is ‘both’, he explained.

He began with some datasets showing positive trends, including for cardiovascular disease and teenage pregnancy, but noted that the trends in diabetes type 2 and obesity are much more worrying.

In the Q&A session afterwards, he was pressed Dr Kailash Chand, deputy chair of the British Medical Association (BMA), on seven-day working, with GPs already feeling overstretched and at crisis point. Stevens cited the strong evidence on excess mortality at weekends, and said patients are often confused about their options outside of working hours, thanks to the “right old alphabet soup” of A&E, NHS 111, out-of-hours GP services, walk-in centres, minor injuries units and so on.

Husain asked him whether he supported health secretary Jeremy Hunt or the medics and consultants who joined the #ImInWorkJeremy campaign on Twitter, rejecting the implicit idea that they currently only work during weekday office hours, harming patient outcomes. Stevens did not answer directly, but did say he was “on the side of staff and patients”.

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