NHS staff: Sickness absence and intention to leave the profession

Objective To determine key workforce variables (demographic, health and occupational) that predicted NHS staff's 1) absence due to illness (both COVID-19 and non-COVID-19 related) and 2) expressed intention to leave their current profession. Methods Staff from 18 NHS Trusts were surveyed between April 2020 and January 2021, and again approximately 12 months later. Logistic and linear regression were used to explore relationships between baseline exposures and 12-month outcomes. Results We included 10,831 participants for analysis. At 12-months, 20% stated they agreed or strongly agreed they were actively seeking employment outside their current profession; 24% said they thought about leaving their profession at least several times per week. Twenty-percent of participants took 5+ days of work absence due to non-COVID-19 sickness in the 12-months between baseline and 12-month questionnaire; 14% took 5+ days of COVID-19 related sickness absence. Sickness absence (COVID-19 and non-COVID-19 related) and intention to leave the profession (actively seeking another role and thinking about leaving) were all more common among NHS staff who were younger, in a COVID-19 risk group, had a probable mental health disorder, and who did not feel supported by colleagues and managers. Conclusions There were several factors which affect both workforce retention and sickness absence. Of particular interest because they are modifiable, are the impact of colleague and manager support. The NHS workforce is likely to benefit from training managers to speak with and support staff, especially those experiencing mental health difficulties. Further, staff should be given sufficient opportunities to form and foster social connections. ### Competing Interest Statement NG runs a psychological health consultancy (March on Stress Ltd) which provides some mental health training for NHS organisations. No other authors report any conflicts of interest. ### Funding Statement This research was funded by the National Institute for Health Research (NIHR) Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, NIHR ARC North Thames, and the NIHR Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between the UK Health Security Agency, King's College London and the University of East Anglia. SAM Stevelink is supported by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and funded by the National Institute for Health and Care Research, NIHR Advanced Fellowship, Dr Sharon Stevelink, NIHR300592. The NHS CHECK cohort study from which this data is taken was funded from the following sources: Medical Research Council (MR/V034405/1); UCL/Wellcome (ISSF3/ H17RCO/C3); Rosetrees (M952); Economic and Social Research Council (ES/V009931/1); NHS England and NHS Improvement; as well as seed funding from National Institute for Health Research Maudsley Biomedical Research Centre, King's College London, National Institute for Health Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed are those of the authors and not necessarily those of NHS England, NHS Improvement, the NIHR, UKHRA or the Department of Health and Social Care. For the purpose of open access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval for the NHS CHECK study was granted by the Health Research Authority (reference: 20/HRA/210, IRAS: 282686) and local Trust Research and Development. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data will be available to researchers who provide a justified hypothesis and structured statistical analysis plan addressing a legitimate research question that is approved by the NHS CHECK Senior Research Team and after the signing of a data sharing agreement. Only deidentified participant data will be provided.