Predictors of sickness absence and intention to leave the profession among NHS staff in England during the COVID-19 pandemic: a prospective cohort study

Lauren J Scott*, Danielle Lamb, Chris Penfold, Maria Theresa Redaniel, Nora Trompeter, Paul A Moran, Rupa Bhundia, Neil Greenberg, Rosalind Raine, Simon Wessely, Ira Madan, Peter Aitken, Anne Marie Rafferty, Sarah Dorrington, Richard Morriss, Dominic Murphy, Sharon A M Stevelink

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Objectives
This study aims to determine key workforce variables (demographic, health and occupational) that predicted National Health Service (NHS) staff’s absence due to illness and expressed intention to leave their current profession.

Design, setting and participants
Staff from 18 NHS Trusts were surveyed between April 2020 and January 2021, and again approximately 12 months later.

Outcome measures Logistic and linear regression were used to explore relationships between baseline exposures and four 12-month outcomes: absence due to COVID-19, absence due to non-COVID-19 illness, actively seeking employment outside current profession and regularly thinking about leaving current profession.

Results
22 555 participants (out of a possible 152 286 employees; 15%) completed the baseline questionnaire. 10 831 participants completed the short follow-up questionnaire at 12 months and 5868 also completed the long questionnaire; these participants were included in the analyses of sickness absence and intention to leave, respectively. 20% of participants took 5+ days of work absence for non-COVID-19 sickness in the 12 months between baseline and 12-month questionnaire; 14% took 5+ days of COVID-19-related sickness absence. At 12 months, 20% agreed or strongly agreed they were actively seeking employment outside their current profession; 24% thought about leaving their profession at least several times per week. 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
Several factors affected both workforce retention and sickness absence. Of particular interest are the impact of colleague and manager support because they are modifiable. 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. Selection bias may have affected the presented results.
Original languageEnglish
Article numbere097483
JournalBMJ Open
Volume15
Issue number6
DOIs
Publication statusPublished - 4 Jun 2025

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.

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