Sickness Absence Data Analysis

This research programme made use of routinely collected data on sickness absence during the first wave of the COVID-19 pandemic. By using this data as a proxy for confirmed COVID-19 illness we were able to explore the risks of COVID-19 amongst different staff groups. The data also allowed us to explore the impact of the pandemic on non-COVID-19 sickness absence (including mental health), and stratify the risks for different demographic groups. The research programme brought together experts from across the UK and involved collaboration between academics and government bodies.

Healthcare workers and other keyworkers (workers whose job was considered essential to societal functioning) had a higher likelihood of testing positive for COVID-19 than other workers during the first lockdown in England. With approval by the NHS Health Research Authority, we were allowed access to two pseudonymised databases prepared by the NHS Electronic Staff Record (ESR) Central Team. They contained information on demographic and occupational characteristics of all staff continuously employed by NHS trusts in England from 01 January 2019 to 31 July 2020, and on all their absences from work during that period, other than for annual leave – data from nearly one million individuals.

Main findings / Outputs:

  • Between March and July 2020, the overall risk of COVID-19 sickness absence in National Health Service staff in England was lower at older ages, higher in non-white staff and (in comparison with administrative and clerical staff) more than doubled in registered nurses and among workers such as healthcare assistants providing support to health professionals. The risk in healthcare scientists was little different from that in administrative and clerical occupations.

  • In comparison with White ethnic groups, the risk of short-duration COVID-19 sickness absence was modestly elevated in South Asian but not Black groups. However, all Black and ethnic minority groups were at higher risk of prolonged COVID-19 sickness absence. Odds ratios (ORs) relative to White ethnicity were more than doubled in South Asian groups (Indian OR 2.49, 95% confidence interval (CI) 2.36–2.63; Pakistani OR 2.38, 2.15–2.64; Bangladeshi OR 2.38, 1.98–2.86), while that for Black African ethnicity was 1.82 (1.71–1.93).

    After exclusion of episodes directly related to COVID-19, the overall incidence of sickness absence during the initial 10 weeks of the pandemic (March–May 2020) was more than 20% lower than in corresponding weeks of 2019. Trends for specific categories of illness varied substantially, with a fall by 24% for cancer, but an increase for mental illness.

  • Over the study period, 164 202 new sickness absence episodes for mental ill health were recorded in 12.5% (119 525) of the study sample. There was a spike of sickness absence for mental ill health in March–April 2020 (899 730 days lost) compared with 519 807 days in March–April 2019; the surge was driven by an increase in new episodes of long-term absence and had diminished by May/June 2020. The increase was greatest in those aged >60 years (227%) and among employees of Asian and Black ethnic origin (109%–136%). Among doctors and dentists, the number of days absent declined by 12.7%. The biggest increase was in London (122%) and the smallest in the East Midlands (43.7%); the variation between regions reflected the rates of COVID-19 sickness absence during the same period.Impact of COVID-19 pandemic on sickness absence for mental ill health in National Health Service staff | BMJ Open