Four lessons around NHS absenteeism that are relevant to all businesses

Lizzie Buxton

Written By Lizzie Buxton

22nd November 2018

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The NHS has been battling with the highest rates of absence of all business and organisational sectors for years.

In 2017, the public health sector sickness absence rate was recorded as 3.3 per cent by the Office for National Statistics, compared with a UK average of 1.9 per cent.  The cost to a mid-sized NHS trust could be more than £3m every year.

As a result, much energy and investment has been ploughed into detailed research and guidance on what is going wrong and how to address it.

Some NHS trusts are making strides to address the underlying issues that contribute to absenteeism rates, whilst others still have much further to go.

Where success is being seen, issues have been highlighted or discoveries made, there are not only lessons for other NHS organisations but for other businesses and sectors too.

Below are a few insightful resources relevant to all organisations with an interest in developing positive cultures and reducing absenteeism.

1. The theory of ‘compassionate leadership’NHS leadership

Professor of organisational psychology at Lancaster University, Michael West, has spent 30 years carrying out research to understand how effective healthcare teams can be created.

He is committed to the role ‘compassionate leadership’ can play in doing that. It’s an interesting concept for anyone trying to create an effective team.

In a video published by NHS Leadership Academy, Professor West defines compassionate leaders as those who are positive, supportive, authentic, open and honest, appreciative of staff and curious about how they can better themselves.

For effective teams to thrive, Prof West outlines the importance of having a clear vision which is embodied in the actions of leaders, a limited number of clear objectives, enlightened people management, leaders focused on creating an environment to create consistent, effective team working and continual improvement. He says if something is not improving it is probably diminishing.

He said:

Underpinning all of this must be a commitment to compassionate leadership; developing the skills of compassionate leadership – learning to attend, to listen with fascination to those we lead, to develop a deep understanding of the challenges they face in their day-to-day work and encouraging an emotional intelligence and empathy in our interactions with those we lead in order that we then can really help and support them to do the jobs they are committed to doing.

2. Culture and leadership toolkit

NHS Improvement’s ‘creating a culture of compassionate and inclusive leadership’ resource is a detailed guide, with tools to diagnose the current culture of an organisation.

The resource is a three stage approach to ‘discover’ the current situation, ‘design’ a strategy to address issues and ‘deliver’ or implement necessary change.

medical culture and environment HRPhase 1 is around assessing the current culture using existing data, the perceptions of board, staff and stakeholders and knowledge and workforce analysis.

The document notes the importance and impact of rich data in giving a high level picture of an organisation’s culture and related outcomes. It also notes the ability of data to provide a baseline to evaluate the impact of a programme.

The document also includes mini guides such as:

3. Staff ‘engagement’ leads to reduced absenteeism

Engagement was defined by Macleod and Clarke (2009) as ‘when the business values the employee and the employee values the business’. It is perhaps the difference between employees choosing to do the minimum or to do more.

The King’s Fund report Leadership and engagement for improvement in the NHS concluded organisations with engaged staff deliver better patient experience, fewer errors, have less absenteeism and stress, lower infection and mortality rates, stronger financial management and higher staff morale and motivation.

The report said: “The evidence to this review, and the literature on engagement, is littered with examples of staff who work harder, think more creatively and care more because they feel fully involved in the enterprise.

“The study by Salanova and colleagues (2005) suggests engagement improves performance in part because engaged staff are more likely to put energy into interactions with clients, while their positive approach may in turn motivate other staff, thereby creating a more engaged workplace.”

It added:

Engagement is fostered through staff having jobs with meaningful, clear
tasks, some autonomy to manage their work, involvement in decision-making
and supportive line managers.

They are part of a well-structured team in an organisation that is focused on quality and celebrates success. In short, engaged staff feel valued, respected and supported.

4. Practical help for stressed staff supporting stressed nhs staff

Andrew Foster, Chief Executive of Wrightington, Wigan and Leigh NHS Foundation Trust, wrote an article for HSJ offering practical tips to help stressed staff, following a period where his hospital had 14 ambulances queued outside and all beds were full.

He said:

One of our main objectives is to maintain a positive and healthy culture and particular priorities are to stamp out anything that looks like blame.

When things are tough it is far too easy to find someone to blame but this is deeply corrosive to teamwork and relationships.

Poor relationships are also a cause of stress. On the flip side, good teamwork helps create good support at work, which helps build resilience against stress. Another way of generating positive energy is to look for and acknowledge successes, even small ones.

There are numerous instances of individuals arriving early, staying late and generally going the extra mile. It is important to recognise these invaluable contributions and to constantly and routinely thank staff.

It is also important as an employer to show that you are concerned about staff welfare so it is vital to have a regular, senior presence on the ‘shop floor’. This also creates the opportunity to listen to staff and ask for their suggestions on what can be done to improve the situation and to improve their health and wellbeing at work.

Free guide: The Absenteeism Report 2018: Causes, consequences and cures

It’s clear that in the research and learning that has already happened in the NHS that connects to the issue of absenteeism, there is much to learn for all sectors.

For further insight into the issue of absenteeism, see our extensive, and free to download, report –  The Absenteeism Report 2018: Causes, consequences and cures.

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