How much is staff absence costing the NHS?

Sickness absence within NHS England has been rising. But what’s the cost to the average NHS trust – and what can HR leaders do to bring their costs down?

NHS England’s most recently reported data from February 2026 shows a sickness absence rate of 5.4% across NHS England, down slightly since January 2026 (5.7%) and is slightly higher than February 2025 (5.3%). A decade ago the rate stood at 3.98% — the steady upward trend since then is hard to ignore.

The financial impact of sickness absence within NHS England is significant, especially when looking at mental health-related absences.

The financial implication of staff absence

The latest NHS financial sustainability (2024-2025) report shows that NHS’s financial position continues to worsen. They highlighted that local NHS systems overspent by around £1.4 billion in 2023–24 – more than twice the amount from the previous year – driven by increasing demand, underinvestment in facilities, inflationary pressures, and workforce challenges.

A 2024 study from the National Library of Medicine (operated by the United States federal government) suggested that sickness absenteeism costs the NHS approximately £2.4 billion per year, or £1 in every £40 of the total NHS budget.

It was also noted by the study that presenteeism was a persistent issue within the NHS, with 44% of NHS staff in 2020 reporting pressure to attend work when feeling unwell. This is despite a global pandemic putting an unprecedented level of strain on the workforce.

And although it is difficult to estimate the exact cost savings that could be achieved by improved management of sickness absences in the NHS alone, the Government’s Keep Britain Working: Technical Note estimates that the costs of ill-health of the whole country add up to around £85 billion.

With the Employment Rights Act introducing a day-one entitlement to Statutory Sick Pay (SSP) and removing the lower earnings threshold, the cost of absence for employers – including the NHS – is likely to increase.

Here’s the good news. There are practical steps NHS trusts can take to address absence – and by doing so, improve productivity and patient experience.

So, how do you drive down absence rates? With the right combination of outsourced expertise and technology support.

Empower NHS line managers

People managers are the front line of HR. If the NHS is to reduce the incidence and cost of absenteeism, managers need to be capable and confident in handling absence – and that starts before a case escalates.

When managers are uncertain about what to say or do, they often delay addressing an absence issue until it has already become a more serious problem. This is particularly true for mental health-related absence, which accounts for around 15% of all sickness absence in the UK workforce and continues to rise within the NHS. Research highlights employees feeling a lack of support from their manager or employer (45%) as a significant contributing factor.

Establishing a formal absence management process matters — but it isn’t enough on its own. Managers need to understand how to apply it, feel confident doing so, and have access to timely, expert support when cases become complex.

Our research into HR leader priorities confirms that manager capability gaps are already impacting absence rates. Closing those gaps – through structured training and systems that guide decision-making – is one of the highest-impact actions an NHS trust can take.

Take a proactive, data-driven approach

Reactive absence management is costly and by the time a case reaches formal stages, the human and financial impact has often already taken hold.

A more effective model is one where managers are prompted to act at the right moment – whether that’s a welcome-back conversation, an early wellbeing check-in, or escalating a complex case for specialist support. This kind of structured, consistent approach reduces recurring short-term absence and creates the conditions for honest, supportive conversations that help employees return to work sooner.

Underpinning this all is robust data and the analytics to turn it into actionable insights. NHS trusts need technology that captures the right absence data, identifies root causes – whether workload pressure, team culture, or leadership gaps – and enables HR to build evidence-based wellbeing strategies. Visibility of absence patterns across a trust also allows resources to be targeted where they’ll have the greatest effect.

Solutions like empower®, our employee relations case management tool, provide HR leaders with the means to make data-driven decisions and empower managers to handle more ER cases.

What good absence management delivers

The impact of getting this right is significant. Starbucks UK achieved a 10% reduction in absence within 12 months, returning 15,000 hours to frontline services, by empowering managers to self-serve routine people matters, backed by an expert, outsourced HR Advice Line and the insights from empower®.

For an NHS trust, that kind of reduction translates directly into staff wellbeing, capacity and patient experience.

Practical steps for NHS HR leaders

With the changes to SSP under the Employment Rights Act now in force, the cost of absence will only increase if left unmanaged – now is the time to act. Key priorities need to include:

• Reviewing absence and SSP policies to reflect the new legislative position
• Benchmarking current absence rates so you can measure the impact of day-one SSP on short-term absence patterns
• Building manager confidence through clear training and guided processes
• Investing in technology that captures the right data and prompts timely action

Our HR consultancy team can help NHS trusts identify gaps in policies, processes and data to manage absence more effectively. Get in touch to discuss how we can support your trust.