As the UK’s largest employer, the health of NHS staff is the ultimate measure of the service’s operational health.
Here at Stribe, we work with healthcare sector businesses to understand the pressures and opportunities for both employers and employees, because we believe that understanding the state of employee wellbeing is absolutely imperative to making positive organisational change.
We’ve just completed a review of 15 years of NHS sickness absence rates, looking at absence across healthcare Integrated Care Systems (ICS) while also digging deeper into what employees themselves say is affecting their workplace happiness and culture.
While the acute crisis of the pandemic has thankfully passed, our data reveals a disturbing new reality, where staff sickness has settled at a substantially higher baseline.
This suggests a sustained, worsening challenge in health and attendance that demands a strategic and targeted response focused on supporting people.
For a long time, the NHS staff sickness calendar was entirely predictable. You’d see a big peak in the cold winter months, especially in January, due to seasonal bugs, and a clear dip to the lowest point in the summer, often in May.
This all changed in 2020. The established pattern was shattered and the sickness rate jumped sharply from 4.51% in February to 6.20% in April. This massive, non-seasonal spike is a clear sign of the pandemic impact on the frontline workforce.
Interestingly, though, the absolute highest sickness rate in the entire dataset wasn’t in 2020 at all. It was a staggering 6.72% in January 2022, which coincided with the peak of the highly infectious Omicron variant wave.
We have to face a worrying new reality, staff sickness hasn’t gone back to normal, it’s settled at a much higher baseline.
This is a sustained challenge that highlights worsening employee wellbeing.
If we look at the period from mid-2023 to the most recently published data in May 2025, a worrying pattern emerges, where the year-on-year sickness rate is almost consistently above the zero line.
This shows a changing trend, seeing the sickness rate for almost every month in 2024 and 2025 is higher than the corresponding month in the previous year.
The sickness rates have not returned to pre-2020 levels.
For example, May 2017 saw a rate of 3.84% but May 2024 was 4.71%. This confirms a long-term upward trend that we must accept as the “New Normal” baseline, a baseline that is nearly a full percentage point higher than a decade ago.
National averages only tell half the story.
The pressure across the service is wildly uneven, demanding that we target resources where staff are struggling the most.
The London Ambulance Service NHS Trust (LAS) is a prime example of this crisis. They stand out with the highest and most consistently elevated sickness absence rate in the country.
Even before the pandemic, their baseline was routinely high (5.0% to 6.5%). Then they hit an almost unthinkable peak of 10.94% in May 2020, the highest recorded rate in our data, illustrating the stress on emergency staff.
Worryingly, their rates remain exceptionally high post-pandemic, sitting at 6.1% in May 2025. The LAS appears to be operating in a state of chronic stress and under-capacity, and for 2025 planning, they represent a significant operational risk.
They simply cannot recover without aggressive, targeted retention and staff wellbeing drives.
The data from 2023–2025 also shows a clear geographical split in sickness absence, highlighting a disparity between the northern/central regions and the South East of England.
In May 2025, the highest sickness rates were in the North West (5.5%) and the Midlands. In stark contrast, London and the South East reported the lowest rates, both at 4.2%. This suggests that whatever post-pandemic factors are driving sickness, be they workload-related, socio-economic or environmental, they are hitting Northern and Central regions disproportionately harder than the South.
When we look at why staff are off sick, the answer is clear, concerning and has escalated significantly.
Anxiety, stress, depression and other psychiatric illnesses was the most reported reason for sickness in May 2025, accounting for over 608,100 full-time equivalent days lost across the NHS and 28.6% of all sickness absence.
This is an increase from the previous month and underscores that the main driver of absence is psychological strain.
We see this strain visible in specific sectors, too.
Mental Health Trusts consistently have higher sickness baselines (4.0% to 5.0%) than large acute trusts (like Guy’s and St Thomas’, which were around 3.0% to 3.8% pre-pandemic). The danger is that the new, higher sickness plateau for many services is at risk of hardening into the chronic, sustained rates already seen in the Ambulance and Mental Health sectors.
Recent initiatives appear to be paying off in retention, with fewer people leaving the NHS.
In the 12 months leading up to September 2024, only 1 in 10 (10.1%) hospital and community healthcare workers left the NHS.
While this is still a high number, it marks a definite improvement from the same period in 2022, when 1 in 8 (12.5%) staff members left the service, suggesting a two-year retention programme has had a positive effect.
Crucially, the quality of management is clearly acting as a protective factor for staff wellbeing. A strong 73% of workers agreed that their immediate manager is interested in listening to them.
Even better, 70% said their immediate manager works with them to come to an understanding of problems. This measure shows particular improvement among key groups like Ambulance staff, having increased by over nine percentage points since 2021, a hopeful sign, given the pressure these teams are under.
However, despite those pockets of managerial success, staff feedback also shines a light on some serious, deep-seated issues that are undermining employee wellbeing.
One major problem is unpaid work. It is not the younger workers who are averse to long hours, in fact, it is the staff aged 41 to 65 who are doing the most unpaid work. This reveals a high-stakes reliance on mid-career staff who are increasingly prone to burnout.
Another stark issue is fairness. Only 56% of staff felt their organisation acted fairly with regard to career progression or promotion, regardless of ethnic background, gender, religion, sexual orientation, disability or age. This exceptionally low metric points to a significant failure in the equitable management of talent within the organisation.
The age of one-size-fits-all wellbeing initiatives must end. Our analysis of the sickness data provides a clear mandate for aggressive, targeted interventions.
The challenges faced by the LAS (chronic, sustained high absence) are fundamentally different from those of an Acute Trust (which shows a stronger capacity to manage routine absence).
The “New Normal” sickness baseline is here to stay unless organisations start introducing change. Some positive changes could include:
We have the data to prove that the problem isn’t temporary, it’s systemic.
The next step is using real-time employee insights to build resilience from the ground up and finally turn the tide on the NHS’s chronic sickness crisis.
If you’re looking for better ways to improve employee relations, take a look at our employee engagement products.
