Staff absence forecasts reveal ‘bleak picture’ for coming days

The number of NHS staff in London absent due to covid has more than doubled in four days, and one in three of the workforce would be absent by new year’s eve if the growth rate continues.

The rapid increase in recent days is set out by internal NHS monitoring figures seen by HSJ.

It comes amid growing concern about the impact of the omicron variant, particularly in London, in the coming days and weeks. Sajid Javid this morning said the impact on the NHS was uncertain and it was still possible it may be overwhelmed.

Covid-related absences in the capital increased 140 per cent from 1,926 on Sunday 12 December to 4,695 on Thursday 16 December (see chart left).

If the daily growth rate of around 20 per cent continued, one in 10 would be off for covid-related reasons by Christmas Day, and around one in three by New Year’s Eve.

As of Thursday 5.5 per cent of London NHS staff were absent — for both covid-related or other reasons — up from 3.8 per cent on Sunday. The rate on Thursday was last reached around the end of January, shortly after the peak of last winter’s covid wave.

NHS England medical director Steve Powis said in the Sunday Times that the absence rate in London by Christmas day could be as high as 20 per cent. London Mayor Sadiq Khan has declared a major incident, in large part because of absences in critical services.

Admissions of covid positive patients to London hospitals have risen 42 per cent in the last week, with the rate of growth accelerating every day. NHS leaders fear the the variant and its impact on families, carers and contacts threatens to undermine services even before the omicron wave peaks, expected sometime in January. 

The workforce is also being stretched by the requirement to staff a huge expansion in the covid vaccination campaign, which government has said is the “national mission” and the service’s main priority.

Although London is bearing the brunt of the Omicron wave, trusts around the country are drawing up plans to deal with a sharp jump in staff absence. One national NHS leader said he was working on the basis of 20 per cent staff absence, another added that 30 per cent was their worst case scenario.

One trust chief executive in the north of England told HSJ this morning: ”The modelling nationally and locally paints a pretty bleak picture. The trouble is it is based on assumptions that aren’t playing out in practice (at the moment!). [We are] watching the numbers creep up at the moment. We are at about 7 per cent [staff absence] but slowly rising.”

Asked about the data, NHS England pointed to guidance issued this week which asked trusts to prepare for workforce pressures, including to ”consider contingency options for significant staff absences to ensure essential services can be maintained”.

NHS England London said: “The Omicron variant is spreading rapidly in London and this is affecting all Londoners, including NHS staff, which is leading to higher levels of staff absence and teams are working hard to minimise any impact from this and to work flexibly during this time. Londoners should continue to seek healthcare when they need it and can help us by going to NHS111 online first when it’s not an emergency, or by speaking with a pharmacist for non-urgent advice.”

It said business continuity plans had been made for shortages and could include “mutual aid”, with less pressured trusts helping others.

The chief medical officer, Professor Chris Whitty, warned earlier this week of the prospect of “substantial” staffing gaps in coming weeks due to omicron absence.

Officials have since moved to relax isolation guidance for health and care staff — meaning they can go to work even if a member of their household has covid, as long as they have no symptoms and are testing negative — which it is hoped will help some services.

Government is under pressure to put more restrictions in place to prevent the spread of omicron, and reports today say plans are being prepared for potentially restricting indoor mixing and hospitality, but this has so far been resisted by ministers. 

Updated Sunday 19 December 2021.