Why is it so hard to get rid of NHS staff who take the pi** with sickness

[Danijane]

Just wondering why NHS trusts don't seem to get very firm on staff who take the piss with sickness leave?
I work on a busy admin team where staff often say "ill just go off sick if X happens..". Like going off sick (often longterm) is the solution to any problem at work.
Theres 1 girl on the team (single mum with no local family in UK) who goes off sick for several weeks every school holiday period. She's just done it again as her daughter finishes school this week. So that will be likely a couple of months off with "stress".
Another woman on the team who lives with her single mum daughter and 2 young grandkids also "gets sick" every school holiday and festive period, also for several weeks at a time. Her daughter works high power job including lots of travel.
Our manager recently said how nice it would be get time off over Xmas for a change and I asked why not book it then. She replied that she can't because the other senior on our team will be off sick... She always is off sick at Xmas but manager is frustrated as said can't do anything about it, even though it's a clear pattern.
How can this be the case? I mean why can't management do anything about persistent piss takers?
Is this an issue right across the NHS?

It's interesting how people claim that they are 'entitled' to sick leave, whilst totally ignoring the circumstances under which they have that entitlement (i.e. actually being genuinely sick).

You're entitled to maternity leave too, but only when you're actually having a baby - you can't just say that you're taking the ML that you're fully entitled to because you just happen to fancy a few months off!

I do think there must be something smarter that can be done. I have known more than one NHS employee who has exactly six months worth of stress every year or two, for which GPs write a 4-weekly sick note. Management get about 3 words to go on from Dr eg “stress at work” or “stress at home” plus whatever the employee chooses to say, employee may tell different stories to Dr, OH, HR, union and management.

Fit notes are meant to be able to say employee could cope with eg X hours/week or different/reduced duties but never do. GPs are too busy and overworked so NHS mgmt/OH/HR can’t contact them to discuss resolution/compare stories. But GPs suffer indirectly from tight NHS/public sector budgets being wasted on non-productivity. If we could eg get the GP to join each 4-weekly NHS long term sickness meeting for 10 minutes once stress lasts longer than 2-3 months with no work at all recommended on the fit note, I wonder if we’d see a reduction in NHS stress levels. Call it a multidisciplinary meeting. Or bring in a “stress nurse” working for primary care who does this and the sick notes and liaises with (at least public sector) employers and is empowered to say “time off doesn’t seem to be helping any more” or “let’s imagine your sick pay ended next week” or “do you think this is really the job for you” etc as well as referring/signposting to online CBT etc and reviewing the outcomes, and who is targeted to reduce the length of sickness episodes.

Or maybe the many GPs/MH nurses on here will have a better idea? Whose job is it to confront someone who is lying or exaggerating their stress levels because they’d rather not be at work? Is there something like heart rate/blood pressure we could objectively measure a persons level of stress by? Require employees off work with stress for months/on repeated occasions to wear an NHS smartwatch and record exercise and meditation and stress levels?!

I also think clearly separating stress associated with a grievance from other stress would be helpful for clarity of reporting, because it seems to be an accepted part of grievance procedures that employees go off with long term stress.

Honestly I’m normally quite a leftie and generous/forgiving person but it just seems so unfair for a generous sickness support system, which is so important for those with severe/terminal illness etc, to be abused by those brazen enough to do so.

Agree with this, 2 piss takers sacked in the last 6 months in my NHS dept.
Unfortunately it was a long time coming and a change in management that I think pushed these on.
To add, they were TOTAL piss takers who worked the system, at the point pf half pay at the 6 month mark, miraculously recovered to get into work for a week.. then off sick again, rinse & repeat.
Absolutely nothing wrong with them by all accounts. Openly admitting to colleagues that they were working the system.

All great points. In my experience it comes down to the point of a person who is not fulfilling their contract by maintaining reasonable attendance CAN be dismissed, even if it’s real sickness. It’s just that it rarely happens because if the work involved. At the trust I was manager at, they were very good and did dismiss people.

Thats not how it works, coming back in for a week does not restart the sick leave entitlement.

I was out last night, with some former colleagues, asked how the sick leave policy is working, in their opinion its gone from too lax to draconian, staff put on warnings for having repeat bouts of Covid, proven via testing, caught from patients, another nurse rang at home everyday to "prove" she is at home and not playing golf - she off work after being seriously attacked in AE.

13 Mar 2025 — 1 in 7 NHS staff (14.38%) experienced physical violence from patients, their relatives or other members of the public in 2024

What private sector organisations employees have that rate of physical assault?

It’s interesting that so many here are criticising the managers for not dealing with repeated and suspicious patterns of sickness in the NHS. Yet it is always the managers that are called wasteful and unnecessary when budgets are under scrutiny

The two are connected. Not managing absence is an expensive game in lots of ways. Either in covering the person that’s off, or in other team members becoming less productive, because they don’t see piss takers being dealt with. Dealing with poor performers and those with problematic absence should be their top priority.

When 1 in 7 are attacked and there aren't enough managers....

Perhaps dealing with the thuggery they experience and decent infection control should be a priority too?

But no, lets go for the employee instead.

I don’t disagree with you. There should be zero tolerance for abuse of NHS staff. (The nature of the Trust I worked for meant it was exceptionally rare, thankfully.)

Don’t forget that a large number of the staff with problematic absence aren’t patient facing.

The highest rates are among patient facing roles, according to the Nuffield trust.

But take admin, very low pay, often at/near NMW rates, poor/lack of management.

Look i'm not saying that sickness shouldn't be addressed, of course it should but i would look at the causes as well.

A two pronged approach.

Many posters just go for the worker, with some saying that staff shouldn't even be paid when off sick regardless.

Shit rolls downhill, When the patient facing staff are abused, they tend to take it out on everybody else as as human nature. So the receptionist gets it, Who then snaps at the admin staff

I’m not talking about low paid administrators.

Not just NHS. The magic words are 'mental health' .

Patient facing staff are more likely to catch viruses etc. Not an issue. Particularly post Covid where they would be encouraged not to come in coughing and sneezing as they would have previously.

We had some very high ranking staff who had been playing the game for years before I joined.

We actually revised our national sickness management policy under pressure from the unions who wanted the level of sickness absence brought down. By focussing on supporting staff to attend work, rather than mattering everyone that didn’t, we achieved both. Could evidence support given to problem non-attenders and progress them to attending or dismissal, and supported those that weren’t really ill, but felt the only option was to be off sick. 60% of our staff were female and 60% of them were between 40 and 60. The pressure on them (kids/grown up kids with kids/elderly parents/unwell spouses) plus the impact of menopause was completely unseen previously. By changing uniforms, installing air conditioning, adjusting shift patterns, allowing flexibility where we could, counselling, financial management support, menopause cafes, upslilling managers in good absence conversations (first call, ongoing comms at appropriate intervals, returns to work), a good relationship with the TU and occ health we managed to reduce absence significantly and identify those needing a stronger approach.

Well, as a tax payer who's never worked in the public sector this is all very depressing! Please all you PPs flagging problems managing such dreadful staff get your shit together - as a country we can't afford this level of inefficiency and ineptitude!

Hope you weren't banging pots for these "Dreadful staff"

In general persistent absence in state organisations is not tackled. Sometimes it’s obvious a staff member is genuinely unwell. There are always people who hardly work at all before they are off sick again. Of course managers must deal with this and it’s their job. It’s a leap to say there are too many managers but most behemoth employers have waste. Often it’s doing things in a slow inefficient way and not dealing with issues that might make working conditions better. All the time we hear that there’s not enough staff but too little effort is put into making sure work distribution is fair and that everyone works as a team. That means people letting down the team are spoken to. Possibly by senior nurses if that’s a better method.

One of the main problems is that because of persistent piss taking, then genuine staff are treated with judgement and aren’t always believed.

Toxic workplaces and poor management causes more sickness and low staffing levels and ridiculous and unachievable quotas and targets obviously increase stress. It’s a cycle.

TBH, I didn’t clap or bang pots or even stand on the doorstep. I thought that was all performative bullshit.

Like everyone else I was very grateful for NHS staff during the pandemic. But I was even more grateful for the shop workers who flogged into work to keep supplies going for all of us. And all the people in the chain behind them. I had special praise for our milkman.

And what do you do when it’s your manager doing it? My line manager was constantly off sick-I had no respect for her at all. I remember her isolating many times during Covid as she’d ’been In contact’ with someone. In reality, she was doing up her house.

In my trust, sickness was monitored by HR, line management did what the HR team told them to do.

Definitely sounds like a public sector problem. I work in the private sector and you’d be out of the door if you took that much sick, it would be noticed as a pattern and investigated.

On another note it’s no wonder that the public sector is failing in so many areas, it must be costing a fortune to pay all this sick pay regularly. I guarantee you if the NHS was run like the private sector and had to try and hit targets and please shareholders it wouldn’t be wasting half the money it does now. I don’t blame the people working in the public sector I blame the system for being set up so badly, sounds like it needs a big shake up judging by how many people are saying it’s a common problem.

I know a public sector worker who told me she planned to retire in four years “but really just three years and six months left as I’ll go off sick for six months, it’s what they owe me”.

absolute fuckwittery. She’s no good at her job either (I used to work with her) but the tools to manage her were frustratingly low.