I was surprised to see myself in the news yesterday. Apparently I'm fat and lazy and I should really pull myself together. This, at least, is how the findings of Dr Steve Boorman's report on the health and wellbeing of NHS staff were presented, and it is likely that this is how they will enter the popular consciousness. In fairness to my colleagues, I would like to add a little balance.
First of all, the good doctor is dismayed to learn that NHS staff smoke just as much as the general adult population. Other people know it's bad for them too – it doesn't stop them. Why should we be different? He also flatly refuses to believe that a mere 3% of us drink more than 21 units per week. He may be correct to do so, but this selectiveness with the evidence is a little worrying.
He has not calculated rates of obesity in NHS workers independently but chooses to agree with a Department of Health estimate of over 300,000, out of a total of about 1.4 million. This is a little over 20%, but for that to be meaningful it needs to be compared to the general population. In 2006, 24% of adults in England were classified as obese. So there hardly seems to be much difference between NHS staff and the population as a whole.
If you also bear in mind that not all NHS workers are health professionals – we have engineers, electricians, porters, laundry staff, who we would not expect to be "health ambassadors" – these statistics lose their sting somewhat. We're not much different to everyone else – 1.4 million people in a huge diversity of professions? We're grouped by our employer, not by who and what we are.
A problem that greatly concerns Boorman is absenteeism – and how much it costs. A whopping 45,000 of us are absent every day. It sounds dreadful so stated, but the NHS is the biggest single employer in Europe. More meaningfully, the figure is 10.7 days' sickness absence per worker per year.
The private sector as a whole performs far better at 6.4 days. It was 7.2 days in the previous year, which suggests to me that job insecurity in times of recession is a factor, but this doesn't seem to have been taken into account. Anyhow, this is thought to be a reasonable and meaningful comparison and it has been made much of in headlines. Now, this really shouldn't need saying, but NHS staff are in frequent close contact with sick people. We catch things from them.
NHS staff also compare "unfavourably with staff in government departments". True, the Department of Health manages a breezy 6.4 days per year, but the Home Office is comparable at 10.5 days and Work and Pensions scores 11.1. Overall, the NHS rates are said to be "well above the average for the public sector as a whole (9.7 days)". One day is "well above"? Considering that we work in the presence of disease, perform difficult lifting tasks and face attacks from the public, I think we cope quite well – although it is fair to mention that we are spared the dangers of paper cuts and health problems associated with sitting at a desk for our entire working day.
But I confess that I haven't been doing my bit to help. I was ill recently. I work quite intensively with a small group of patients who have very poor general health and suffer from frequent infections. A nasty chest infection was going around and I copped it squarely. I spent two days at work with a temperature of about 38.5 degrees, before being cast out by colleagues who sensibly identified me as a risk to their own health. I was ill – symptomatic and/or taking medication – for three weeks, but I took only eight working days off sick. (This is known as presenteeism, apparently.) I was trying to avoid taking too much time off, so that I wouldn't be sent to occupational health.
The logic is impeccable. Staff morale is valued by my employer, which wants to empower me. A key indicator for staff morale is attendance. Therefore there is a strategy to improve attendance rates through close monitoring and return-to-work interviews with managers. Success will be measured by a fall in absenteeism, with targets duly set.
Because I'd had eight days off, an appointment was made for me to see an occupational health nurse. It feels like going to the headmaster's office, but she was very nice about it all. She wrote to my manager to confirm that I was fit to continue with my duties and off I went. I'm not certain I can say that the experience was terribly empowering, but perhaps that will come with time. I can say that I will continue to avoid taking sick time, however I feel. And if my attendance is good, my morale must be good too, right? Job done.
Boorman may disapprove of our fecklessness, but unlike the impression you might get from the media, he reserves his main criticism for our employer. Drawing a link between staff health and outcomes for patients, he urges the NHS to make meaningful investment in our wellbeing, describing it as "ironic" that its public health agenda is not "available to its own staff". So I should be relieved to learn that Boorman has called for board-level leads to "drive forward" strategies to help me to exercise more, drink less (or at least more honestly) and to have a more positive mental outlook. To support this, performance will be measured and hospitals will be fined for failure to meet key standards. It sounds like just what I need.
