NHS leavers during the pandemic and number of staff infected with COVID

Dr Minh Alexander retired consultant psychiatrist 17 December 2022

NHS WORKFORCE SHORTAGE

There is currently a serious NHS workforce shortage.

The most recent NHS Digital statistics show an overall vacancy rate of 9.7% and a total of 133,446 vacancies.

The NHS is short of 47,496 nurses and 9,053 doctors.

London has the highest vacancy rate, of 12.9%. Mental health services in London have a vacancy rate of 16.5%.

      

NHS LEAVERS DATA

There is limited transparency on how COVID has affected NHS staff.

I asked NHS Digital for data on all reasons for staff leaving the NHS, as some of these parameters may reflect poorer staff health.

This is data from NHS Digital for all reasons for leaving, across different NHS staff groups, which spans three years before the pandemic, up to Quarter 1 of 2022/23:

NHS Digital FOI response 15 December 2022

The data is drawn from the NHS electronic staff record.

The health-related elements of this NHS leavers data are summarised below.

This leavers data raises questions about the effects of the pandemic on the NHS workforce, that can only be fully answered with more detailed, direct enquiry.

DEATHS IN SERVICE

Unsurprisingly, according to the NHS Digital data, reported deaths in service increased during the pandemic.

Period	Reason for leaving	All staff groups
2017-18	Death in Service	920
2018-19	Death in Service	900
2019-20	Death in Service	985
2020-21	Death in Service	1,425
2021-22	Death in Service	1,225
2022-23 Q1	Death in Service	295

Alongside this, ONS 2020 data on COVID deaths by occupation listed 414 COVID deaths in health care workers between 9 March and 28 December 2020.

Disappointingly, a January 2022 ONS FOI response by ONS revealed that ONS holds no data for 2021 on COVID deaths by occupation:

“Unfortunately, we do not hold mortality analysis for 2021 which includes details of

occupation.”

In the first year of the pandemic, all NHS staff deaths in service broke down by staff group as follows:

NHS Staff Group	Number of deaths in service in 2020/21
HCHS Doctors	70
Nurses & health visitors	290
Midwives	15
Ambulance staff	20
Scientific, therapeutic & technical staff	105
Support to doctors, nurses & midwives	430
Support to ambulance staff	45
Support to ST&T staff	75
Central functions	145
Hotel, property & estates	200
Senior managers	10
Managers	20
Other staff or those with unknown classification	5

ONS data reported the following COVID deaths for some clinical staff groups, in the period March to December 2020:

Staff group	Deaths involving COVID-19
Medical practitioners	35
Psychologists	2
Pharmacists	6
Ophthalmic opticians	1
Dental practitioners	2
Medical radiographers	5
Podiatrists	1
Health professionals n.e.c.	4
Physiotherapists	1
Occupational therapists	2
Speech and language therapists	0
Therapy professionals n.e.c.	2
Nurses	157
Midwives	9

DISMISSAL UNDER CAPABILITY

These dismissals theoretically may include incapability due to ill health issues.

NHS incapability dismissals have dropped during the pandemic.

If incapability proceedings are in train regarding staff affected by COVID, they may not have concluded yet.

It is also possible that there were fewer dismissals under other types of incapability proceedings, due to the NHS workforce shortage and severe service pressures.

Period	Reason for leaving	All NHS staff groups
2017-18	Dismissal – Capability	2,740
2018-19	Dismissal – Capability	2,635
2019-20	Dismissal – Capability	2,470
2020-21	Dismissal – Capability	1,965
2021-22	Dismissal – Capability	2,075
2022-23 Q1	Dismissal – Capability	550

RETIREMENT – ILL HEALTH

There has been a slight increase in NHS ill health retirements.

Period	Reason for leaving	All staff groups
2017-18	Retirement – Ill Health	1,235
2018-19	Retirement – Ill Health	1,175
2019-20	Retirement – Ill Health	1,140
2020-21	Retirement – Ill Health	1,240
2021-22	Retirement – Ill Health	1,355
2022-23 Q1	Retirement – Ill Health	340

VOLUNTARY RESIGNATION – HEALTH

There has been a rise in NHS voluntary resignations on health grounds.

Period	Reason for leaving	All NHS staff groups
2017-18	Voluntary Resignation – Health	4,225
2018-19	Voluntary Resignation – Health	4,475
2019-20	Voluntary Resignation – Health	5,040
2020-21	Voluntary Resignation – Health	5,105
2021-22	Voluntary Resignation – Health	7,070
2022-23 Q1	Voluntary Resignation – Health	1,845

It is also possible that COVID related issues may have contributed to other staff departures via other routes.

For example, there has been an increase in voluntary early retirements, without actuarial reduction.

VOLUNTARY EARLY RETIREMENT

Period	Reason for leaving	All NHS staff groups
2017-18	Voluntary Early Retirement – no Actuarial Reduction	1,290
2018-19	Voluntary Early Retirement – no Actuarial Reduction	1,305
2019-20	Voluntary Early Retirement – no Actuarial Reduction	1,250
2020-21	Voluntary Early Retirement – no Actuarial Reduction	1,260
2021-22	Voluntary Early Retirement – no Actuarial Reduction	1,595
2022-23 Q1	Voluntary Early Retirement – no Actuarial Reduction	370

NUMBER OF NHS STAFF INFECTED WITH COVID

An unprecedented study of the NHS workforce took place in 2020, in which NHS workers had blood tests for antibodies to the COVID virus (SARS-CoV-2), an indication that they had been infected by the virus.

National cross-sectional survey of 1.14 million NHS staff SARS-CoV-2 serology tests: a comparison of NHS staff with regional community seroconversion rates

The study took place before the national vaccination programme commenced, so any antibodies found would relate to infections and not vaccination.

The study gathered data between May and August 2020.

It found that 16.3% (186,897 of 1.14 million) NHS staff who participated tested positive for antibodies against Sars-CoV-2.

London NHS staff were the worst affected, with 23.9% testing positive for antibodies.

In April 2022 ONS estimated that about 70% of people in England had been infected with COVID-19, based on regular community sampling throughout the pandemic. This proactive sampling detected asymptomatically infected people, as well as the symptomatic.

How many NHS workers have now been infected?

How many NHS workers have been infected more than once?

Published NHS COVID sickness data focusses on productivity and is framed in terms of days lost.

NHS Digital publishes data on NHS FTE days lost to COVID related absence and absence rates across the NHS.

NHS England publishes related data on acute NHS trusts.

However, the actual numbers of staff known to be infected are not clearly given.

And yet it should be possible from the NHS Electronic Staff Record to tell how many staff are known to have been affected.

An FOI request made by the Guardian to acute NHS trusts in Spring 2021,  which only a proportion of trusts answered, revealed that at least 77,735 NHS staff in England were known to have caught the virus by that point.

The Guardian reported:

“Out of those trusts who responded, Frimley health trust in Surrey had the largest number of staff who caught the virus – 4,464 – followed by Guy’s and St Thomas’ in London (3,654) and University Hospitals Birmingham (2,554).”

Frimley Health NHS Foundation Trust has a workforce of about 10,000 staff   

Guy’s and St Thomas’ has a workforce of about 23,000,

Wales Online similarly received FOI responses from five out of seven Welsh health boards which showed that by May 2021, 18.2% of staff were known to have been infected with COVID-19.

An up to date FOI response from Great Western Hospitals NHS Foundation trust (acute), shows that a total of 3178 staff are known to have been infected with COVID-19. The distribution across different groups is as follows:

Staff Group	Number
Add Professional Scientific and Technical	79
Additional Clinical Services	827
Administrative and Clerical	534
Allied Health Professionals	226
Estates and Ancillary	58
Healthcare Scientists	84
Medical and Dental	157
Nursing and Midwifery Registered	1213
Total	3178

Great Western Hospitals has a workforce of about 6,000 staff.

RIDDOR reports provide another glimpse into the risks faced by NHS staff.

Health and Safety Executive COVID RIDDOR data shows that 27.7% (12,330 of 44,458)of COVID RIDDOR reports received between April 2020 and March 2022 related to ‘Human Health Activities’.

Of 459 fatal COVID RIDDOR reports in this period, 170 (37%) related to Human Health Activities.

But there are currently variable mitigations in place and no mask mandate in hospitals.

What long term effect will repeated exposure to COVID-19 have on the health of the NHS workforce?

It would be reassuring to see a more person centred approach, with central collation of data on numbers of affected staff and sequelae, and not just faceless productivity stats.

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