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National Patient Safety Agency

New guidelines to help NHS staff get quick confidential healthcare

5 March 2010


New guidelines for frontline services have today been published to help clinicians with health problems get prompt help without fear or stigma.


Invisible Patients sets out how organisations can ensure they support their workforce and build healthy workplaces for clinical professionals.  Its recommendations are based on evidence reviewed for the full Health of Health Professionals report as well as best practice within healthcare organisations across the UK.


Invisible Patients identifies the need for healthcare organisations and individual practitioners to prevent and manage ill health and for specialist services to be created to treat those small numbers of sick health professionals.


Welcoming the report, Professor Sir Liam Donaldson, Chief Medical Officer for England, said:  “This report highlights the fact that those who provide essential healthcare services can themselves develop health problems.  Most importantly, it provides a framework and recommendations to address these problems.

“I would encourage all healthcare organisations to use this report to aid them in developing systems that will help improve the health of health professionals and foster a healthy workplace where safe and high quality care can be delivered to patients."


Professor Alastair Scotland, chair of the Health of Health Professionals’ Working Group which produced today’s report, explained: “Staff within the NHS make up the largest group of patients it serves. 


“However, health professionals are often reluctant or find it difficult to seek help for their health problems.  This is often because they feel they are letting their patients and colleagues down, or because of practical reasons such as workload or even fear of being stigmatised. 

“Ill health in clinicians and health professionals may remain hidden, leading to worsening of their condition and even to possible adverse effects on the quality of care provided to their patients.


“Today’s framework calls on organisations to ensure seven key recommendations are implemented.  These point to how the current gaps in service provision, knowledge, processes and the evidence base can be filled.”


Invisible Patients acknowledges higher rates of depression, anxiety and substance misuse in health professionals than in other groups of workers due to heavy workloads and the emotional demands of treating patients.  Sometimes these go un-noticed and when they are, often the individual needs of the practitioner patient are not met.


In addition, the framework recognises current levels of sickness absence in the NHS amount to 10 million lost days – the equivalent of 4.5 per cent of the entire workforce costing the NHS around £1.7 billion.  However presenteeism – coming to work and performing at less than full capacity as a result of ill health – has been estimated to cost one and a half times this amount.


Dr Anna van der Gaag, President of the Health Professions Council (HPC), said:  “I believe this report makes a helpful contribution to enhancing patient safety across the health care sector.  


“Maintaining good health amongst health professionals is an important part of maintaining patient safety.  Regulators also have a key role to play in promoting greater clarity and consistency in their guidance in this area.


“Finally, I welcome the call for more research to increase our understanding of ill health amongst health professionals and its consequences for our service to patients.”


Gail Adams, Head of Nursing at UNISON, said: “It is sad that nurses and other healthcare professionals spend their lives looking after others, but are often the last to get help when they need it.  This timely report recognises the difficulty many face asking for help with alcohol or drug dependency or with mental health problems.

"It’s essential that the service works to implement all of the report's
recommendations urgently.  We need to make sure staff do get support and
access to independent advice, if they become unwell.”


For a full copy of the report, please visit Invisible Patients



Note to editors:


Seven recommendations from the framework that seek to improve the health of health professionals are listed below:


  • Prompt access to GPs and occupational physicians with enhanced skills and to confidential specialist assessment/treatment services;
  • Occupational health services should be strengthened and accredited with appropriately trained staff and adequate funding;
  • Maintaining good health and how to cope will ill health should become an integral component of the undergraduate and postgraduate curriculum for all professional groups;
  • A review should be undertaken of how heath information about sick health professionals could be shared among organisations and managed appropriately to ensure continuing care;
  • The nine health profession regulators to consider how they might adopt a consistent approach in relation to health and to fitness to practise;
  • Procedures for revalidation of each health professional should set out clearly how concerns about how health matters should be handled when these may impact on impact on fitness to practise;
  • Long term studies should be carried out to look at the health and wellbeing of different groups of health professionals in different health care settings.



1.       Media enquiries to the NPSA Press Office:

Simon Morgan – 020 7927 9580 / simon.morgan@npsa.nhs.uk or Dominic Stevenson – 020 7927 9351 / dominic.stevenson@npsa.nhs.uk



2.      The National Clinical Assessment Service (NCAS) was set up in 2001 and, since 2005, has been a division of the National Patient Safety Agency (NPSA).


NCAS provides advice, support and formal assessment in respect of doctors, dentists and, since April 2009 following recommendations in the White Paper Trust, Assurance and Safety, pharmacists.


NCAS provides its services to healthcare professionals throughout the UK, to the NHS, the independent sector and Defence Medical Services, and to the Isle of Man, Channel Islands and Gibraltar.



3.        The NPSA is an Arm’s Length Body of the Department of Health. It encompasses three divisions; the National Research Ethics Service, the National Reporting and Learning Service and the National Clinical Assessment Service. Each has its own sphere of expertise to improve patient outcomes. The NPSA’s vision is to lead and contribute to improved, safe patient care by informing, supporting and influencing healthcare individuals and organisations. For more information visit: www.npsa.nhs.uk.