Nurses’ sickness absence and the role of the Bradford Factor
Attendance monitoring tool is used by some NHS employers but with workforce’s sickness rates high, do you worry about being penalised for having a high score?
Sickness rates are climbing in England’s NHS , and any absences you take are likely to be monitored by the human resources department. One of the most commonly used tools for monitoring staff absence is the Bradford Factor.
What is the Bradford Factor?
The Bradford Factor is a simple formula that allows employers to monitor short-term sickness absence, defined as lasting under four weeks.
It is a weighted system based on the fact that regular short absences are more difficult to deal with operationally than one longer absence.
Attendance monitoring tool is used by some NHS employers but with workforce’s sickness rates high, do you worry about being penalised for having a high score?
Sickness rates are climbing in England’s NHS, and any absences you take are likely to be monitored by the human resources department. One of the most commonly used tools for monitoring staff absence is the Bradford Factor.
What is the Bradford Factor?
The Bradford Factor is a simple formula that allows employers to monitor short-term sickness absence, defined as lasting under four weeks.
It is a weighted system based on the fact that regular short absences are more difficult to deal with operationally than one longer absence. For example, five absences of two days each are considered more problematic than one absence of ten days.
The tool was developed by Bradford University in the early 1980s and is popular in the private and public sectors. Employers use it as a trigger to address sickness absence with employees – either through support for the individual or even disciplinary procedures.
How is sickness absence calculated using the Bradford Factor?
The Bradford Factor is calculated using the formula S2 x D = B:
- S is the total number of separate absences
- D is the total number of days’ absence
- B is the Bradford Factor score
It is added up over the course of a defined period, normally one year. For example, ten days of absence could occur as:
- One absence of ten days which would have a Bradford Factor of 10 – (1x1) x 10
- Five absences of 2 days each which would have a Bradford Factor of 250 – (5x5) x 10
- Ten absences of 1 day each which would have a Bradford Factor of 1,000 – (10 x 10) x 10
Individual employers can set thresholds for certain interventions and trigger points at their own discretion. A common approach is to consider anything between 50 to 100 as a threshold for basic monitoring, with a score exceeding 200 to 250 as the point at which action may need to be considered.
Are there any drawbacks?
Unions and even some HR professionals have raised concerns about it being too blunt an instrument.
Unison is particularly critical, saying it is essentially used to impose limits on absence rather than helping staff overcome sickness or poor health. It says employers that use the Bradford Factor are accepting the idea that staff are untrustworthy and willing to ‘throw a sickie’ or have a ‘duvet day’.
The union is also concerned about the way it can penalise people with chronic and unpredictable conditions that can lead to bouts of absence, such as cancer.
This is something Chartered Institute of Personnel and Development has warned about too.
It says HR teams should beware of applying the Bradford Factor too rigidly, advocating flexibility in monitoring systems so that underlying health or disability-related reasons are recognised and recorded. It points out if this is not done, employers could be in breach of the 2010 Equality Act.
Sickness absence monitoring: what should nurses expect from employers in the NHS?
NHS Employers sickness absence toolkit makes clear staff should expect to be asked what the reason is for an absence, how long they will be off and if any work needs to be picked up in their absence. By doing this frequently, repeat absence can be avoided by ensuring appropriate services such as counselling, physiotherapy or occupational health support can be offered when appropriate.
The toolkit says employees should expect managers to discuss whether any extra support or adjustments are required too. For example, it says staff with caring responsibilities can ask for flexible working and maybe even special leave, while those with ongoing health conditions such as cancer can be granted time off, with the reasons accurately recorded.
How widely used is the Bradford Factor in the NHS?
It is unclear just how widespread the use of the Bradford Factor is in the NHS or wider economy for that matter.
Some published HR policies by NHS organisations make specific reference to it, while others merely say sickness absence is monitored but do not spell out how.
However, NHS Employers assistant director of development and employment Jennifer Gardner believes there is a definite shift away from tools like the Bradford Factor. ‘Many employers across the NHS are moving away from sickness absence triggers to a more person-centre approach,’ she says.
This involves proactive ‘supportive conversations’, where absence is discussed at an early stage and bespoke support put in place, she adds.
Bradford Factor: blunt instrument, or a safeguard of fairness?
NHS HR leaders on either side of the debate explain their organisations’ approaches to sickness absence monitoring
‘It’s considered unfair’
Rotherham, Doncaster and South Humber NHS Trust is in the process of scrapping the Bradford Factor.
Executive director for people and organisational development Nicola McIntosh says the trust is consulting unions about a new sickness absence policy.
‘We are proposing to no longer use the Bradford Factor as we appreciate this method could be considered unfair to people with a health condition,’ she explains.
‘It ensures consistency’
Solent NHS Trust uses the Bradford Factor as part of its approach to managing sickness.
The organisation’s 2022 staff survey showed almost three-quarters of staff feel the trust takes positive action on health and well-being and would recommend it as a place to work – both of which are scores above the national average.
Trust chief people officer Shahana Ramsden says the key is to engage staff and talk to them about their individual situations when the Bradford Factor flags problematic absence.
But she adds the tool has an important role, helping ensure ‘consistency and fairness’ to all staff.
Further information
- NHS Digital (2023) NHS sickness absence rates, December 2022
- Bradford Factor
- NHS Employers (2014) Sickness absence toolkit
- RCN (2021) RCN employment survey
- Unison – Sickness absence – the Bradford Factor