The 'Better care, Better Value' indicators are an important step forward. The sickness absence rate in the NHS has never been below 4.5 per cent in the past decade. Despite investment to 'improve working lives' and the health of NHS employees it has remained resistant to change in almost all trusts.

The 'Better care, Better Value' indicators are an important step forward. The sickness absence rate in the NHS has never been below 4.5 per cent in the past decade. Despite investment to 'improve working lives' and the health of NHS employees it has remained resistant to change in almost all trusts.

A quick review of the new indicators for acute trust suggests that absence data is not available from 14 of the 135 trusts. Six trusts report an absence rate of 0 per cent in April and May - not a single employee absent.

A further 47 trusts report a rate below 2 per cent (which is lower than any non-specialist acute trust achieved in 2004 when the last national data was published). The data for absence is not yet sufficiently reliable and precision needs to improve.

Although sickness absence is only one of the indicators it has great importance - improvements to patient care and other savings are dependent on healthy people being at work to deliver them. Absence rates in other large public employers are being reduced by first-rate occupational health but not yet in the NHS.

It is noteworthy, and a pity, that improved attendance is not included in the£2.2bn savings. The cost of absence is considerable both in terms of hundreds of millions of pounds of lost salary, agency costs, pressure on co-workers, and above all disruption to patient care. We have long since forgotten the 30 per cent absence reduction target set in 1998 - is it time to recall this and deliver it?

Richard Preece,
Business development director,
Atos Origin Occupational Health