BMA warns that without further measures, NHS could face almost 50,000 staff off sick with Covid-19 by Christmas Day

Press release from the BMA

Location: England
Last reviewed: 18 December 2021
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There could be almost 50,000 doctors, nurses and other NHS staff in England off sick with Covid-19 by Christmas Day, if the Government fails to introduce any further measures1 to stop the spread of the virus, the BMA warns today. This would have a devastating impact on the ability of the health service to provide even the most urgent care.

Based on an analysis2 of current case numbers and trends, and applying these to the total NHS workforce in England, even in the best case scenario, the BMA estimates that more than 32,000 staff could be off sick with the virus on 25 December, having tested positive in the 10 days before. In the worst case scenario, almost 100,000 more than this could be affected – with more than 130,000, or almost 1 in 10 staff, off sick. This also does not take account of additional staff who would be self-isolating due to being a household contact of someone with Covid-19.

To avoid such extreme workforce shortages that would severely limit the health service’s ability to guarantee care to patients both with Covid-19 and with other equally serious conditions, the BMA says the Westminster Government must now introduce further measures, above and beyond its Booster strategy, to stem the spread of the virus – including reducing levels of social contact.

Dr Chaand Nagpaul, BMA council chair, said:

“After almost two years into the pandemic, no one wants to introduce further measures limiting what people are able to do, especially at this time of year, but these stark figures on levels of NHS staff absence show the devastating consequences of what could happen if the virus is left to continue spreading at the current rate.

“The Booster rollout is incredibly important, but with daily cases on Thursday more than three times higher than the same date last year, the Westminster government’s strategy of relying solely on vaccinations is not enough, is poor public health practice and is already causing preventable harm not only to the NHS but also to education and the economy.

“The reality is that MPs have broken up for Christmas leaving the NHS brutally exposed to suffer the consequences of surging case rates and without the restrictions needed to bring these under control.

“Amid the surging case-rate, driven by the hugely transmissible Omicron variant, doctors are not only incredibly worried about the potential impact this could have on hospitalisations, but also about what it would mean for patient care across the NHS if we have vast swathes of staff off sick with the virus.

“We’re already seeing services being affected by staff absences, and these estimates show it could get far, far worse. Without enough staff, appointments and treatments will need to be cancelled or postponed, and waits for care in both GP surgeries and hospitals, will rise even further, compromising the level of care remaining staff can offer. This is not to mention the impact it could have on the NHS’s capacity to deliver the Booster programme itself.

“If our estimates of staff absence are realised – which we honestly hope they are not – this would be truly devastating, leading to an inability to provide even some of the most urgent services.

“But hope alone will not change the trajectory of the pandemic, which is why we need action now. As doctors, it is our moral duty to protect patients’ lives, and therefore speak out when they are put at risk.

“The Government should recall MPs next week to give the NHS the protections it needs. These would mean cancelling large indoor gatherings, re-introduction of the two-metre social distancing rule and sending a strong message to the public to limit social mixing, especially ahead of Christmas when we know people will want to see their families and loved ones.

“There should also be clearer messaging to take a lateral flow tests before mixing, in addition to mask-wearing, distancing and ensuring adequate ventilation for gatherings.

“Additionally, we believe that the Government should provide financial support to businesses affected by additional restrictions, so that employers and staff do not suffer detriment in contributing to the national effort to contain the virus.

“Without targeted action, infection rates will continue to rise to unprecedented levels. We need action now to prevent a new lockdown becoming the only way to protect the health service from being overwhelmed.

“The NHS is not just an acronym, but a life-saving service made up of dedicated , hard-working and loyal staff – and without these people, it fails in that most basic function, and the consequences do not bear thinking about.”


Notes to editors

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

  1. The BMA is calling for:
    - Limits to social mixing and reducing contacts between households, such as those being recommended in Scotland;
    - Cancellation of large social gatherings;
    - Better protection for healthcare workers – including the clear recommendation and supply of high-grade FFP3 masks for staff coming into contact with suspected or confirmed Covid-19 cases, and FFP2 masks for all other patient-facing staff;
    - Mask wearing in all indoor public settings, including hospitality settings when people are not eating or drinking;
    - Reintroduction of social distancing;
    - The introduction of ventilation standards in public venues;
    - Re-introduction of universal mask wearing and social distancing in schools;
    - Negative lateral flow test results to be a requirement in Covid certification – rather than double-vaccination, given the Government’s own admission that two doses of vaccine are not enough to protect against Omicron;
    - Financial support for businesses and individuals impacted by any new measures.
  2. Methodology:
    - The BMA has calculated staff on leave by Christmas day by applying case rates in the wider UK population to the NHS workforce in England. Isolation rules require staff to self-isolate for a period of 10 full days from a positive test, so we accumulate all those with a positive test from the 15th December until Christmas day to give the total number of NHS staff off sick due to COVID on Christmas day.
    - We use the most recent three-day average case rates for both the 15th and 16th December, and then forecast case rates forward based on doubling rate assumptions as below. Although isolation occurs from the date of positive test rather than date reported, data is not yet available on date of test in recent days (as it comes with a week’s lag) and we consider this to be a reasonable proxy for daily rates of initial isolation. We use data for the UK because data for England is again only available with a lag, but reports suggest that rates in England are higher than the UK average, so this is a conservative assumption.
    - We consider three key scenarios, based on variation in number of days for COVID doubling rate, and whether healthcare staff are just as or less likely than the general population to test positive. On the one hand, healthcare staff are more highly vaccinated, but on the other they are more exposed to the virus and they are more likely to be compliant with testing and therefore the need to isolate.
    o Best case scenario – case rates double every 4 days, rates of infection in healthcare staff are 75% of UK population: 32,960 staff of sick
    o Middle scenario – case rates double every 3 days, rates of infection in healthcare staff are 75% of UK population: 46,307 staff off sick
    o Worst case scenario - case rates double every 2 days, rates of infection in healthcare staff are the same as the UK population: 130,631 staff off sick
    - We use the most recent data on the total headcount of healthcare staff in England, combining headcount data on NHS Hospital and Community Health Services in England and headcount data for General Medical Practice staff, and 2021 population projections for the UK.
    - Staff numbers are rounded to the nearest 1,000.
  3. Further data available here.