Preventing Absence: Supporting an NHS Nurse Before Sick Leave

The Situation

Priya, a registered ward nurse with twelve years' service, was visibly struggling — fatigue, dropped concentration in handovers, tearful in private conversations with her ward manager — but had not yet been signed off. Her manager wanted to intervene before sick leave became inevitable, both for Priya's wellbeing and because the ward was already stretched on staffing. The Trust's occupational health service had a six-week wait for non-urgent referrals.

The Challenge

• Priya was reluctant to admit she was struggling and worried about being seen as 'not coping'
• The ward could not absorb another absence in the short term
• Internal occupational health had a long wait that the manager judged unacceptable
• There was no clear single trigger — concerns were cumulative, not acute

Our Approach

A pre-emptive remote assessment was commissioned. The clinician — an OT with occupational health experience — carried out the assessment in confidence, focusing on functional capacity, sustainable workload, and the specific stressors of Priya's role. The framing throughout was supportive rather than performance-based: 'what do you need in place to stay well in this job?' rather than 'are you fit for it?'

What We Recommended

The Outcome

• Priya took no sick leave in the six months following the assessment
• Subjective wellbeing measures improved at the three-month follow-up
• The ward avoided an estimated 4–8 weeks of replacement staffing costs
• Two colleagues subsequently self-referred for early-intervention assessments before reaching crisis
• The Trust has begun piloting Return Well for pre-emptive referrals as well as post-absence

Key Takeaway