NHS nurses are experiencing more sickness, including for anxiety and depression, than before the pandemic and face a tough winter that could impact patient care, nursing leaders have warned.

The Royal College of Nursing (RCN) analysed figures for staff sickness from before the pandemic and earlier this year, and found thousands of days lost to staff absence on already overstretched wards.

The NHS in England recorded over 18% more sick days among nurses and health visitors in May 2021 compared to May 2019 (73,209 more sick days).

The analysis showed staff are now more at risk of mental health problems, chest and respiratory problems and migraines than before the pandemic.

Since May 2019, the number of full-time equivalent (FTE) days lost for mental health reasons has increased by 31.4%, from 102,491 in 2019 to 134,669 in 2021.

Meanwhile, days lost due to chest and respiratory problems rose by 52.5% (from 10,949 to 16,696) and headaches or migraine rose by 51.9% (from 9,105 to 13,833).

Anxiety, stress or depression remains the most common reason for staff sickness.

As a proportion of all days lost, this has increased by 3.3% throughout the pandemic, from 25.5% in 2020 to 28.3% in 2021.

The RCN said the NHS is already suffering from widespread nursing vacancies in England and the health service could come under huge pressure if sickness absence rates rise, with an impact on patient care.

It argued nursing staff face a difficult winter in treating the backlog of NHS care, working on the flu and Covid booster vaccine programmes and dealing with the usual seasonal pressures, including an expected surge in flu patients.

On average, at least 5% of all nurses and health visitors were absent through sickness in January for the past five years, but last January (2021) almost 7% were ill.

The RCN wants ministers to be legally accountable for assessing the workforce requirements for the NHS and social care, and for workforce planning and supply.

RCN council chair Carol Popplestone said: “Even in a climate of widespread staff shortages, which governments have refused to acknowledge, there cannot be a stigma against nurses needing time to take stock.

“Without challenging it, we don’t just lose nursing staff for a few days, we lose them forever.

“There will be immense pressure on health and care services this winter and services can’t afford to lose safety-critical professionals to avoidable illnesses on top of tens of thousands of nursing vacancies.

“The risk to our patients is too high to do nothing.

“We want employers to work with us to make sure staff can get the vaccines they’re eligible for, are rested and have breaks, and look after themselves so they can look after patients better.”

One nurse, Natalie, from Norfolk, said the pandemic had taken its toll on her mental health and wellbeing and that of her colleagues.

“More of us are having to take sick days due to the side effects of stress and anxiety, which leads to short staffing, which then causes more pressure and burnout on staff and leaves staff that are currently off feeling guilty,” she said.

“It’s a vicious circle. On an average shift, we can be to two registered nurses and a healthcare assistance down, and there is also increased pressure on newly qualified nurses and registered nursing associates when they actually need support developing themselves as registered practitioners.”

Another nurse, Noeleen Behan, from north London, said: “Covid-19 is a still an issue, and staffing is a massive issue so I’m not surprised we’re seeing high sickness rates.

“A lot of nurses are very worried about the high demand we’re going to see this winter. People have barely had time to recover and there hasn’t been any break.

“The problem is we aren’t attracting anyone in with the poor pay award and more people are leaving because of the poor pay award, so unless something’s done about that we aren’t going to see the numbers we need for safe staffing.”

An NHS spokesman said: “NHS staff have pulled out all the stops to care for more than 450,000 Covid patients in addition to keep routine services going throughout the pandemic, and it is absolutely crucial that they receive the support they need as we head into winter, which is why a comprehensive support package is available for all NHS workers including a confidential helpline and rapid access to mental health services.”