Nurses and midwifes are among NHS staff with the highest sickness leave

The survey by the Auditor General for Wales, Sir John Bourn, says patient care has been affected and more could have been done to tackle the problem.

More than 15 days a year - or 6% of staff hours - are being lost in Wales to sickness for every member of full-time staff.

In England, an average 4.7% of contracted hours are being lost by NHS trust staff.

It is clear that more could have been done by the trusts to address this problem Sir John Bourn

Nurses and midwives - who together make up almost half of the NHS workforce in Wales - are among the groups with the highest recorded levels of sick leave.

Speaking to BBC Wales on Friday, Liz Hewitt of the Royal College of Nursing in Wales said it was only to be expected from overworked, overstretched staff.

Mistakes in recording mean actual levels of sickness absence could be even higher, according to Sir John's report. He also warned sickness levels in the Welsh NHS are continuing to rise.

Sir John recognised that a certain level of sick leave was inevitable in any organisation, and said the NHS was a "stressful and potentially hazardous environment in which to work".

But he said sickness levels on this scale placed a "significant strain" on the delivery of services by the NHS.

"It is clear that more could have been done by the trusts to address this problem, and that the assembly's NHS Wales department could have issued firmer guidance and targets by which progress should be measured," he concluded.

No single reason was identified but poor methods for recording and monitoring absenteeism were a concern.

Trusts have invested cash in schemes to try to reduce stress and protect staff from accidents.

But the report said their impact was being undermined by a lack of reliable information about the real seriousness of the situation.

Procedures

Sir John said the introduction of an electronic staff record system across the NHS in England and Wales should help - but trusts would have to wait until mid 2005 at the earliest before it is introduced.

Most managers still lacked any formal training in the management of sickness absence and so underlying problems and trends in individuals' sickness absence went unchecked.

Sir John's report will be presented to the assembly's audit committee next month when Anne Lloyd, director of the NHS in Wales, will also give evidence.

A spokeswoman for the Welsh Assembly Government said it was looking forward to receiving the committee's report in due course, but said it would be inappropriate to offer any comment before then.