Sickness absence in the Northern Ireland civil service has increased by 10 per cent in five years, with staff off for an average of almost 13 days annually, auditors have found.
A joint report by comptroller and auditor general Kieran Donnelly and local government auditor Pamela McCreedy said "consistently high levels" of sick leave within the organisation had cost £169 million (€190 million) since 2015.
They said the levels are almost double that within the civil service in England.
Sickness absence levels with councils in Northern Ireland are even higher, with an average of almost 14 days per employee in 2018-19 – a 13 per cent increase in five years.
Council sick leave is also the highest in the UK.
Mr Donnelly said: “High levels of sickness absence within the public sector are not a new phenomenon. However, this report finds few signs of sustained improvement.
“It is time for public sector organisations to make a concerted effort to reduce the level of sickness absence and to develop a consistent approach to managing attendance. With that in mind, the Local Government Auditor and I identified a number of key principles in managing attendance that should be applied across central and local government.
“A strong attendance culture needs to be embedded across the Northern Ireland public sector, and driven from the top.
“We are recommending that organisations focus on targeting long-term absence through preventative measures and early intervention.
“It is also vital for all organisations to measure and analyse sickness absence levels if they are to understand their impact, not only in terms costs, but also on the quality of services delivered to the public.”
The Audit Office last week highlighted that long-term absences account for over three quarters of the working days lost in the NICS and almost two thirds of the days lost in local councils.
The latest report highlighted mental health conditions as a prominent cause of sickness absence, often involving longer absences.
The report noted that older employees make up a significant proportion of the public sector workforce.
It said while older employees are not off more often, when they are absent it tends to be for longer periods of time.
A Department of Finance spokeswoman said: "The level of sickness absence is regrettable.
“Reducing sick absence rates remains a priority for the civil service.
“The NICS remains committed to working jointly with trade union colleagues and other partners such as our Employee Counselling, Welfare and Occupational Health teams to support colleagues to stay in work and return to work as soon as they are able.”