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Presenteeism: What it really means for management

Zara Whysall
Employee engagement

New survey findings from the CIPD[1], as well as recent academic research of my own[2], highlights the significant and growing problem of presenteeism in the UK.  HR Directors are understandably concerned by the finding that sickness presenteeism is at least twice as common as sickness absence; employees are spending an average 2.5 weeks a year at work despite feeling unwell. Contributor Zara Whysall, Head of Research – Kiddy & Partners.

The figures speak for themselves. The rise of presenteeism means that employees are operating at an estimated average of 84% full capacity, equating to a lost productivity cost to the employer of £4,058.93 per person per annum.  On average, each year employees spend 13 days at work whilst sick, in contrast average annual sickness absence of 6.63 days each year.   So employees are ill at work for more days than they are off sick, but the question for HR practitioners and managers is: Is sickness presenteeism always a bad thing?

Misunderstanding presenteeism
Work can be restorative to health.  In fact, it’s long been reflected in occupational health best-practice that you don’t need to be 100% ‘fit’ to attend work.  Conversely, worklessness can be detrimental to physical and mental health and wellbeing. The concept of the UK’s ‘fit note’, which replaced the sick note in 2010, rests on the fact that early return to work following illness can be good for health – not to mention the economy.  What’s more, if proactive adjustments can be made to enable someone to remain at work, all the better.  So presenteeism shouldn’t be viewed as an inherently negative phenomenon.  The problem is, that’s not such a snappy media headline!

It’s also assumed that employees use presenteeism as a substitute for absenteeism – instead of taking sick leave, they struggle in to work. But evidence suggests otherwise.  In reality, the two tend to coexist.  When employees are ill, they typically engage in both sickness absence and sickness presence.  So it’s less about stopping people coming into work when they’re experiencing ill-health – although in some cases that may be appropriate- and more about reducing both sickness presenteeism and sickness absence by preventing ill-health in the first place.

The management challenge
So where does this leave managers?  Clearly not all ill-health is preventable, or influenced by work.  But the way that work is managed plays a significant role in some of the leading causes of sickness absence. For example, back pain, neck and wrist problems account for 22% of sickness absence with mental health issues – stress, depression, anxiety – accounting for 12% of sickness absence.

The psychosocial quality of work has been identified time and time again as a significant risk factor for these common health problems.  These include the amount of support provided at work, the degree of control an employee has over their work, the level of demands placed on them, and the clarity of expectations.  Managers have a significant influence over all of these things.  Presenteeism is more likely to occur when the psychosocial environment is poor, so when employees have little support and lack autonomy, for instance. It reinforces the importance of ensuring work is designed and managed in ways that are beneficial rather than detrimental to health.

Well-managed work
Any potential benefit of coming to work when unwell will, of course, depend on the health condition the person is experiencing; managers need sound advice on the best course of action from qualified health specialists.  This also means being proactive about how employers address presenteeism: encourage your employees to report health problems, then take the required steps to help them progress back to full productivity rather than going in the opposite direction and taking more time off.

Measures such as improvements to the workplace and how tasks are designed and managed, an open discussion between employer and employee around health concerns as well as encouragement to seek early treatment can all enable employees to continue working without exacerbating health – indeed hopefully actually facilitating recovery.

By ensuring that your managers are equipped with the skills to ‘manage well’, they can play a key role in reducing both sickness absence and sickness presence, whilst increasing productivity and engagement.

[1] CIPD (2018). Health & Wellbeing at Work Report, https://www.cipd.co.uk/knowledge/culture/well-being/health-well-being-work

[2] Whysall et al (2018). Sickness presenteeism: measurement and management challenges. Ergonomics, 61:3, 341-354. http://www.tandfonline.com/doi/full/10.1080/00140139.2017.1365949


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