Presenteeism: Exploding myths and exploring management implications

Presenteeism made front page news in The Times this month, citing research by CIPD and Kiddy’s Head of Research, which reveals the significant and growing problem of presenteeism in the UK.  Presenteeism is at least twice as common as sickness absence, but what gets left off the front page is that presenteeism isn’t necessarily all bad.

Work can be restorative to health, and it’s long been reflected in occupational health best-practice that you don’t need to be 100% ‘fit’ to attend work.  The concept of the UK’s ‘fit note’, which replaced the sick note in 2010, rests on the fact that an 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 coincide. 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.

What can managers do?  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, including musculoskeletal problems (e.g. back pain, neck and wrist problems, accounting for 22% of sickness absence) and mental health issues (e.g. 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.  Psychosocial factors 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 (i.e. employees have little support, lack autonomy etc.), reinforcing the importance of ensuring work is designed and managed in ways that are beneficial rather than detrimental to health.

The 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.  However, 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.