Just being at work does not equal being productive, particularly if an employee is poorly. Sam Barrett looks at what can be done to tackle the culture of presenteeism


Whether they’ve got a cold, stomach bug or something more serious, having sick employees in the workplace isn’t good for business. Working while unwell has a significant effect on productivity, and is only likely to spread germs to colleagues.

Speaking at the Chartered Institute of Personnel and Development’s annual conference and exhibition last November, psychologist Professor Sir Cary Cooper labelled presenteeism, where employees work while unwell or spend excessive and often unproductive hours in the workplace, as the single biggest threat to UK productivity, with an annual cost to businesses double that of absence.

Unfortunately it’s an ingrained problem. “We’ve an over-attendance culture,” says Paul Avis, marketing director at Canada Life Group Insurance.

“Our research has found that nine out of 10 employees have come into work while ill, with 13% saying they’d have to be admitted to hospital before they’d consider calling in sick. It’s not a healthy attitude.”

All sorts of reasons lie behind this. While some of this will be a hangover from the recession, when job insecurity was rife, Canada Life’s research also found that 32% of employees said their workload was too great to take time off sick and while 21% were worried about the financial implications.

Perhaps even more worrying, it found that more than one in 10 employees said their colleagues and senior managers had made them feel guilty for taking time off when they were ill.

Dr Mark Winwood, clinical director of psychological health at Axa PPP healthcare, isn’t surprised: “Some businesses talk about malingering and not being a team player when they’re dealing with absence.”

Technology has a part to play. As well as enabling sick employees to log on at home instead of struggling into work, work is now a click away, whatever the time of day.

“It used to be seen as the saviour of business but if you have access from home there is a tendency to log on at any time of the day or night,” says Kieran Stratton, manager, individual assessment at Ellipse.  “Working long days doesn’t lead to more getting done; it can lead to an employee being burnt out and unproductive.”

Changing the culture

While colleagues coughing and sneezing can be disruptive, it can be just as problematic where someone has a long-term illness and struggles to come in.

For example, Avis says he has been asked to intervene when a group income protection (GIP) claimant had returned to work before they were well enough. “It was causing distress to other staff members as well as duty of care issues for the employer. If you’re long-term sick, it’s really important to take time off to focus on getting well again,” he says.

Whether it’s a short or long-term illness, a cultural shift is often required to prevent presenteeism taking hold. “Once this culture is established it’s hard to get out of it,” says Stratton. “Change has to come from the top of the tree.”

Ellipse is a good example of this. Although the company had developed a culture of people working from home rather than taking a sick day, the chief executive John Ritchie recognised that this was unproductive and told staff they were either ill or working from home, not both.

“He framed it as being better to take a day off to get well than having to spend a week being unproductive,” says Stratton. “It has changed the culture but you do need to say it again and again for the message to get through.”

It’s also sensible for the management to set a good example. Ensuring that employees see managers take time off when they’re sick and don’t send emails outside of work hours helps to show this type of behaviour is acceptable.

Promoting wellbeing can help to reset workplace culture, but Dr Winwood recommends any activity doesn’t just focus on the things employees should be doing to stay healthy. “You need to promote the importance of recognising when someone’s not coping,” he explains.

Providing support

Line managers have an important role to play in this, too. “They need to be able to identify the early signs of stress and other common health problems and provide appropriate support,” says Rebekah Haymes, senior consultant at Willis Towers Watson. “This could be helping an employee manage their workload, directing them to the employee assistance programme or even telling them to take a day off.”

As well as training up line managers, it’s sensible to have a range of external support services to hand. Occupational health and, where someone is off work long term, rehabilitation services can help employees back into productive employment.

These services assess someone’s situation and, where appropriate, provides advice on how to enable a return to work.

“We offer a medically endorsed return-to-work plan,” says Avis. “Our vocational rehabilitation specialists will only recommend that someone goes back to work when they are fit and well. This gives everyone confidence that the timings are right to get them back.”

Facilitating this can require advice on a range of different areas. This could include guidance on reasonable adjustments; conflict resolution, where work is the cause or contributing to the problem; or designing a phased return or a move, either permanently or temporarily, into a less stressful role.

The nature of some wellness issues means having a service that is independent of both the employer and the employee is important, according to Cathy Topp, HR and employment law consultant at Citation.

“The employee’s GP will side with them while an employer’s own occupational health department may struggle where there’s a work-related problem,” she says. “If you use an independent service they’ll be able to take an objective view.”

Outside services

There are a number of different ways to access these services. Advice can be bought in on a case-by-case basis with a variety of charging structures available.

“Usually you’ll pay a fee of anything from £50 to £200 for each case you refer and in some cases there’s also a retainer,” says Stratton. “This would get you an initial report outlining the nature of the problem and you might then need to pay for further reports and treatment.”

The government’s Fit for Work Service is also an option where someone has been, or is likely to be, off work for at least four weeks. The advice and support they provide is free, although they may recommend treatment that the employer could fund to help the employee back to work.

“Four weeks may be leaving it too late,” says Haymes. “But it’s better than nothing.” Rehabilitation services are also included within GIP schemes, where insurers have the incentive of potentially reducing the length and cost of a claim.

“It’s in everyone’s interests to help someone get better,” says Avis. “We even offer a day one mental health intervention service to help people long before they can make a claim. As a result, 86% of the referrals to the service don’t result in a claim.”

Typical costs for a scheme range from around 0.5% of payroll for a limited payment term plan through to 1.5% or so for a fully comprehensive scheme. But, whether you go budget or full cost, Avis adds that the rehabilitation support provided will be exactly the same.

Stratton also recommends not just looking at these services as costs: a spend on a GIP scheme or occupational health services should be regarded as an investment. He explains: “If an employee has a bad back that stops them coming into work for a fortnight, the employer might lose £1,000 in productivity. If they spend £200 on a course of physiotherapy, the employee might only have to take three days off, reducing the overall cost to the employer to £500.”

While there are plenty of options to help address presenteeism and long-term ill-health problems in the workplace, it may also be worth considering something more radical. Topp looks to some of our European neighbours as good examples.

“Sweden is moving to a six-hour working day, with early adopters finding it is more, rather than less, productive to have a shorter day,” she says. “Employees in Holland and Germany also work fewer hours but are more productive.”

The way forward

Although we’ve some catching up to do, some UK companies have already introduced these types of measures. Following a two-month trial of a six-hour working day, Liverpool-based marketing agency Agent Marketing picked the elements of the new regime that worked for its employees, management and clients.

Its standard day is now 08:30 to 17:30 but employees can leave work at 16:00 one day a week, and every Friday the hours are 09:00-16:00. Agent Marketing’s head of communications Jeanette Gill says it works well. “Everyone’s enjoying it and it does ensure we get a healthy work/life balance. Employees really appreciate the flexibility it gives them.”

But whether you go the full hog and introduce shorter days or you take other steps to reduce presenteeism, ensuring the right culture and support systems are in place can pay dividends.

“If employees see you’re looking after them, you’ll invariably get more out of them,” says Stratton. “A shorter number of productive hours are much better for a business than having an office full of sick or stressed, unproductive employees.”