Health

Presenteeism: what is causing Britain’s working-while-sick epidemic?


For a nation that Rishi Sunak has accused of having a “sicknote culture”, and one previously derided by Conservative ministers as being filled with shirkers, Britons really do go into work a lot when under the weather.

Forget the stereotype of the sickie taken to sit in front of the TV or enjoy the sun, the much more accurate tableau is that of someone sneezing and coughing in the workplace.

An analysis published by the Institute for Public Policy Research (IPPR) this week found that the cost of presenteeism – detrimentally working through sickness – grew by £25bn in the UK last year compared with 2018. It built on previous research suggesting presenteeism was far worse a problem than absenteeism – people taking sick leave – with the UK consistently ranking highly for the former among European nations.

Sir Cary Cooper, a professor of organisational psychology and health at Manchester University’s business school, said he coined the term presenteeism in the 1980s.

“A journalist called and said to me: ‘Cary, if I look at the figures, we’re in the middle of recession and sickness absence rates are down. How could they be down when people are losing their jobs, feel job insecure, getting ill from worry?’ I said: ‘Well, would you want on your HR record to be off ill? You’re going to turn up to work sick just to show face time.’ So, I think in a way, we have that kind of context now.”

Insecure work is now a widely acknowledged cause of presenteeism but there are others. Cooper said there were also those who turned up ill who did not want to create extra work for colleagues and “thought they were being kind”.

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Rachel Suff, a wellbeing adviser for the CIPD, the professional body for HR and people development, said workload pressure was another contributor as was management culture; many companies operate a trigger system whereby if someone is off sick three times within a certain period they receive a warning.

Andrew Bryce, a research associate at the University of Sheffield and co-author of a 2022 paper on presenteeism, said its rise was also owing to the fact that ill health, in particular mental health, was increasing.

Costs of presenteeism cited by the IPPR included the impact on individual productivity and recovery time from short-term illness, making bad work decisions, and making colleagues sick – known as “contagious presenteeism”.

It might have been expected that protocols on attending the workplace when permissible during the coronavirus crisis – from telling people not to come in if in doubt to on-site temperature checks – would have effected a lasting culture change, but experts said it was not that simple.

“A lot of people were working from home during the pandemic and so actually people who had Covid didn’t necessarily take the time off, they would just work from home,” said Bryce. “Boris Johnson, when he got Covid, didn’t stop working [initially]. He continued being prime minister whilst being seriously ill. What sort of example did that give to the rest of the population?”

Cooper said “a lot of employers are trying to go back to the old way”, by which he meant abandoning hybrid and flexible working adopted during the pandemic, which were better for people’s health and productivity. He said there was room for optimism in that many companies were monitoring presenteeism and there was a change of culture among younger workers.

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“The good news – and it’s good news for our economy as well – is that generation won’t tolerate bad work, and by bad work I mean a culture that kind of demands presenteeism,” said Cooper. While he cited his MBA students refusing to work for certain investment banks, he acknowledged they were in a very different position from “very vulnerable” blue collar workers.

The IPPR report found that those with the lowest education levels and income, less skilled occupations and minority ethnic backgrounds were more likely to work through sickness.

Suff said that an ageing workforce could lead to more presenteeism but highlighted as a positive development Labour’s proposals to remove the three-day waiting period and lower earnings limit for claiming statutory sick pay. She said she believed arguments that it would result in more sickness absences were misguided in light of what we know about presenteeism. “We would hold a much more optimistic view of people and their attitude and relationship to work,” she said.



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