Workplaces have long been concerned with absence of their employees and have monitored rates of absenteeism. Many employers have used initiatives to reduce the levels of absenteeism of their workforce. Such an approach may have been short-sighted. Have companies ignored presenteeism and in favour of the more obvious and detectable absenteeism?

Presenteeism is where employees are on the job, but are not functioning fully due to illness and medical conditions (Hemp, 2004). At first glance, it may not be obvious how this is problematic. Surely it is better to have employees in work rather than absent and off work? To discover why this is not the case the productivity of workers must be considered. When an employee is ill and at work they are not able to work to the same quality or as fast. This results in poor work outcomes or excessively slow work, which can both be more costly to the company that if the employee stayed at home while ill. The productivity loss from presenteeism was found to be three times that of absenteeism (CIPD, 2007).

Presenteeism has been considered to be on the rise in recent times. In the NHS, 65% of staff reported that they came in to work when they were sick enough to stay home (O’Connor, 2006). The public sector and health industries have some of the highest rates of presenteeism, which is often explained as the duty of care they feel, e.g. patients may suffer if they stay off work ill. Due to this, the time lost due to presenteeism is much higher in the public sector (See table below). Also, high pressure white collar jobs- those in financial services, pharmaceuticals and sciences- have lower rates of absence but higher rates of presenteeism.  

Industry Average Days Lost Per Employee Per Year: Absence Average Days Lost Per Employee Per Year: Presenteeism
Media 1.4 18.6
Manufacturing 2.4 19.1
Pharmaceuticals 1.8 25
Public Sector 3.5 31.1

Source: Britain’s Healthiest Workplace, Financial Times (2016)

Presenteeism- What are the causes?

It is often suggested that economic factors are a major cause. In times of low job security and recession, employees may feel like they cannot afford to miss work even if they are ill over fears they could lose their job or that they need the pay for that period. Indeed a Bupa report found that stress levels and job insecurity increased during the 2008 Financial Crisis, with a quarter of people working longer hours to negate the risk of losing their job (Paton, 2008). The increased stress could also lead to an increase in presenteeism. CIPD estimates that 40% of workplace absences are due to stress and depression. However, if employees feel they cannot afford to take sick leave due to the economic environment, they will come to work while severely stressed which will negatively impact their productivity.

Another factor is that of absence initiatives used by employers. Adrian Lewis, Absence Management Expert at Activ Absence, explains that there has been a huge rise in initiatives to cut the cost of absences by employers. The problem is that the majority of these has been disciplinary in nature, rather than aimed at discovering the root cause of the absences. This may, therefore, have contributed to a rise in presenteeism, as employees fear disciplinary action from managers if they stay off work while ill. This ties in with a wider factor in the causes of presenteeism, which is employer expectations. These can be both the perceived expectations felt by employees and the real expectations managers hold. Research by the company Overbury found that 80% of employees believed those spending more time in the office are thought to be harder workers by bosses (Prater & Smith, 2011). Furthermore, 60% believe that being seen working late increases an employee’s chance of promotion. This highlights why employees would therefore be keen to work while ill in order to meet their employer’s expectations. These perceived expectations employees feel are not far from the reality either. 50% of senior managers are less inclined to recommend someone for promotion if they have spent less time at work than their colleagues (Prater & Smith, 2011).

An often overlooked cause of presenteeism is that of peer pressure. Focus is often given to the manager’s’ expectations and demands on employees while ignoring the influence of colleagues on one another. 45% of employees reported that would lose respect for a colleague who was often absent and spent less time in the office (Overbury report- Prater & Smith, 2011). This can create a culture of pressure for employees to not be absent for fear of letting the ‘team’ down or the fear of victimization by colleagues.


Presenteeism- Potential Solutions?

The problem of presenteeism has received increased recognition among organisations, however 50% of workplaces admit they are currently doing nothing to combat it (CIPD, 2015). The organisations that are tackling presenteeism have adopted multiple, differing  strategies. The law firm Allen & Overy introduced on-site GPs and Dentists that employees can visit. Google has focused on the mental health of employees and runs ‘mindfulness classes’ to built good mental health into their culture (Cheese, 2016). Similarly, there has been a focus on mental health by the large financial and professional firms in London. KPMG and Deloitte, among others, launched The City Mental Health Alliance to combat mental health problems and the stigma surrounding them in the workplace (Cheese, 2016).

One example that highlights the improvements that organisations can experience by combating presenteeism is the steps some companies have taken to help employees suffering from allergies. Hay fever and other allergies are often overlooked when considering illness at work, but is extremely common and can impact an employee’s performance. It is estimated that hay fever sufferer’s productivity drops by 10% compared to non-sufferers during summer (Hemp, 2004). Navistar’s International Truck and Engine Corporation offered their employees free consultations with an allergy specialist. The organisation found that employee’s productivity increased by up to 25% after their allergies were correctly diagnosed and treated by the specialist (Hemp, 2004). Furthermore, Bank One found that a quarter of their employees suffering from allergies did not take any kind of medication, mainly as they were reluctant to pay for antihistamines. Bank One calculated that the cost of providing antihistamines to these employees was $18 per person, per week and was worthwhile due to the offset of resulting gains in productivity- calculated to be $36 per person, per week (Hemp, 2004).

The gains Bank One experienced highlight the impact presenteeism can have on worker productivity and potential rewards firms can reap by focusing on reducing illness at work by helping employees. Companies should seriously reconsider the emphasis they place on trying to prevent absence, particularly in the form of disciplinary action. Attempting to reduce absenteeism simply redirects the losses the company faces into the form of presenteeism, with reduced worker productivity while they continue to work while ill. Since 22% of employees in the UK suffer with mental illness (ONS, 2017), it is particularly important that companies address this if they want to reduce presenteeism. Following Google’s example of ‘mindfulness classes’ is a simple action that can contribute to improved mental health and demonstrates consideration by employers towards their employees.




  • Chartered Institute of Personnel & Development (2007). Absence Management. London






  • Office for National Statistics-ONS (2017). Sickness Absence in the Labour Market. 


  • Prater, T. and Smith, K. (2011). Underlying Factors Contributing To Presenteeism And Absenteeism. Journal of Business & Economics Research (JBER), 9(6).