The UK is facing a long-term sickness crisis, with presenteeism on the rise. Right now there are over 2.5 million people across the country who are ‘economically inactive’ due to illness and adverse health conditions, and the number has been steadily rising since 2020. ONS figures show that those who are inactive because of long-term sickness have increasingly complex health issues, with the numbers of people reporting multiple physical and mental health conditions on the rise.
The reasons behind the surge in long-term sickness are many and varied. A leading factor may be the mental health pandemic we’re experiencing as a nation. Between 2019 and 2023, the number of people not working because of depression, ‘bad nerves’, or anxiety rose by 40%. It is a fair assumption that there will be a growing proportion of people in work who are also suffering from these symptoms. The important question for employers is how to identify, predict and mitigate the causes of long-term sickness, so they don’t become causes of long-term absence.
Sickness absence or presenteeism?
When we are ill, we make a conscious choice about whether to be absent from work, or to ‘keep going’ through our illness. We will consider a range of factors to make this decision, both ‘positive’ and ‘negative,’ that influence our intrinsic or extrinsic motivation – in other words, what we want to do vs. what we feel we should do.
Where we experience transactional leadership styles, high demand workload, and long working hours, we may feel motivated to work through illness because it’s expected of us, and we worry about the rection to our absence from our managers and colleagues. By contrast, where we experience high levels of autonomy, flexible work arrangements, high work engagement, meaning, enjoyment and purpose at work, we are likely to show up when sick because we crave the social and emotional benefits of our work. In both cases, presenteeism is the result.
Paradoxically, presenteeism may actually improve work performance in the short-term, especially for highly engaged employees who are able to proactively cope with health impairment. Presenteeism is associated with increased effort, work engagement, and job performance after one week. There is an argument that says sickness presence is better than sickness absence, simply because there will be some level of productivity with sickness presence, even if it is reduced (whereas there is zero productivity with sickness absence), and while this may be true at an organisational level, what does that mean for the individual employee?
This short-term gain masks a darker reality. Over time, presenteeism will have a detrimental impact on both wellbeing and job performance outcomes. If choosing sickness presence rather than absence, a person must deploy emotional and cognitive resources to manage both sickness symptoms and work tasks simultaneously. Over time, this drains their energetic resources, despite a self-perception of being robust enough to work through health impairment, leading to gradual depletion in energy for work. Presenteeism will lead to declining job performance and work engagement and increasing emotional exhaustion in the long-term. It is a strong indicator for future absenteeism and labour force exit, so there is a compelling case for investing in solutions to reduce it.
Recent research has focused on the critical importance of health-promoting collaboration, good supervisor and social support, appreciation and recognition at work, and job-enrichment as interventions that can reduce levels of presenteeism in workplaces. The physical workplace environment and the encouragement of an active lifestyle can also improve the psycho-physical health of the workforce and may impede the increase of employee presenteeism.
There is a great deal of information available about presenteeism and how employers can tackle it. This includes offering flexible working hours and providing workplace health provision such as a 24/7 GP phoneline and access to mental health support. Critically, business leaders must create a culture where employees feel able to take time off when they need it.
Managing presenteeism in the workplace may not be the answer to the UK’s long-term sickness crisis, but it does have an important part to play. When people feel supported through ill health, they may be more likely to stay with their company, rather than looking for another job or quitting altogether. A shift in focus away from reactive healthcare to preventative healthcare can help to keep people in employment, and will ultimately lead to a happier, healthier, and more productive workforce.