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How unhealthy is presenteeism? And we're not talking about germs.

Future of work
Team photo from Montreux, Switzerland

If you've ever felt compelled to drag yourself to work even when you're under the weather, you've experienced presenteeism.

It's a growing issue where employees feel obliged to show up at work regardless of their physical or mental health.

It's not just about soldiering on through a cold or flu. It's about the impact on productivity, workplace morale, and overall health.

We look into the causes and effects and share strategies to reduce the issue in your organisation. Let's get into it.

What is presenteeism in the workplace?

Presenteeism definition and overview

presenteeism

The concept of presenteeism is when employees show up for work while unwell, not fully functioning, or unable to perform daily tasks because of illness or stress.

Instead of staying home to rest or get medical help, employees feel the need to work, often due to job insecurity and work pressure. When employees feel they can't take time off, they push through their illness and end up producing subpar work.

While it might come across like they're a dedicated employee, presenteeism can be harmful for a few reasons:

  1. If a sick employee isn't resting when they're ill, they could end up struggling with further health issues, as well as potentially making others in the office ill.
  2. An ill employee isn't going to do their best work. By being in the office, productivity is stifled as it stops others, who, at that moment, are of better health, from handling the task on their behalf. It also increases the workloads of the other team members as there is reduced productivity from the ill teammate.
  3. When an employee does this, it makes others feel like they need to follow suit when they're ill and that they're not 'soldiering on' if they don't. This directly impacts team morale and sets a bad example for the company culture.

Presenteeism vs Absenteeism

A more familiar concept is absenteeism, which is where an individual frequently takes leave from work, for reasons such as physical illness, injury or appointments.

Absenteeism is easier to quantify as it's clear when someone is not present at work.

Presenteeism, on the other hand, is an invisible issue. An employee could be dealing with a debilitating health concern but still appear fine on the surface, making it harder to calculate and manage.

While absenteeism causes immediate and visible gaps in productivity, presenteeism can be more hidden. It creates a slow drain on resources as the quality of work dips due to poor health. While absenteeism results in missing a day of work, presenteeism can result in multiple days of lower productivity.

Absenteeism can be managed with time-off policies, flexible working conditions and encouraging employees to take time off when needed. However, tackling presenteeism requires addressing work culture, employee well-being, and job stress.

Reasons for presenteeism

Knowing what triggers presenteeism can help you to understand how it can be reduced or controlled effectively.

Job insecurity and financial concerns

Job insecurity and financial worries are one of the major factors of presenteeism at work.

When you think your job is unstable, the pressure to show commitment by always being present is significantly high, regardless of your overall health.

This fear of losing their job is then heightened by worrying about missing out on income and what impact that will have on themselves and their dependents.

Insufficient sick leave

Inadequate or inflexible absence and sick leave policies can also lead to presenteeism.

If an employee has taken time off recently to recover from an illness or is reprimanded when using their sick leave, showing up for work when ill seems like the necessary option.

The policy in the UK: if an employee has been ill for more than 7 days in a row (including non-working days, such as weekends and bank holidays) they must produce a 'sick note' from a healthcare professional. You can read more about what's required here.

While legally there is no maximum number of sick days an employee can take, companies often have limits written into their sick leave policies, to assist with productivity and to ensure fairness.

Workplace culture and expectations

Presenteeism can also stem from organisational culture and expectations.

A company that rewards overtime, prolonged hours and minimal time off will see higher instances of employees ignoring their health concerns to meet expectations.

This arises from a perceived idea that a good employee is one who is constantly present and productive, even when unwell. This kind of company culture puts extra pressure on employees and can directly lead to presenteeism.

Mental health

Illness related to mental health conditions are often unrecognised or poorly understood in organisations and can lead to an increase in presenteeism.

Conditions such as anxiety or depression can be less observable but can significantly impair work performance. Unsurprisingly, presenteeism is more common in organisations that have a negative culture around mental health and don't offer support to their employees.

Mind, a mental health charity in the UK, have looked into the impact presenteeism has on the workforce.

In the report, the Centre for Mental Health found that presenteeism costs the UK economy £21.2 billion annually, nearly double the cost of absenteeism at work, which costs the UK economy £10.6 billion per year.

Factors such as stress, burnout, exhaustion, anxiety, and depression can significantly impact an individual's performance at work. Rather than allowing themselves time to heal, employees might hide their struggles under the guise of work and fall into a cycle of presenteeism.

Encouraging mental health awareness and promoting workplace support mechanisms are some ways to create a better working environment and tackle the issue.

Consequences of presenteeism

Presenteeism ripples through entire organisations, affecting employee health, organisational performance, and workplace morale.

On employee health

Let's start with employee health. Presenteeism tends to worsen health issues and prolong recovery times. It's like pouring salt into an open wound.

For example, a common cold could develop into a more serious respiratory issue if an employee doesn't rest and recover properly.

Chronic medical conditions, too, like migraines and back pain, can worsen under the pressures of presenteeism.

For those who struggle with mental health issues like stress and anxiety, these levels can rise due to the constant strain of trying to perform at work while battling health issues.

On organisational performance

Consider the knock-on effects on your organisation's overall performance and the business impacts presenteeism has.

Presenteeism causes a productivity loss, despite the initial impression of increased output. Productivity isn't just about turning up; it's about delivering quality work – something that's generally tougher when employees aren't well.

Plus, presenteeism can also spread diseases, further lowering productivity if more employees fall ill.

On workplace morale

Last but not least, presenteeism weighs heavily on workplace morale.

Employees seeing their colleagues struggling through ill health can lead to feelings of discomfort and frustration.

It can also create a toxic culture where employees feel obliged to be present, irrespective of their health. They may start believing that taking sick leave carries a stigma, which in turn can boost presenteeism even further.

How to reduce presenteeism

Acknowledging and working to reduce presenteeism is essential to maintaining a healthier, more productive team. Here are the strategies we'd recommend implementing to tackle presenteeism in your workplace.

Developing comprehensive leave policies

Having clear and comprehensive absence procedures and policies can act as a deterrent to presenteeism.

Encourage a balance between work and personal life, by providing annual leave, salary during sick days, and job-protected unpaid leave for family health reasons.

For instance, consider a policy that ensures employees receive income during periods of illness, protecting against presenteeism due to financial pressures.

Sick policies can be included in an employee's contract or shared during the onboarding process for new employees.

If you're looking to share yours with existing employees, make sure to communicate it clearly and be open to the questions your team may have.

If your sick policy is transparent and well-communicated, it can help workers make informed decisions and reduce the likelihood of presenteeism.

Outlining disciplinary action

With every policy, there is a need for clear disciplinary actions that will follow if policies aren't adhered to. What does this look like for your organisation?

Create a presenteeism policy that outlines the consequences of it. Let's be clear, this isn't about being tough on your employees, but about showing your employees the negative effects of presenteeism on their health and the team's health.

For example, a disciplinary action might involve a mandatory sick leave for an employee consistently ignoring their health problems to attend work.

Promoting a supportive work environment

Encourage an open dialogue about mental and physical health issues your team might be struggling with.

As part of this, offer training to managers to better handle conversations about health in a sensitive and supportive manner.

Also consider creating a safe, anonymous platform for employees to provide feedback on health and well-being matters. You can then use this to make your organisation better and more supportive to everyone.

Implementing wellness programmes

Presenteeism doesn't have to be handled reactively. By implementing wellness programmes and creating opportunities for team bonding, you can handle presenteeism proactively. If your staff are more connected to their teammates, they're more connected to their roles.

Design initiatives with a focus on mental health – offer regular stress management workshops, mental health awareness sessions, or provide access to counselling services.

Google offers wellbeing support to employees by providing mindfulness resources as well as a gym membership and other health-related benefits.

Want to do something more restorative? Why not plan a company retreat with wellness at the centre?

Plan activities that teach your employees valuable wellness techniques that they can use in their everyday lives.

This venue in Devon has classes on meditation, mindful movement, self-leadership and empathetic communication and collaboration training.

Conclusion

There is a link between presenteeism and absenteeism because if presenteeism is not managed effectively, it can turn into absenteeism.

As mentioned above, a presenteeism culture is largely influenced by standards the company has already created, so making sure your culture is collaborative, welcoming and supportive is essential.

Promote a healthy workplace culture where wellness is a priority by offering mental and physical health resources, and train managers to handle health-related conversations.

Wellness programs and team-building activities can also play a big role in reducing presenteeism, helping employees and employers feel more connected and supported.

The benefits to this are clear: a happy and healthy workforce are more productive and engaged and contribute to a more positive and resilient work environment.

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