Presenteeism: What’s causing Britain’s sick-work epidemic?

For a nation that Rishi Sunak has accused of having a “sick leave culture”, and which has previously been derided by Tory ministers for being full of slackers, Britons actually do go to work a lot when they are feeling unwell.

Forget the stereotype of the sick person sitting in front of the TV or enjoying the sun: the much more accurate picture is that of someone who sneezes and coughs in the workplace.

An analysis published by the Institute for Public Policy Research (IPPR) this week found that the cost of presenteeism (working even when unfit) rose by £25bn in the UK last year compared with 2018. The analysis built on previous research suggesting that presenteeism was a far worse problem than absenteeism (people taking sick leave), with the UK consistently ranking high for the former among European nations.

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

“A journalist called me and said, ‘Cary, if I look at the numbers, we’re in the middle of a recession and sickness absence rates are down. How could they be down when people are losing their jobs, feeling insecure and getting sick out of worry? ’ I said, ‘Well, would you want to have a sick note on your HR record? You’re going to come to work sick just so you can be present. ’ So in some ways, I think we have that kind of context now.”

Today, job insecurity is a widely recognised cause of presenteeism, but there are others. Cooper said there were also people who called in sick because they did not want to create extra work for their colleagues and “thought they were being nice”.

Rachel Suff, wellbeing adviser at the CIPD, the professional body for HR and people development, said workload pressure was another contributing factor, as was management culture; many companies operate a wake-up system whereby if someone is absent through illness 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 due to the fact that poor health, particularly mental health, was increasing.

The costs of presenteeism cited by the IPPR include the impact on individual productivity and recovery time from short-term illness, making poor work decisions and making colleagues ill, known as “contagious presenteeism”.

One might have hoped that protocols around coming into the workplace when permitted during the coronavirus crisis — from telling people not to come in if they have concerns to on-site temperature checks — would have produced lasting cultural change, but experts said it wasn’t that easy.

“A lot of people were working from home during the pandemic, so actually, people with Covid weren’t necessarily taking time off, they were just working from home,” Bryce said. “Boris Johnson, when he got Covid, didn’t stop working. [initially]He remained prime minister despite being seriously ill. What example did that set for the rest of the population?

Cooper said “many employers are trying to go back to the old ways” – meaning moving away from the hybrid and flexible working adopted during the pandemic, which was better for people’s health and productivity. He said there was room for optimism as many companies were monitoring presenteeism and there was a culture shift among younger workers.

“The good news – and it’s good news for our economy too – is that this generation will not tolerate bad work, and by bad work I mean a culture of presenteeism,” Cooper said. While he mentioned that his MBA students refused to work for certain investment banks, he acknowledged that they were in a very different position than “very vulnerable” blue-collar workers.

He IPPR Report They found that those with lower education and income levels, lower-skilled occupations and minority ethnic backgrounds were more likely to work while sick.

Suff said an ageing workforce could lead to more presenteeism, but highlighted as a positive development Labour’s proposals to scrap the three-day waiting period and reduce the earnings threshold for claiming statutory sick pay. He said he believed arguments that this would lead to more sickness absence were flawed in light of what we know about presenteeism. “We would have a much more optimistic view of people and their attitude and relationship to work,” he said.