Tackling presenteeism through employee wellbeing

Head of Work and Well-Being Ltd Dr Bridget Juniper highlights the role of employee wellbeing programmes in tackling the emerging and costly issue of presenteeism.

If workforce productivity is a priority, is it worth focusing your efforts on the vast majority of staff who are turning up to work or reducing the small numbers of people who don’t?

In most cases, the answer is to concentrate resources on the former scenario and this relates directly to the issue of presenteeism. It is a subject that is increasingly tabled for discussion as HR and OH managers are challenging its acceptability and are becoming increasingly aware of the costs connected to it.

First, it is important to note that there are three definitions linked to presenteeism, each of which highlights a different aspect. The conventional definition refers to lost productivity that occurs when employees come to work when they are ill and therefore perform below standard. This can also be termed “sickness presence” or “lost health-related work productivity”. Some commentators expand the term to encompass healthy employees who are just non-productive. No employee is 100% productive all of the time but examples of this type of behaviour might include surfing the web for extended periods, making lots of personal phone calls or popping out to the shops on an overly frequent basis.

At the other end of the spectrum is the kind of presenteeism that is given over to those that are overly present, ie they consistently put in long hours and will not take their full holiday quota.

Accounting for loss

The costs to organisations of presenteeism mostly concentrate on lost productivity through ill health. A 2004 article in Harvard Business Review (Hemp, 2004) estimated an annual drain of $150 billion on US businesses as a direct consequence of common ailments such as hay fever, headaches and heartburn.

quotemarksThe costs to organisations of presenteeism mostly concentrate on lost productivity through ill health.”

Results from one case study showed that conditions such as migraine and depression resulted in 4.9% and 7.6% productivity losses respectively. Closer to home, the Sainsbury Centre for Mental Health estimated that in the UK in 2006, presenteeism, based on psychological health problems alone, accounted for 1.5 times as much working time lost as absenteeism. The centre explained that the higher costs of coming to work when unfit is more common among higher-paid staff. If costs of idle staff who fit the second definition are factored in, the numbers are much higher.

Wellbeing solution

So, if this is the scale of the problem, what can be done about it? The good news is that an effective employee wellbeing programme can help significantly. The first step for employers is to get an informed view of the situation in their own workplace through a proper evaluation of wellbeing levels. This can be best achieved through an assessment that asks individuals to indicate their current wellbeing status, estimate their time taken off owing to sickness and to estimate levels of presenteeism.

Employees are reliable in judging these last two aspects and the findings will provide OH and HR teams with some valuable data on the size of this, often hidden, problem, where it is occurring and how it links to specific health and workplace issues.

As an example, some recent work conducted by Work and Well-Being Ltd among nurses in a busy NHS hospital found that 43% considered ill health to have had a negative effect on their performance during work over the past four weeks, while a much smaller percentage reported sickness absence over the same period.

Pressure relief

Two common factors behind presenteeism that are often reported are workplace stress and, not surprisingly, perceived pressure from managers to attend work when they are unwell.

As well as tackling workplace stress, it is worth reviewing absence management policies to ensure that they are fit for purpose and are properly understood by individuals as well as the managers who are expected to apply them. It is also worth revisiting flexible working arrangements and workplace adjustments so that particular health problems can be accommodated.

What about those employees who are at work but are not being productive despite good health? Perhaps they are being poorly managed or they are lacking motivation to put in the effort even though it is well within their capability. Again, a decent wellbeing assessment will help unearth the profile for this kind of worker and shed light on the best approaches.

People who fall into the third and final presenteeism bracket also deserve a mention. It is reasonable to expect people to work long hours from time to time if there is a particular project or deadline that needs to be met. What is not acceptable is an assumption that a pattern of toiling long into the night is sustainable without carrying repercussions for the wider health and wellbeing of employees.

quotemarksGiven the extent of the potential problem, the gains from tackling presenteeism are huge.”

Companies that define someone’s success by the hours that they put in are compounding the problem. This is a common issue with professional-services firms, which place a great deal of emphasis on utilisation rates but regularly encounter work-life balance issues among their fee earners. Employees at these companies need to be supported through effective management and HR policies.

If this is not done, they run the risk of developing illnesses that mean they may fall into the conventional presenteeism definitions or they become absent. Neither scenario is good for either party.

Systematic approach

Given the extent of the potential problem, the gains from tackling presenteeism are huge. Whether the problem lies with people dragging themselves in, people unable to drag themselves away, people just not working effectively or a mix of all three, their wellbeing is a key indicator.

If tackled systematically, it can provide a compelling picture of something that is generally difficult to detect and will pay dividends not just to the individuals and their teams but to the organisation and its bottom line.

Dr Bridget Juniper is head of Work and Well-Being Ltd, which specialises in the measurement of employee wellbeing. She has conducted award-winning research on employee wellbeing at Cranfield University and publishes regularly in scholarly journals and frequently presents to academic and corporate audiences.


Hemp P (2004). “Presenteeism: at work – but out of it”. Harvard Business Review. Issue: Oct.

Centre for Mental Health.

XpertHR provides good-practice guidance on wellbeing as well as a model policy to help manage staff health and wellbeing.

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