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The cost of presenteeism

The cost of presenteeism

Dr Adrian Massey FFOM, Deputy Chief Medical Officer for Duradiamond Healthcare - a 985 framework supplier - discusses the cost of presenteeism and the ways an occupational health provider can help to reduce presenteeism in the workplace.
Presenteeism is generally understood to mean coming into work despite illness, injury/anxiety, which often results in reduced productivity and working long hours than necessary.
The cost of mental health problems in the UK workforce was £34.9 billion in 2017 with presenteeism costing £21.2 billion (Centre for Mental Health). Further research found that 86% of employers have observed staff coming into work while ill in the last year (CIPD). However, presenteeism reduces productivity, increases employee stress and turnover and reduces engagement and morale.
An organisation’s presenteeism rate can be calculated by the following equation:
Cost of ill health (including indirect costs) X 150% (Centre for Mental Health) = presenteeism rate.

Source: (CIPD)

A good occupational health provider can work with you to reduce presenteeism in the workplace by: 

  • Working in partnership with your stakeholders to develop an effective health & wellbeing strategy - and one that tackles both presenteeism and absenteeism.
  • Ensuring the strategy educates and empowers employees, incorporating sleep, work/life balance, mental health, diet and exercise.
  • If you already have a health & wellbeing strategy, reviewing it to consider what additional mechanisms can be put in place to further promote health and wellbeing at work.


  • Working collaboratively with you and your managers to help improve overall attendance, whilst ensuring employees achieve the benefits from working in a healthy environment.
  • Reviewing absence management policies and ensuring managers are trained and supported in implementing them.
  • Helping managers and employees to understand that when considering presenteeism, a return to work can be therapeutic and a positive component of a health recovery.  Employees don’t always have to be 100% fit to return.
  • Training managers to understand, identify the signs of stress and how to manage employees effectively. Training and awareness should help identify problems before they develop.
  • Educating managers and employees on the relationship between absenteeism and presenteeism - and the negative effects of presenteeism on both employees and the organisation.


  • Adopt a flexible approach to sickness absence to avoid causing further presenteeism and that employees are treated fairly.
  • Monitoring employee working hours: HR can identify excessive overtime or holidays not taken.
  • Becoming aware of cultural trends towards absenteeism/presenteeism and being prepared to address them.
  • Identifying presenteeism in your workplace via tailored surveys and monitoring.
  • Developing an open, honest culture where illness can be discussed and understood: a top-down approach incorporating wellness champions.


  • In long-term absence cases, ensuring return-to-work interviews are planned with all relevant parties. The interviews should be used to check the employee is ready to return, rather than as a disciplinary tool.
  • Ensuring employees are supported during transformational activities such as downsizing and restructuring. Should redundancies be imminent, providing outplacement support to help employees find alternative employment; this will reduce stress and improve engagement.
  • Allocating workloads to ensure fair distribution of work, with built-in contingency for absence.

For more information on ESPO's Occupational Health framework (985) please click here, or contact the Managing People and Professional Services team on 0116 294 4072 or email