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13th February 2019

Virtually all of us – between eight out of 10 and nine out of 10 if recent research is anything to go by – admit to dragging ourselves into work when unwell. The conventional occupational health wisdom is that such “presenteeism” is a bad thing – but is it?

Employee health and wellbeing – should we be wringing our hands about presenteeism?

“Presenteeism”, or coming into work when unwell, is a concept much discussed at the moment within attendance and absence management.

To highlight just a few recent statistics, a survey by People HR last month (February) concluded that “an overwhelming” 79% of Britons have forced themselves to go to work when sick, with a quarter (24%) buckling to pressure from their boss.

Similarly, last year research from a major UK insurance provider suggested as many as nine out of 10 employees continue to work when they have a minor illness, with many feeling their workload is too large to take time off.

Also last year, the Chartered Institute of Personnel and Development argued that presenteeism in UK workplaces has tripled since 2010, with more than eight out of 10 employers (86%) saying they had observed staff coming into work while they had been unwell over the previous 12 months, compared with 72% in 2016 and 26% in 2010.

The conventional wisdom is that workers forcing themselves to come into work in this way when they should really be tucked up and convalescing at home is a bad thing.

Effect on productivity

It can, after all, mean infections and illness simply end up being passed round the office. At the same time, often the productivity and quality of work being carried out is significantly down simply because the employee is feeling so under the weather. And in a safety-critical environment this could, of course, be a serious issue.

Equally importantly, if it is a case of workers dragging themselves in because of fear, bullying or some other sanction, it can be a sign that an organisation’s workplace and management culture is not what it should be.

All these are valid points, and worthy of debate and discussion. Clearly, if an employee has a highly contagious illness – for example a norovirus – they’re not exactly going to be popular if they stagger in and pass it all round their colleagues.

Similarly, if presenteeism is a symptom of bullying or fear – and it may therefore be mental health presenteeism as much as an employee feeling physically unwell – that is something that needs to be addressed and tackled within the workplace context.

Engagement and motivation

But while it is only right that employers take presenteeism and it costs, effects and potential consequences seriously, should they automatically assume that presenteeism is always inherently bad?

After all, there is an argument to be made that, if the dragging into work is done for the right motives, an employee being prepared to get off their sick bed can simply be a sign they’re engaged and motivated.

Similarly, depending on the severity of the illness, in our increasingly connected workplaces it can be that voluntarily remaining on the end of an email from home, even sporadically, may not be a massive imposition for a mildly sick employee.

And then there’s the productivity question. Yes, if you’re feeling like death warmed up you’re unlikely to be firing at 100%. But is it better as an employer to have even 50% of an employee’s productivity than none at all? Yes, if someone is clearly struggling send them home. But if they’re managing, even just about, what’s not to like?

Striking a balance

The key, as Optima Health Chief Medical Officer Dr Lucy Wright makes clear, is for managers to be given the tools and training to recognise and understand the difference between “good” and “bad” presenteeism, and to understand the different sort of management support and intervention that each requires.

“If an employee genuinely should not be at work, it is important they understand that and are encouraged and supported to take the time off they need to recover and come back to work fighting fit. Within that, it is vital managers are communicating the importance of not passing infectious diseases around the workplace unnecessarily,” she says.

“Equally, managers and organisations need to be aware of – and proactively tackle – presenteeism that is being caused by bullying, stress or anxiety.

“But it is also important managers recognise that presenteeism may not always be bad and can sometimes even be a sign employees, especially if the illness is only minor, feel valued and motivated and actively want to be at work or contributing.

“It is all about striking a balance: supporting and encouraging workers to take the time off they need and not to struggle in if they don’t feel up to it. But also making it clear that, if workers do still feel able to contribute, and are keen to, that they are given the freedom and support to do so,” Lucy adds.

Optima Health are attending the Health & Wellbeing @Work Show, NEC Birmingham on 5th and 6th March. Dr Lucy Wright will be delivering a talk on Presenteeism on 6th March at the conference.