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Karen Steadman
Senior Researcher
Karen Steadman

Well enough to work?

Authors: Karen Steadman

02 May 2014

As I sit here, coughing at my desk, my colleagues wincing at the sound, fearing that my cough will become their cough - or perhaps just getting irritated at how loud it is - I, like many other workers, may wonder: Should I be at work today?

More research was released today by AXA PPP healthcare, highlighting the extent of presenteeism in the UK. The study of 2000 employees found 67% reporting that they had gone to work when sick, with ailments cited including colds and flu (47%), back ache or musculoskeletal problems (11%) and poor mental health (6%).

Though to some employers, employees coming to work even when sick may seem like a boon, evidence indicates that the business costs of coming into work, while sick, can be greater than the costs of sickness absence. The Work Foundation has previously identified a significant relationship between presenteeism and performance. Further, it has been estimated that mental health related presenteeism accounts for 1.5 times as much working time lost as absenteeism. Given it is senior, high-paid, members of staff who are more prone to coming in when sick, it is easy to see how these costs might grow.

Presenteeism may be a warning sign of problems to come; it is often associated with poor help-seeking behaviour, which reduces the ability to intervene early in preventing a health issue worsening. Indeed, as The Work Foundation findings reveal, higher levels of sickness presence are also associated with reduced psychological wellbeing and higher levels of sickness absence.

In the AXA PPP study, reasons for attending while ill included a heavy workload (21%), guilt about staying away from work (18%), pressure from managers or colleagues (14%), and fears for job security (8%).  An interesting finding is that a fifth of participants (21%) said they went to work as they weren’t sure if they were actually ill enough to justify taking the time off. 

All of these bring us to the root of the problem of presenteeism: workplace culture. Much of the decision-making about whether or not to attend work while sick will be based on what we know about our workplace. For instance, if my workplace makes it clear that coming in with a cold, and therefore possibly spreading it around the office, is not the done thing then I won’t. Of course, on the other hand, if everyone comes in then why wouldn’t I?  Managers in particular are seen as setting an example in this regard; you can have a very thorough set of health and wellbeing, and sickness absence management policies and programs, but if your manager always comes in when ill, works long hours, and doesn’t take breaks, then this may seen normal behaviour to be replicated by team members.

Of course, making health related expectations apparent to employers is not always as clear cut as the examples given above. There will be many factors to weigh up – including the extent to which the current condition affects your ability and that of others to work, and as mentioned earlier whether there are implications for longer-term health and wellbeing.  What is important here is that managers take an active interest in the health and wellbeing of their employees and make sure they know their health is an important workplace issue. Worryingly, the AXA study also found a proportion of employees (particularly in London) who, on attending work while sick, were prevented from going home by their manager. If managers want to maintain a healthy productive team, they need to set the tone.