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The Future of Presenteeism

Presenteeism, which is coming into work when unwell, has grown in notoriety over the last twenty years, particularly in organisations where long working hours is the norm. 80% of UK employees admit to working when sick. Employers are warned that ignoring presenteeism may store up long-term issues.

Not all presenteeism is apparently bad news. ‘Functional presenteeism’, where working whilst unwell does not actually further compromise their health, can have a positive effect on an employee’s psychological wellbeing. The employer would, however, still need to assess whether the work or workloads poses a risk to the employee‘s health and consider adjusting work/workloads to ensure the employee’s presence remains a positive experience. However, this is about the only type of presenteeism which might be acceptable. The other types are not recommended; ‘dysfunctional presenteeism’ has no positive impact on the employee let alone their productivity and may mean their health does not recover; ‘therapeutic presenteeism’ is where the employee finds working recuperative and helpful to them, but not to their performance or long term recovery; and ‘overachieving presenteeism’ which in the short term may give rise to amazing performance but is at considerable cost to the employee’s health.

Presenteeism can therefore cause enduring issues with productivity, seriously compromise employee health, and/or mean that the employer fails in its health and safety obligations. Dealing with presenteeism is compounded further by two-thirds of the UK workforce working remotely during the pandemic and employees feeling compelled to be available all the time, finding it harder to switch off.  Identifying presenteeism is much harder when employees are working remotely. If an employee is struggling with a physical or mental health issue when working from home, their manager may find it harder to spot. The employee may also find the decision as to whether to take sick leave all too complicated without that managerial intervention.

The root cause of presenteeism is often an organisation’s culture. Unmanageable workloads was found to be the greatest cause of workplace stress according to a recent CIPD workplace survey.   According to the Health & Safety Executive, in 2017/18, 44% of all work-related illnesses are attributable to work-related stress, depression or anxiety. Given the amount of time we spend at work, it is no surprise that employers are under a common law duty to take reasonable care of the health and safety of employees. This is extended to ensuring, so far as is reasonably practicable, the health, safety and welfare at work of employees under the Health and Safety at Work Act 1974. These duties mean that employers should take reasonable steps to look after both the mental and physical health of their employees.

While employers are alive to issues created by homeworking during the pandemic including stress, loneliness, anxiety, lack of exercise, difficulty delineating work from home life, and have responded with advising employees (or directing them to appropriate advisors) to incorporate regular exercise, screen breaks, maintaining good mental health and managing their work/life balance, it should be born in mind that strong leadership is also critical to identifying presenteeism to be proactive about their health and safety duties.

As part of the health and safety responsibilities, employers also have a statutory duty to conduct ‘suitable and sufficient’ risk assessments to identify hazards and degree of risk (Management of Health and Safety at Work Regulations, 1999). Identifying hazards for homeworkers is more than providing them with information on how to set up their desks properly, possibly ensuring a basic first aid kit is available at home and that all technical equipment is maintained. Keeping in regular contact with homeworkers is an important health & safety compliance step. Presenteeism could be a hazard that needs to be managed and assessed.

Applying the principles of prevention, those relevant to stress include avoiding risks, combating risks at source, developing a coherent overall prevention policy that covers technology, organisation of work, working conditions, social relationships and the influence of factors relating to the working environment, and giving appropriate instructions to employees. Providing relevant information to employees in a comprehensible way about the risks to their health and safety in ignoring risks identified in their working environment will help the employer mitigate and manage the risk.

Managers have a further part to play in taking reasonable steps to support the health of homeworkers, and that is to give them an avenue to tell the employer (essentially reporting) about any risks they may have identified. They need to treat such reports seriously; a dismissive response will undermine the employees’ ability to report risk.

Presenteeism is not a UK phenomenon. Studies of US employees refer to presenteeism as a “serious drag on productivity and contribution”; Harvard Business Review defines it as “the problem of workers’ being on the job but, because of illness or other medical conditions, not fully functioning.”  While poor sick pay and low annual leave may force employees to attend work whilst they are below par, another cause of presenteeism is the workplace culture where managers strongly discourage employees from taking time off, even when sick, giving rise to a culture of always being present however unsatisfactory that might be. Whether you are comparing the UK to the US or other countries, the higher the number of hours employees work each year does not generally mean that the country’s GDP will be higher than one with a lower annual hours per employee. Measuring productivity is not as simple as counting the hours that people spend at work. According to the OECD, the average American spent 1,783 hours at work in 2017; the UK 1,676; the French 1,472 and the Germans 1,363. However, Germany, France and the US had a higher GDP than the UK. Spending fewer hours at work does not mean lower productivity. Many economic advisers attribute a higher skills base to increased productivity and performance, to which my conclusion is that presenteeism is not the answer.

In the circumstances, managing presenteeism (and upskilling leaders to do so) as the world of work changes again post-pandemic, will still be important to comply with health and safety obligations, to reduce the propensity of workplace stress and remove factors that generally hinder productivity.

If you are an employer and would like to discuss the impact and implications of presenteeism on both your employees and your business, you have any other questions arising from this alert, or for specific legal advice on particular circumstances, please contact our Partner, Emma Bartlett, who specialises in employment and partnership issues for multinational employers, senior executives, partnerships and partners.

This article was first published in CEO Today Magazine.