Presenteeism is when someone continues working despite being unwell, even though their health is affecting their ability to work effectively.
It can happen when employees feel pressure to be available, worry about falling behind, are concerned about job security, or simply don't feel comfortable taking time off. It can also happen when workplace expectations make working through illness seem normal.
With hybrid and remote working now common across many organisations, presenteeism doesn't necessarily mean someone physically turning up to the office while they're ill. They might be answering emails from bed, joining meetings while they have flu, or continuing to work when they're struggling with their mental health.
Presenteeism: key facts for employers
- Presenteeism isn't the same as good attendance. Someone can be physically present but unable to work effectively because they're unwell.
- It can happen anywhere. Office-based, hybrid, and remote workers can all experience pressure to work when they're ill.
- It can affect productivity and well-being. Working while unwell can reduce performance and may delay recovery.
- Mental health matters too. Stress, anxiety, depression, and other mental health problems can contribute to presenteeism.
- Managers have an important role to play. Clear absence policies, realistic workloads, supportive conversations, and healthy leadership behaviours can help reduce pressure to work when unwell.
What causes presenteeism in UK workplaces?
There isn't one reason why people work when they're unwell. Presenteeism can develop when individual circumstances combine with workplace expectations and culture.
Common causes include:
Job insecurity
Employees who are worried about their job or financial situation may feel reluctant to take time off, even when they're ill.
Heavy workloads and deadlines
When workloads are already high, employees may feel that taking time off will simply leave more work waiting for them when they return.
An always-on culture
If managers regularly send emails outside working hours, respond to messages late at night, or talk about working while they're ill, employees may interpret this as an expectation that they should do the same.
Performance pressures
In some roles, targets, billable hours, sales figures, client deadlines, or other performance measures can create pressure to remain available.
Unclear sickness policies
If employees aren't sure when they should take sick leave, how sick pay works, or whether taking time off will affect their performance record, they may choose to work instead.
Employers can reduce some of these pressures by making absence policies clear and training managers to apply them consistently. Acas recommends clear absence policies, manager training, regular workload reviews, and a culture where employees feel comfortable raising problems.
What are the effects of presenteeism on employees and businesses?
Working while unwell doesn't necessarily mean someone is being productive. If illness affects concentration, energy, decision-making, or communication, an employee may be working but achieving less than they normally would.
The potential impacts include:
Lower productivity
An employee may take longer to complete tasks, struggle to concentrate, or find it harder to make decisions.
More mistakes
Reduced concentration can increase the risk of errors. In roles involving financial information, customers, safety, compliance, or complex decision-making, those mistakes can have wider consequences.
Lower team morale
If some employees regularly work while ill, colleagues may feel pressure to do the same. This can create an unhealthy expectation that taking sick leave shows a lack of commitment.
Longer recovery
Continuing to work while unwell can make it harder for someone to recover. Acas specifically advises employers to create a culture where employees do not feel pressured to work when they're ill.
Increased costs
Presenteeism can have a significant financial impact. Deloitte's research estimates that presenteeism accounts for around £24 billion a year in costs to UK employers associated with poor mental health.
The wider picture also shows why employee health matters to businesses. HSE's latest statistics estimate that 1.9 million workers experienced work-related ill health in 2024/25, with stress, depression, or anxiety accounting for 964,000 cases.
What is digital presenteeism?
Digital presenteeism is essentially presenteeism in a remote or hybrid working environment.
Someone doesn't need to physically come into the office to feel pressure to work while unwell. Technology can make it possible to stay connected even when someone should be resting.
Examples include:
- Logging into work while on sick leave.
- Replying to emails from bed because you don't want colleagues to think you're ignoring work.
- Joining a video meeting while suffering from flu or another illness.
- Continuing to work while taking medication that affects concentration or alertness.
- Checking Teams or Slack throughout the day while recovering from illness.
- Saying you're "fine to work from home" when you're actually too unwell to work effectively.
Remote working can make presenteeism harder to spot because managers don't have the same visibility of how someone is feeling.
That means managers need to focus less on whether someone is visibly present and more on whether workloads, expectations, communication, and performance indicate that someone may need support.
How can managers spot presenteeism in remote and hybrid teams?
Managers shouldn't try to diagnose whether someone is ill. Instead, look for changes in behaviour or working patterns that could indicate that someone is struggling.
Possible signs include:
- A pattern of minor mistakes from someone who normally produces accurate work.
- A noticeable drop in concentration or engagement.
- Repeated out-of-hours messages or emails.
- Someone continuing to work despite telling you they're unwell.
- A pattern of being "available" online but contributing very little.
- Regularly joining meetings but appearing unable to participate.
- Sudden changes in performance, communication, or working patterns.
None of these signs automatically means someone is experiencing presenteeism. There could be many reasons for a change in someone's behaviour.
The important thing is to start a conversation rather than make assumptions.
For example:
"I've noticed you've been working quite late recently. How are things going, and is there anything we need to look at in terms of your workload?"
Or:
"You mentioned you're not feeling well, but I've seen you replying to messages this morning. Please don't feel you need to work if you're unwell. Let's talk about what you need."
A supportive conversation can give the employee an opportunity to explain what is happening and allow the manager to consider practical support.
What should employers do to reduce presenteeism?
There isn't a single policy that will eliminate presenteeism. Instead, employers should look at the workplace conditions that may be encouraging people to work when they're unwell.
Train managers to recognise the signs
Managers don't need to be health experts, but they should know how to have appropriate conversations about well-being, workload, absence, and work-related stress.
HSE highlights the importance of giving managers the knowledge and skills to manage work-related stress and create supportive working environments.
Make sickness policies clear
Employees should know how to report sickness, what support is available, and what happens while they're away.
Policies should also explain how employees can keep in touch during absence and what support is available when they return.
Make sick pay information easy to understand
Uncertainty about pay can be one reason someone feels they need to keep working.
Make sure employees know where to find information about statutory and contractual sick pay and who they can speak to if they have questions. Acas recommends that employers are clear about sick pay entitlement and the organisation's sickness policies.
Review workloads regularly
If someone feels that taking a day off will leave them with an unmanageable workload, they're less likely to feel comfortable doing so.
Managers should regularly review workloads, deadlines, resources, and priorities, particularly during periods of high demand.
Set healthy boundaries
Managers set the tone for their teams.
If leaders regularly send messages late at night, work while they're sick, or praise people for doing the same, employees may assume that being constantly available is expected.
Modelling healthy boundaries can help create a different expectation.
Make it safe to take sick leave
Employees shouldn't feel that taking legitimate sick leave means they're letting their team down.
Acas recommends creating a culture where employees don't feel pressured to work when they're ill and where well-being is taken seriously.
What is the difference between presenteeism and absenteeism?
Presenteeism and absenteeism are related, but they're not the same thing.
| Question | Presenteeism | Absenteeism |
|---|
| What does it mean? | Working despite being unwell or not fully fit to work. | Being away from work because of illness or another reason. |
| What might drive it? | Pressure to work, job insecurity, heavy workloads, or an always-on culture. | Illness, caring responsibilities, stress, or other personal circumstances. |
| What might employers measure? | Reduced productivity, mistakes, performance changes, or patterns of working while unwell. | Sickness absence rates, absence frequency, or length of absence. |
| What can employers do? | Support healthy working practices, make sickness policies clear, review workloads, and create a culture where people feel able to take time off when needed. | Understand the causes of absence, provide appropriate support, and manage absence consistently and fairly. |
Neither should be viewed simply as an attendance problem.
A high level of absence may indicate an underlying workplace issue, while a low absence rate doesn't necessarily mean employees are healthy. People may instead be coming to work when they should be taking time to recover.
What policies can help reduce presenteeism?
A practical approach starts with your existing people policies and management practices.
Review whether your organisation has:
- A clear sickness absence policy.
- Clear information about sick pay.
- A consistent process for reporting sickness.
- Guidance for managers on supporting employees who are unwell.
- A process for keeping in touch during longer periods of absence.
- Return-to-work conversations.
- Flexible or phased return arrangements where appropriate.
- Workload and work-related stress assessments.
- Access to well-being or occupational health support where appropriate.
Policies alone aren't enough. Managers need to understand them and apply them consistently.
How can employers create a healthier workplace culture?
Reducing presenteeism is ultimately about creating an environment where employees don't feel that they have to choose between their health and their job.
That means looking beyond well-being initiatives and considering the everyday experience of work.
Do employees have realistic workloads? Do managers model healthy behaviour? Can people take sick leave without feeling guilty? Are performance expectations clear? Do employees know where to go for support?
HSE's latest figures show that work-related stress, depression, and anxiety remain a major source of work-related ill health in Great Britain, accounting for more than half of reported cases in 2024/25.
Addressing the causes of work-related stress is therefore an important part of creating a healthier working environment.
What should I do if I think someone is experiencing presenteeism?
Start with a conversation, not an assumption.
Ask how they're doing, check whether their workload is manageable, remind them of your sickness policy, and make it clear that they don't need to work simply because they're at home or have access to their laptop.
If someone is unwell, they should follow your organisation's sickness absence process. Acas advises that workers should take time off when they need it and that employers should make sure employees have enough time to recover.
If they're returning after sickness absence, a return-to-work conversation can help establish whether they are ready to return and whether any support or adjustments are needed.
For longer-term or complex health issues, HR, occupational health, or appropriate professional support may also be needed.
How can manager training help tackle presenteeism?
Managers are often the people best placed to notice changes in behaviour, workload, performance, and well-being.
But spotting a potential problem is only the first step. Managers also need to know how to have supportive conversations, apply absence policies consistently, recognise work-related stress, and escalate concerns appropriately.
Training can help managers develop the confidence and practical skills to do this.
Kaplan offers training and development solutions for organisations looking to strengthen their managers' skills, including areas such as leadership, well-being, and managing workplace stress.
Explore training for employers
Additional resources
At Kaplan, we have many resources that you can use if you need support.
Many of our staff are mental health first aiders, and if you think you or anyone in your workforce could benefit from some of our well-being and mental fitness resources, visit our learner well-being page where you can find the relevant people to speak to for advice.
You can also get more advice by:
If you have any safeguarding concerns, please raise them by contacting our Safeguarding Team via safeguarding@kaplan.co.uk.
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