Research published by Birmingham’s Aston University in 2010 revealed the cost of presenteeism to be £15bn per year – and this amounted to twice the cost of absenteeism
This may come as a shock to managers who largely underestimate the tangible effects of presenteeism. In his 2009 study, Presenteeism in the Workplace: A review and research agenda, Professor Gary Johns from the Department of Management at Concordia University in Canada presents the problem rather more visually. He talks about an “iceberg effect” in which the “more visible portion of work loss (absenteeism) is dwarfed by that portion beneath the surface (presenteeism)”. Absenteeism, in fact, is just the tip of the iceberg.
Culture of fear
The economic downturn has a key part to play in raised levels of presenteeism due to heightened job insecurity and more pressure on many people who fear that taking a legitimate sick day will annoy colleagues and compound their already unmanageable workload.
However, presenteeism existed long before the recent recession. Also, it wasn’t always thought of as a bad thing, but as part of good organisational citizenship behaviour, says Nuala OSullivan, senior lecturer in human resource management at Westminster Business School. “Initially it was more related to good spirits and being present and on time,” she says. “In the factories in the 1920s, for instance, it was essential that people were present because if someone was missing from work the whole process didn’t function properly.”
Echoing this, Johns’ 2009 study lists nine definitions of presenteeism taken from various writings on the subject over the years, one of which is “exhibiting excellent attendance”. OSullivan believes, however, that the culture within many organisations today means the citizenship behaviour pendulum has swung too far in the opposite direction: “We’re getting to the point where we have a culture that encourages not just presenteeism but also the forgoing of lunch hours and coffee breaks.”
The UK’s long-hours culture has been well documented. Figures published by the Office for National Statistics in 2011 showed that full-time managers and senior officials in the UK worked some of the longest hours in Europe. As such, they are often role models for the undesirable version of presenteeism.
People think, ‘I’ve never had a day’s sick leave in my life’ rather than ‘If I go in and infect everyone else, there will be no one left standing in the department’ – so they go in to work.
Nuala OSullivan, senior lecturer in human resource management, Westminster Business School
“If employees see a manager or team leader putting in long hours and coming to work when they ill, they are going to do it as well,” says Rosie Bailey, co-founder of people development consultancy OnTrack International. “Speaking as a business owner, I know how easy it is for managers to do this, especially as times are tough and there aren’t enough hours in the day. But when people see this, they regard it as the norm, and the danger is that managers concentrate on input rather than output.”
In China, it is acceptable for workers to put their heads on their desks and take a short nap, while Spain has its siestas and many organisations in the US have embraced the concept of duvet days. However, such ideas tend to sit uncomfortably with employers in the UK.
Boom and bust
This isn’t helped, says OSullivan, by the baby boomer generation that still occupies many leadership and management positions. “They haven’t necessarily experienced the job insecurity and unprecedented levels of stress that many teams are working under today,” she says. “This means they find it hard to understand why people are having trouble functioning. They just want to push forward.”
All of this has led to a case of “good soldier syndrome” in the UK, says OSullivan. “People think, ‘I’ve never had a day’s sick leave in my life’ rather than ‘If I go in and infect everyone else, there will be no one left standing in the department’ – so they go in to work.”
Breaking down such a culture is central to defeating presenteeism, says Marcus Powell, group organisational development and HR director at Nuffield Health. The subject was one of those highlighted in a study that his company produced with Ashridge Business School, Corporate investment in employee wellbeing: The emerging strategic imperative.
Nuffield Health also carried out a survey of 1,600 workers in the UK, which found that nearly three quarters of them had gone to work while sick, and more than half had gone in with a contagious illness such as the flu.
Powell says that employers need to talk more about presenteeism and shift the culture away from employees thinking they have to be seen in the workplace 100% of the time to be productive. “Does sitting at my desk from nine until five reflect that I’m a productive worker?” he asks. “There are other ways of working and once you start having these conversations, most enlightened managers will accept that as long as the job is being done and delivered to a good quality, you can be as flexible as you want.”
Encouraging the measurement of employees’ performance on output rather than input is one of the big challenges that managers face as organisations move towards more flexible and remote working. However, it isn’t always practical. According to Nuffield Health’s research, the industries in which employees feel most pressure to attend are those where employees have to be in situ: retail tops the list, followed by manufacturing and education.
Dealing with presenteeism head-on is as much about good general management practice as anything else. The better the manager and the relationship they have with their team, the better they will be at detecting signs of presenteeism. In some individuals, the physical symptoms will be easier to spot, but they must also be alert to stress-related issues and mental health problems like anxiety.
“The more you get to know your staff, the more you will be able to pick up if they are behaving out of character or are unwell,” says Collier. “Also, exercise an open-door policy. Many managers claim to but it doesn’t actually happen. Remember that a little time-out with a member of the team goes a long way.”
A one-to-one may reveal a domestic situation or problem that is causing an employee to come to work regardless of their own health. For instance, OSullivan says women with children will often save their own sick days in case they need to take time off when their child is ill. Powell says managers must act like coaches to understand what an employee is going through. “This means regular one-to-ones and dialogue to find out what is really going on,” he says. “One of the reasons that people are present in the workplace when they shouldn’t be is because there is a lack of trust within the relationship.”
Bailey says that “aggressive” absence policies will often signal this lack of trust to a workforce. “Some employers hold the view that if they pay full sick pay, employees will take it as days off. But if your team is committed and there is trust, they won’t do this to you,” she says. “If an employer is picky about time off when ill, then when they need an employee to go the extra mile that individual is more likely to think, ‘Stuff it, if that’s how you treat me.’ Behaviour breeds behaviour.”
We are all likely to have been guilty of presenteeism at some point during our working lives. While it may sometimes be an act of martyrdom, in most cases it has the best of intentions behind it, which is perhaps why managers find it a difficult area to tackle. There are some methods to help measure it, such as the Work Limitations Questionnaire and the Stanford Presenteeism Scale, but until now its detrimental effect on an organisation and an individual’s health hasn’t been fully realised.
Presenteeism’s profile is rising, though, and the increased focus on wellbeing by employers will hopefully further heighten its importance and ensure it becomes part of discussions between HR, occupational health departments and management. It’s unlikely to ever have the same status on the management agenda as absenteeism, but at least there are signs that it is throwing off its cloak of invisibility in the workplace.