A Strategy to tackle Presenteeism and Absenteeism

White paper in response to the Aviva Working Lives Report

The 2017 edition of the Aviva Working Lives Report worryingly shows that seven in ten UK employees – equivalent to 18 million nationally– have gone to work unwell when they should have taken the day off.

In contrast, less than a quarter (23%) say they have taken a day off work sick when they were not actually unwell, indicating that UK employees are three times more likely to go to work unwell than they are to ‘pull a sickie’.

Why presenteeism is a problem

Employers may wonder why absence management experts like Activ Absence should be worried about people going into work when they are unwell, after all, aren’t we supposed to be reducing absence?

The answer is that best practice absence management focuses on improved staff wellbeing and productivity ra-ther than simply placing a value on ‘being present’.

Here’s why ‘Sickly Suzie’ should stay home if she has an infection:

• 1 day at home (working from home if well enough) would help her recover more quickly. By staying in work, she risks prolonging the illness.
• She may infect other members of staff, causing them to need absence from work, increasing overall absence.
• She will not perform well in work anyway, and could affect the productivity of the team as a whole.

Why is presenteeism on the rise?

Why are UK businesses suddenly seeing an increase in presenteeism, yet only a slight drop in absence? Absence Management specialist Adrian Lewis of Activ Absence explains:

“It seems that presenteeism and absenteeism are complete opposites, but in my experience, they both arise from poor absence management practices.”

“UK employers recently started to focus on the cost of absence. The knee-jerk response was to assume ‘everyone is an absentee’ and scare sick people back to work – which just swaps absence challenges for productivity chal-lenges.”

“Tackling absence is not about waving a big stick and chasing ‘lazy’ employees back to work, it is about uncover-ing the root causes of absence and working with your people, systems and practices in order to tackle them.”

“Absence management software alongside best HR practices is the only way to tackle both presenteeism and ab-senteeism, using an evidence-based approach.”

So what strategies can employers deploy to tackle both absence and presenteeism?

1. Investing in health and wellbeing pays off

The report found only 13% of employers claiming increased focus on employee health and wellbeing over the past year, while just over one in ten (12%) felt there were improvements in the working environment over the past year.

Such views chime with employees’ own assessment of their situation: more than two in five (42%) admit they of-ten feel stressed or anxious at work, rising to 46% among younger workers (18-34 year olds). Employers could also be underestimating the impact stress has on their employees, as only 23% cite this as an issue. Instead, em-ployers view coping with workload (32%) and dealing with change (24%) as greater challenges faced by their em-ployees.

Interestingly, Aviva’s findings suggest that those businesses who have invested in their employees’ health and wellbeing are reaping the rewards. Of those that offer health and wellbeing benefits, more than three in four (77%) report a positive impact on the workforce.

Employers also report increased happiness levels (41%) among employees with improved morale (32%) and productivity (30%) as a result of having initiatives in place to keep employees healthy.

Smart employers, therefore, will use their absence management data to define priorities and put the right benefits and workplace wellness initiatives in place to maintain low levels of sickness absence using this strategy:

• Use data to identify your biggest absence management challenges, and
• Put steps in place to impact on that problem

2. Tackling mental health in the workplace

The role that mental ill health plays in workplace absence cannot be underestimated.

Research from the British Heart Foundation uncovered that 36% of all workplace absences in the UK are due to stress and depression, a staggering 80 million working days and £9 billion per year, and also highlighted the fact that many of the following other conditions are also exacerbated by workplace stress, including:

• respiratory dis-eases
• infections
• obesity
• increased levels of substance abuse
• high blood pressure • blood clotting
• low im-munity
• coronary heart disease (because of an increase in risk factors such as smoking, cholesterol metabolism and low levels of physical activity).

Employers have legal obligations under the Management of Health and Safety at Work Regulations 1999, to as-sess the risk of stress-related ill health arising from work activities, under the Health and Safety at Work etc Act 1974, to take measures to control that risk, and under the Disability Discrimination Act 2005.
The Disability Discrimination Act (DDA) applies as much to people with mental ill health as it does to those with a physical disability. It is now illegal for organisations to fail to recognise the mental health needs of their staff.

A mental health at work policy is essential, but occupational health expert Jean Fisher of The OH Business recom-mends employers look at improving openness on mental health in the workplace by introducing a Stress Risk As-sessment, as well as investing in training for line managers. She says:

“Weaving the stress risk assessment approach through an organisation in team meetings appraisals and at every opportunity, will reduce the sensitivity of difficult issues within an organisation. Issues will be picked up very early and employees will feel that they are heard when they start to feel under pressure. This can start gradually and lead to a more open culture in the long term.”

Mental Health Charity Mind produce free resources to help employers manage mental health at work more effec-tively. However, the most important thing is timely intervention, as long term absence is unlikely to help, whereas reasonable adjustments will often enable an employee to remain at work.

3. Get back to basics with return to work procedures.

We believe that cut-down return to work procedures are contributing to high levels of presenteeism.

A return to work interview should take place after every single absence, whether one day or ten – and employees should not find them a ‘fearful’ experience.

It doesn’t have to be formal, but it does need to take place, even if is a quick chat with a line manager that is then recorded onto an absence management system.

This has several benefits:

• It ensures the employee is well enough to return to work
• It sends a clear message that employers care about staff wellbeing, but that absenteeism will be noted
• The line manager can take the opportunity to gently explore whether the employee shows potential signs of stress or depression
• The line manager can consider whether additional support or reasonable adjustments are needed
• The line manager can tackle any clear absenteeism challenges promptly and nip them in the bud
• Recording the outcome of the interview enables future reviewers to have a more accurate view of the em-ployee’s absence history
• The employee should be treated as an INDIVIDUAL and managed accordingly

The recent knee-jerk response to high reported rates of sickness absence has seen HR insisting on return to work interviews, but not doing them until absence reaches a given number of days.

This sends the message that short term absenteeism won’t be challenged and that ‘longer periods of absence will be punished with interviews’.

It is the wrong message on both counts, short term absentees are not discouraged and we’ve seen staff with pneumonia returning early as the cut down process is perceived as a ‘sanction’ in itself.

It is therefore vital that organisations use return to work interviews for EVERY absence and that triggers for further reviews are fair and visible, but allow reviewers to consider individual circumstances

Make best use of Occupational Health Experts & the Fit for Work Scheme

Before requesting a medical report from a GP where a member of staff is off work, consider instructing an oc-cupational health report instead. Normally the costs are lower, and whereas the GP can only consider the em-ployee’s health, an occupational health professional will look at the illness from a work perspective and can suggest reasonable adjustments which could help facilitate a speedier return to work.

Occupational health advisers are also well placed to help where an assessment reveals a risk of absence – their advice on reasonable adjustments can be key to striking a balance between absenteeism and presenteeism.

The new Fit for Work scheme can also be an ally in shortening the impact of long term sickness. When em-ployees are off sick for long periods, can be purely because they are signed off by their GP whilst waiting for an NHS diagnostic appointment.

The scheme gives employers £500 for each employee where occupational health or a healthcare professional has recommended diagnostics or a consultant referral – meaning employees could have private tests and/or a consultant appointment more quickly. This offers a clear win/win for both employer and employee, so should be a no brainer.

In order to qualify, the medical treatment must be recommended to help your employee return to work after a period of absence due to ill health or injury and either a healthcare professional must assess them as not likely to be fit for work for at least 28 consecutive days, due to ill health or injury; or, they have been absent from work for at least 28 consecutive days due to ill health or injury.

The medical treatments must be recommended by a healthcare professional from Fit for Work or by a healthcare professional in occupational health for the tax exemption to be applicable

5.Offer home working options where possible

Whilst management tips for flexible working are a whole topic on their own, we recommend where staff are infectious, but otherwise feel sufficiently well to work, why not consider home working?

This ensures business continuity, and the cost of tools to monitor this are relatively low.

It is a strategy we have deployed within our own business, which has worked extremely.

Conclusion

Whilst seemingly at odds, presenteeism and absenteeism often have similar causes and therefore any absence management strategy should be structured towards managing both.

Those employers who do this most effectively will be using specific absence management tools, monitoring Bradford factor scores and maintaining a high level of employee engagement by using cloud based HR soft-ware and calling in external professionals when necessary.

While none of this comes cheap, in our experience, it is considerably more cost effective than either absentee-ism or presenteeism.

Adrian Lewis, Commercial Director. Activ Absence

Adrian Lewis added:

“THE RANGE OF AFFORDABLE HR SOFTWARE ON THE MARKET RIGHT NOW OFFERS EMPLOYERS MORE OPPORTUNITIES THAN EVER BEFORE TO MANAGE PERCEIVED BENEFITS LIKE HOME WORKING AND DE-LIVER STRUCTURED WELLNESS & BENEFITS PROGRAMMES THAT WILL HAVE A REAL IMPACT ON BOTH PRODUCTIVITY AND SICKNESS ABSENCE. THE TECHNOLOGY, THE TOOLS AND THE EVIDENCE IS AVAILA-BLE, WE JUST NEED TO ENCOURAGE MORE EMPLOYERS TO USE IT!”

Dr Doug Wright, Medical Director, Aviva UK Health, said:

“WHILE EVERY BUSINESS WANTS THE RIGHT LEVEL OF RESOURCE IN PLACE, HAVING EMPLOYEES WHO ARE UNWELL AT WORK IS A FALSE ECONOMY. BUSINESSES NEED TO ENSURE THEY CREATE A WORKING CULTURE WHEREBY PEOPLE DO NOT FEEL PRESSURISED INTO COMING TO WORK WHEN THEY ARE UN-WELL, SAFE IN THE KNOWLEDGE THEIR ABSENCE CAN BE EFFECTIVELY MANAGED.”

“PRESENTEEISM, DRIVEN IN PART BY AN INCREASED ‘ALWAYS-ON’ CULTURE, POSES A GENUINE THREAT TO OVERALL BUSINESS PERFORMANCE THROUGH THE ADVERSE IMPACT ON PRODUCTIVITY AND MO-RALE IN THE WORKPLACE. BUSINESSES SHOULD ENSURE THEY TAKE THE LEAD ON COMMUNICATING PROACTIVELY TO EMPLOYEES THAT IT’S IMPORTANT TO TAKE A STEP BACK WHEN UNWELL AND IT CAN BE IN EVERYONE’S INTEREST.”

“BUSINESSES CAN ALSO COUNTER SUCH ISSUES BY ENSURING THEY CONTINUE TO EXPLORE NEW WAYS IN WHICH TO IMPROVE THE WORKING EXPERIENCE FOR EMPLOYEES. INVESTMENT IN HEALTH.”

“WELLBEING IS NO LONGER A NICE TO HAVE; IT MUST BE LOOKED ON AS A PRIORITY.”