What is presenteeism, and why does it matter?

Being at work while unwell or unproductive — physically present but not functioning, whether through illness, exhaustion or disengagement. Research consistently suggests it costs organisations more than absence does, which is counterintuitive and is why it is now taken seriously.

The two forms:

Working while ill, when you should be recovering.

Being present without contributing, through burnout, overload or disengagement.

Why it costs more than absence. Absence is visible and measured; presenteeism is invisible and therefore unmanaged. Multiple studies have estimated its productivity cost as substantially exceeding that of sickness absence — because it affects more people, for longer, without anyone recording it.

Its specific harms:

Work quality falls, and errors rise. In safety-critical and clinical settings this is a direct risk to others.

Recovery is prolonged, so a short illness becomes a long one and is more likely to recur.

Infection spreads, which is the most obvious and most ignored cost.

It normalises the behaviour, since people take their cue from colleagues and from managers in particular.

It masks problems. An overloaded team that never goes absent looks like a functioning team.

What causes it:

Job insecurity, which is the most consistently identified driver — people on insecure contracts attend when ill because they fear the consequences of not doing so.

Inadequate sick pay. Where statutory sick pay replaces a small fraction of income, or is not payable for initial days, attending while ill is a financial necessity rather than a choice, which is a policy question rather than a wellbeing one.

Absence management policies using trigger points, which penalise absence and therefore incentivise attendance while unwell.

Workload with no cover, so absence means the work waits or falls on colleagues.

Culture and management example.

Remote working has complicated it, making it easier to work while ill and harder to notice.

What actually reduces it: adequate sick pay; genuine cover arrangements; managers modelling taking time off; reviewing trigger-based policies; and addressing workload rather than resilience.