How much is presenteeism costing your company?

The Centre for Mental Health reports that mental health problems within the UK workforce are currently costing employers almost £35 billion a year. Nearly two-thirds of those costs are associated with reduced productivity at work: Presenteeism.

Research shows that whilst presenteeism is hugely costly to employers it is all too often ignored. Managing it will not only save money in both the short and long term, but also contribute to the development of an engaged and productive workforce.

Many companies, seeking to embed well-being into their culture, have adopted the BITC's Workwell model.

According to the Workwell Model, to achieve the 'Working Well' target, organisations must focus on the four main pillars of the model:

• Better work

• Better Relationships

• Better Specialist Support

• Better Physical & Psychological Health

Read on for an overview of the Workwell Model and discover how you can start to apply those principles to your organisation today:

BETTER WORK

Create a happy and engaging work environment

Build a resilient organisation: Culture has a strong influence on both health and well-being. By failing to provide a culture that embraces an individual's need for autonomy and job security, organisations risk developing a culture of absenteeism and presenteeism which will ultimately have a detrimental effect on productivity. Whilst job security is hard to guarantee other steps can be taken to provide a more secure work environment.

HOW: Implement and maintain robust and fairly administered corporate policies. Managers need to be aware of any cultural trends towards absenteeism and presenteeism and be prepared to address them.

Build awareness of presenteeism: Focus more on what can't be seen by moving focus from the more quantifiable absenteeism rates to presenteeism. Managers need to be aware that presenteeism is the more significant cause of lost output than absenteeism and accidents.

HOW: Encourage managers to adopt a more flexible approach to sickness absence in order to avoid causing further presenteeism.

Measure rates of presenteeism: What gets measured gets managed.

HOW: Measuring presenteeism is not easy. One option is to add some questions to existing staff surveys on the subject of health and attendance at work. Additional, more thorough information can be obtained from detailed and focused surveys undertaken on an occasional basis such as during annual reviews. Specially designed instruments for measuring presenteeism do exist and have been published by organisations such as the WHO.

BETTER RELATIONSHIPS

Promote communications and social connections

Make it possible to talk about health in the workplace: Employees with health problems often do not receive support in the workplace as they feel unable to disclose these problems to their manager, nor are managers trained how to respond if they do.

Many of life’s challenges including family issues, financial difficulties, and job insecurity can contribute to presenteeism. Organisational stressors can be minimised through good work design and good management, but work pressure cannot and should not be totally eliminated.

HOW: Training should be provided for both managers and employees so they can have a better understanding of health in the workplace, including actions they can take themselves. This will also help to reduce stigmatising health conditions like depression and facilitate a more open approach to disclosing health conditions.

Identify emerging mental health problems early: Depression and anxiety are more likely to lead to presenteeism than absenteeism. By recognising and understanding the signs of distress and that performance issues may be health-related managers can confidently offer support to employees.

HOW: Managers need training in order to identify the early warning signs of common mental health problems in the workplace to help them intervene as early as possible and speak supportively with employees who are experiencing difficulties. Managers’ competencies should also include understanding the role that work and organisational factors can play in enhancing or damaging mental health and the people skills to promote positive engagement and well-being.

BETTER SPECIALIST SUPPORT

Provide interventions to manage health and well-being

Promote the flexible management of sickness absence: A low level of absence is not necessarily a sign of good management. Aggressive absence policies can do more harm than good, particularly those with fixed trigger points for a certain number of absence episodes that lead to disciplinary action. They can lead to presenteeism which may subsequently result in higher levels of sickness absence in the longer term and reduced productivity.

HOW: Ensure that absence management policies are flexible and that managers are trained and supported in implementing them. Managers should be clear about areas of managerial discretion they can utilise to manage an employee with a health problem. Be extra vigilant about employee well-being during periods of downsizing and restructuring.

Provide specialist support: There is increasing evidence that investment in specialist support such as employee health screening and counselling pays dividends in terms of increased productivity and employee engagement.

HOW: Provide evidence-based interventions to manage health and well-being including specialist services such as occupational health, EAPs (Employee Assistance Programmes), and counselling.

BETTER PHYSICAL & PSYCHOLOGICAL HEALTH

Create an environment that promotes healthy behaviours

Promote health and well-being: There is a good business case for implementing simple well-being programmes in the workplace that address both physical and mental health. Emerging research demonstrates that such schemes have a positive impact on well-being, engagement, and productivity.

HOW: Review your current well-being strategy and consider what additional mechanisms can be put in place to further promote health and well-being at work.

Limit job stress: While only a small proportion of mental ill-health in the workforce is directly caused by work, employers still have important responsibilities. Work-related risks to physical health are generally well understood; those affecting mental health are not.

HOW: Employers can take a number of steps to reduce risks to health and well-being at work. These include using the Health and Safety Executive (HSE) Management Standards for work-related stress. Other tools are also available to help employers manage mental health issues in the workplace more effectively (see below).

Manage the problem, not the symptoms: Both sickness absence and presenteeism are symptoms of an underlying health problem. Good management of ill health in the workplace consists of minimising the risks and the adverse consequences of poor health, both for the individual and for the organisation.

HOW: Develop a health and well-being strategy that deals with all aspects of employee well-being and tackles both presenteeism and absenteeism, not just the symptoms of when things go wrong.

IN CONCLUSION:

The Centre for Mental Health www.centreformentalhealth.org.uk shares these reasons why presenteeism should be taken seriously:

• The costs to business caused by health-related presenteeism appear to be larger, perhaps significantly so, than the costs of sickness absence.

• Health problems in their early stages often manifest themselves mainly in the form of increased presenteeism, which then acts as a strong predictor of future sickness related absence. More presenteeism today means more absenteeism tomorrow.

• Productivity losses caused by health problems are more likely to take the form of presenteeism rather than absenteeism among white-collar workers, particularly professional and executive staff, than they are among blue-collar workers. This is pushing up the costs of presenteeism, as the balance of employment shifts away from manual to non-manual jobs.

• Presenteeism tends to go up and absenteeism down when jobs are at risk, as employees seek to reduce their chances of being made redundant by maintaining a good attendance record even when unwell. The current weak state of the labour market is therefore increasing presenteeism and its associated costs.

• Mental health problems such as depression are particularly likely to take the less visible form of presenteeism, perhaps because employees wish to avoid being labelled mentally ill.

• Finally, all employers should be aware that only a small part of ill health in the workforce is actually caused by work, which on the whole is good for health.

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Useful resources provided by the Centre for Mental Health:

• BITC Workwell Model and the Managing Emotional Wellbeing tool - www.bitc.org.uk

• Health, Work and Wellbeing’s Workplace Wellbeing Tool - www.dwp.gov.uk/health-work-and-well-being

• HSE website and government occupational health advice line - www.hse.gov.uk

• WHO Health and Work Performance Questionnaire www.hcp.med.harvard.edu/hpq HSE Management Standards for work-related stress www.hse.gov.uk/stress/standards DWP Fit Note Guidance

Sources:

Centre for Mental Health https://www.centreformentalhealth.org.uk Managing presenteeism: a discussion paper. May 2011

Forbes, The Price of Presenteeism, Karen Higginbottom, April 20, 2018