Whether it’s flu season, the norovirus, or a particularly suspicious round of headaches the day after the office party, every workplace expects a few sick days here and there. But what about the people who show up anyway?
Presenteeism happens when employees attend work but they’re too sick to perform at their best, or even work at all. They may clock in on time and last their shift, but they’re not physically or mentally able to be productive. Essentially, they’re just going through the motions and it’s bad for business. This guide explains the cost and causes of presenteeism, offering actionable strategies to support employees in putting their health first.
Disclaimer: The information contained in this article and on this website is general information only and does not constitute legal advice. Although all efforts have been made to ensure the accuracy and currency of the information presented, Sonder takes no responsibility for any errors or omissions presented. Please contact a legal representative for individual advice.
Presenteeism: the hidden productivity problem
Workers and their employers can fall into the trap of believing that being present is a positive thing — that not calling in sick gives the business some sort of advantage, making sure that work is still getting done. But in many cases, presenteeism is more likely to hinder productivity than promote it. Here’s the proof:
- The annual cost of employee sickness has risen £30 billion since 2018, according to the Institute of Public Policy Research.
- £25 billion of this increased cost to businesses is caused by lower productivity occurring when people work through their sickness.
- In contrast, only £5 billion of the increased cost is attributable to employee sickness itself.
- When employees work through their sickness, they lose the equivalent of 44 days’ productivity on average. This represents a nine-day increase since 2018.
- UK workers are among the least likely to be absent due to sickness compared to other Organisation for Economic Co-operation and Development and European countries.
- Black and Asian employees in the UK are twice as likely to work while sick compared to white British workers.
What are the main causes of presenteeism?
The exact causes of presenteeism vary depending on the individual and their work culture, but some common causes include:
- Unmanageable workloads and pressure to deliver: Many employees keep working through illness because their workloads are just too heavy to pause. Research from the CIPD Good Work Index 2025 links excessive workload and stress with poorer mental and physical health — yet those same pressures often make people feel they can’t afford to take time off, especially if they’re at risk of redundancy or in line for a promotion.
- Financial constraints and limited sick pay: With statutory sick pay (SSP) set at £118.75 per week in 2025, taking time off can be financially difficult for many UK workers. Especially for those without enhanced company sick pay, the fear of lost income encourages people to keep working, even when unwell.
- Working from home: The jury is out on whether flexible working arrangements like remote work support or hinder wellbeing. According to CIPD, 35% of organisations report that ‘presenteeism’ has risen as a result of employees working from home.
What is the true cost of presenteeism to your business?
| Category | What it looks like in practice | Impact on your organisation |
| Financial costs | Employees “soldiering on” while ill, making more mistakes, slowing down, or re-doing work | Hidden productivity loss, project delays, and wasted salary spend |
| Lost productivity | Time spent “at work” but not performing at full capacity | Lower output despite full attendance levels |
| Lower quality work | Missed details, customer errors, and reduced innovation | Damaged client trust and rework costs |
| Burnout and fatigue | Exhaustion spreading through teams who feel pressured to keep up | Long-term disengagement and future absences |
| Spreading illness | Contagious staff turning up to work or logging in while sick | Wider disruption, more staff falling ill |
| Poor morale | Teams see unwell colleagues pushed to keep working | Declining trust, motivation, and wellbeing culture |
How to reduce presenteeism in your organisation: 5 strategies to try
Encouraging employees to take more sick days isn’t the answer to presenteeism, and it certainly goes against the essence of the government’s Keep Britain Working campaign, which calls on employers to prioritise health and wellbeing, so employees can return to work stronger. These five strategies can help you build a culture where health and performance go hand in hand.
Foster psychological safety and open communication
A culture of presenteeism thrives when people feel unsafe admitting they’re struggling. The CIPD Good Work Index 2025 found that employees with low psychological safety are significantly more likely to report that work harms their health.
At the same time, 82% of UK workers consider it important to bring their authentic selves to work, yet fewer than half feel able to do so. This disconnect creates silent pressure, and stress that often leads to presenteeism.
What you can do
- Encourage honest conversations about workload, stress, and health in one-to-one meetings.
- Respond with empathy, not judgment. When employees open up, focus on support and solutions rather than attendance or performance metrics.
- Equip managers with active-listening and mental-health awareness skills to build trust and confidence in their teams.
Lead by example with healthy working habits
When managers work through illness, it signals that being “always on” is expected. And this is the type of behaviour your employees are likely to mirror.
While the UK government has shelved plans to introduce a formal “Right to Switch Off” policy, its sentiment was important. As a spokesperson for Prime Minister Keir Starmer explained, “Good employers understand that for workers to stay motivated and productive, they need to be able to switch off… A culture of presenteeism can be damaging to productivity.”
What you can do
- Set visible boundaries, such as taking time off when you’re unwell and avoiding sending non-urgent emails after hours.
- Normalise rest by encouraging employees to use their annual leave and take breaks without guilt.
- Recognise output, not hours. Celebrate results and collaboration rather than late nights or constant availability.
Review and promote a supportive sickness absence policy
When employees aren’t sure what’s acceptable, or worry they’ll be penalised for taking time off, they’re far more likely to work through illness instead of getting better.
A clear, compassionate sickness policy helps employees understand when it’s safe to rest — and ensures that managers respond consistently.
What you can do
- Audit your policy annually. As a best practice, involve HR, line managers, and employee representatives to check your sickness and return-to-work procedures are still fit for purpose.
- Test the policy in practice by reviewing recent cases to see how the policy played out; were employees supported, or did it create barriers to rest and recovery?
- Clarify decision-making by establishing who authorises sickness absence, phased returns, or flexible adjustments, so no one avoids time off through uncertainty.
- Re-share your policy at least once a year, ideally at team meetings or wellbeing check-ins to remind employees what support they’re entitled to and how to access it.
Equip managers to spot the signs and support their teams
Line managers should be among the first to notice when someone’s not themselves — but only if they know what to look for. The CIPD Health and Wellbeing at Work 2025 report found that just 29% of organisations provide training for managers to support employee health and wellbeing. Without the right awareness and confidence, managers miss early warning signs, leading to stress, burnout, or prolonged presenteeism across their teams.
What you can do
- Create a clear referral pathway so managers know exactly when and how to escalate concerns; for example, through HR, occupational health, or your wellbeing provider.
- Host peer learning sessions where managers can share challenges and approaches to supporting their teams, reinforcing that wellbeing is part of everyday leadership.
- Track uptake and impact of manager wellbeing training annually to ensure the approach is working and identify where further support is needed.
Provide accessible and preventative wellbeing support
Many organisations recognise the importance of wellbeing, with CIPD reporting that 74% of senior leaders now have it on their agenda; yet fewer take truly proactive action. Too often, wellbeing support is reactive or buried in HR tools.
What you can do
- Provide managers with simple wellbeing check-in templates or questions they can use in one-to-ones to check if someone needs a break.
- Consolidate your wellbeing offer so employees have one clear point of access for physical, mental, and emotional health resources.
- Make early intervention easy by offering confidential, on-demand support options — not just traditional EAPs that require referrals or long waits.
Download the 2026 State of Employee Health and Wellbeing Report now. 🔗
Move from presenteeism to a culture of genuine wellbeing
Presenteeism is a loud, resounding warning that people don’t feel safe to rest or ask for help. But it’s something you can overcome by building a culture of genuine wellbeing.
And that starts with Sonder — a proactive wellbeing and clinical support platform that makes professional care easy to access. With Sonder, your employees can:
- Speak directly with qualified nurses, mental health professionals, and wellbeing experts — 24/7 and on demand
- Access medical, mental, and safety support in one confidential app
- Get fast, practical help without waiting weeks for referrals or appointments
Learn how Sonder can help your teams thrive by booking a demo today.
FAQs
What is the difference between presenteeism and absenteeism?
Presenteeism and absenteeism are different outcomes of employee sickness. Absenteeism happens when employees are not at work due to illness or other reasons, leading to a visible loss of productivity. Presenteeism occurs when employees come to work despite being unwell or mentally exhausted. They may be physically present but unable to perform at their best, leading to hidden productivity loss.
What are the main signs of presenteeism in the workplace?
Presenteeism can be difficult to spot, but there are several common indicators:
- Employees working long hours or skipping breaks even when unwell
- A noticeable drop in concentration, performance, or accuracy
- More mistakes, missed deadlines, or reduced creativity
- Colleagues who seem tired, disengaged, or withdrawn but still attend work
- Increased levels of stress or illness spreading through teams
How can managers identify and address presenteeism?
Managers can identify presenteeism by paying attention to changes in behaviour, quality of work, and team morale. If an employee seems unwell or burnt out but continues working, it’s important to check in privately and ask how they’re coping. Encourage them to take the time they need to recover, and reassure them that their health comes first. Regular one-to-one meetings, clear communication of sickness policies, and easy access to wellbeing support all help reduce presenteeism.
Why is tackling presenteeism important for employee wellbeing?
Tackling presenteeism protects both productivity and people. When employees push through illness, they recover more slowly, risk spreading illness to others, and are more likely to experience long-term burnout. Creating a culture where people feel safe to rest supports mental health, improves morale, and builds sustainable performance. In the long run, reducing presenteeism strengthens engagement, trust, and overall wellbeing across the organisation.
What UK research exists on the impact of presenteeism?
The CIPD Health and Wellbeing at Work 2025 report highlights that over a third of UK organisations have observed rising levels of presenteeism, particularly among hybrid and remote workers. The Institute for Public Policy Research (IPPR) estimates that around £25 billion of the UK’s annual sickness cost stems from reduced productivity when people work while unwell. Together, this research shows that presenteeism is one of the biggest hidden costs to UK businesses, and one of the most preventable.
