Working while unwell doesn’t necessarily make it presenteeism, new report argues

A new report from wellbeing consultancy Robertson Cooper claims to have debunked the accepted wisdom which classifies all instances of working whilst unwell as ‘presenteeism’. The authors argue that this paves the way for a change in how organisations manage employee ill health and its relationship with productivity and absence. The research, which included consultation of the existing research on presenteeism and analysis of new data collected by the firm, categorises three types of working whilst unwell, only one of which it says should be classed as presenteeism and eradicated from businesses.

Up until now, all three types have been considered presenteeism and portrayed as detrimental to employees – and costly to businesses, the report says. Importantly for employers, the two other types of working whilst unwell identified in the report shouldn’t always be considered a cost to businesses. Current analysis and organisational practice fails to acknowledge the differences between these types.

• Functional presence refers to types of working whilst unwell that may actually be desirable for the organisation and employee. These include:
  • Pragmatic presence: when employees perform close to, or at, their full capacity and at the same time recover at least to a certain degree from their health impairment. These are the occasions when employees want to be in work to complete some tasks despite not feeling their very best.
  • Therapeutic presence: when employees are performing well below their maximum productivity, but they get some form of ‘therapeutic’ benefit by being in work (i.e. social connection or a sense of purpose). For example, when duties and/or hours are adjusted to aid return to work after a period of illness.
• Presenteeism, in its true sense, is when employees are unwell and being in work either offers no functionality for the employee (i.e., people are too ill to perform their tasks) or has no therapeutic benefit (i.e., people do not gain other benefits such as social connection and meaning). This behaviour impacts both the business and individual negatively and must be managed appropriately.

The report [registration] used data collected from over 3000 UK respondents in 2023 to show that almost two-thirds of employees (60 percent) have had an occurrence of presenteeism (including all instances of working whilst unwell) in the past three months. Robertson Cooper determined that productivity typically drops by up to 40 percent during any period of working whilst unwell, but how long it lasts determines the impact on productivity. If it lasts less than 5 days in any three-month period, it is no more detrimental to overall productivity than absenteeism. However, when an episode of presenteeism stretches beyond 5 days productivity drops dramatically. It is therefore these instances of presenteeism that should be the focus for employers.

Professor Sir Cary Cooper, co-founder of Robertson Cooper said: “This re-evaluation of presenteeism is a major breakthrough. It enables employers to truly understand presenteeism: what it is and what it isn’t; its real impact on workplace performance; what you can do to manage it more effectively. By dispelling outdated notions, it opens up a new era of informed strategies that optimise productivity and foster a culture of employee health and wellbeing.”

The report also explores the relationship between productivity, working whilst unwell and absence rates in greater depth than has previously been possible. Analysis was conducted of the data collected from employees across nine sectors, which revealed a positive relationship between absenteeism and working whilst unwell – that is, the rates tend to rise and fall together. This has implications for how employers manage the two issues side-by-side.