What is presenteeism?

Presenteeism means reduced productivity when employees come to work and are not fully engaged or perform at lower levels as a result of ill health.

Why manage it?

Centre for Mental Health calculated that presenteeism from mental ill health alone costs the UK economy £15.1 billion per annum, while absenteeism costs £8.4 billion.

Research shows that presenteeism is hugely costly to employers, but all too often ignored. Managing it well not only saves money in both the short and longer term, but also contributes to the development of an engaged and productive workforce. This Managing Presenteeism paper (see right) provides tips on what this might mean in practice. It is based on research and organisational and practitioner experience, as exemplified in the BITC Workwell Model for creating the conditions in which your people can flourish.

An introduction to presenteeism

Bob Grove, joint chief executive at the Centre, speaking at the 2011 BITC Workwell Summit about presenteeism.


These resources and references follow up the Managing Presenteeism paper published in May 2011.

BITC Workwell Model & Managing Emotional Wellbeing tool -

Health, Work and Wellbeing’s Workplace Wellbeing Tool -

HSE website and government occupational health advice line -

WHO Health and Work Performance Questionnaire -

HSE Management Standards for work related stress -

DWP Fit Note Guidance -


These are the references that support the bullet points in the paper's evidence section.

There is now a consensus in the research literature that the costs to business caused by health-related presenteeism are 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 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 work and towards higher-paid 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.

Managing Presenteeism

Presenteeism is hugely costly to employers, but all too often ignored. Managing it well saves money and contributes to the development of an engaged and productive workforce. This paper provides tips on what this might mean in practice. For more on presenteeism, take a look at the resources page.


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Mental Health at Work

Mental Health at Work - Publication Cover Image Mental ill health costs employers nearly £26 billion each year. This paper looks at the costs of ignoring mental distress at work.

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