Understanding Presenteeism and How to Address It in the Workplace

What Is Presenteeism?

Presenteeism is when people show up to work and perform at a reduced capacity due to illness or poor health. They might try to “present” as fit to work while being sick because of a physical health condition, stress, disability, or even mental health difficulties. 

The problem with presenteeism is that it leads to issues for both employers and employees. As well as prolonging illness and putting other staff at risk of getting ill, it also creates financial issues for companies who face big losses in terms of productivity and performance.

What Causes Presenteeism?

According to studies like “The Cost of Carrying On” – a report from the British Medical Association and “Why do employees attend work sick?” – a study measuring presentee motivations, many staff attend work unwell due to:

• Stressful and demanding environments
• Fear of judgement or discrimination
• Worries about being fired
• Financial difficulties from unpaid leave

Some also voluntarily choose to work while ill due to factors like:

• Wanting to support colleagues or “be a team player” 
• Wanting to prove their commitment to the organisation
• Wanting to maintain trust with clients

In one study exploring presenteeism in Sweden, it was found that employees responsible for other people, as opposed to things, were much more likely to engage in presenteeism. This might explain why higher rates of working while sick have been reported in healthcare environments and hospitals, places where employees’ absence can directly affect patient care or place extra strain on already-stretched colleagues.

Compared with the past, many workers also now work from home or in hybrid arrangements. While this flexibility is often positive and may help to prevent illness, it can sometimes mean the lines are more blurred between being “at work” and simply being available. This makes it easier for people to push through rather than formally taking time off.

Signs of Presenteeism in the Workplace

When it comes to spotting signs of presenteeism in the workplace, employers might notice things like:

• Reduced productivity despite full attendance: Employees at their desks every day, but producing less or a lower standard of work than normal.
• Working while visibly unwell: Staff coming in with colds, flu symptoms, coughing, or looking exhausted, rather than taking sick leave.
• Longer hours with less to show for them: Employees staying late or logging in outside normal hours, but not actually producing more or better work. 
• Difficulty concentrating or frequent errors: Increased mistakes, missed deadlines, or trouble following through on tasks that used to be routine.
• Withdrawal or reduced engagement in meetings: Employees who’d normally contribute actively becoming quieter, seeming disengaged, or acting as though they’ve mentally “checked out” during discussions.

Knowing the Difference Between Presenteeism and Absenteeism

Presenteeism means showing up to work with an illness and performing at a lower capacity, whereas absenteeism means habitually not showing up at all. Research suggests that presenteeism is more common than absenteeism, but it appears to depend on the work environment and job demands.

UK data from the Office for National Statistics (ONS) show that an estimated 148.8 million working days were lost due to sickness or injury in 2025, equivalent to an average of 4.4 days per worker. This highlights the scale of absenteeism, although presenteeism may be less visible because employees remain at work despite being unwell.

How Employers Can Address Presenteeism

According to the government’s “Keep Britain Working” report, presenteeism is costing employers £21 billion in lost productivity. 

So, what can be done about it? If you’re an employer, here are some important steps you can take to ensure staff stay home and rest when they need to:

Review how work is managed and supported: Be realistic about what’s expected of your staff. Are there realistic workloads, manageable deadlines, clear channels for raising concerns, and visible support from managers? If employees are being asked to do too much, the risk of them working through sickness increases.

Discuss disability and inclusion: Make it clear that staff are safe and supported to take time off, and that this is actually preferred if people are unwell or struggling, especially if they have a long-term illness or disability. If you can have open discussions about the importance of an inclusive environment and show you’re happy to provide necessary adjustments, staff will feel able to be honest about what they need, rather than pushing through in silence or feeling like they have to hide a health condition to protect their job.

Celebrate effort, not hours spent working: Try to reward staff based on performance and output rather than commitment. If you can make it clear that your promotion pathways have nothing to do with time spent working and all to do with effort, staff will feel less inclined to work when they’re not fit to do so.

FAQs

What are the main causes of presenteeism?

Studies show that there are different reasons for presenteeism. Sometimes it’s more voluntary – staff choosing to show up ill in order to show their commitment to a company or support their colleagues. Other times, it’s because they feel pressured – they may work in a stressful environment where staff feel fearful of being judged or worried about not being paid for time off. Research suggests healthcare environments and places where staff look after people have higher rates of presenteeism. 

Can presenteeism ever be positive?

Presenteeism may occasionally offer benefits if an illness or injury is mild and it helps the employee to take their mind off things. For example, if a staff member has a minor illness but feels well enough to carry out some of their usual tasks, continuing to work may provide a sense of routine or help them feel connected to their colleagues. However, presenteeism is generally not a substitute for taking time to rest and recover when you are genuinely unwell.

Am I displaying “presentee” behaviour?

If you’re showing up to work while feeling unwell and not performing at your best, you’re displaying presenteeism. This can be particularly problematic if you’re carrying an illness that may be spread to others or making mistakes that could affect your work or the people you support.

It’s much more beneficial for you to rest and recover fully so that you can return to work with a clear head and the energy to perform at your best. If you’re worried about the consequences of taking time off, speak to your manager or HR team about your options and any support available to you.