Sickness absence conversation

Sickness Absence Management: a simple guide

Whether short or long-term, sickness absence can hit companies hard. But how do you go about managing it?

How absence affects companies

According to Vitality’s annual Britain’s Healthiest Workplace study, sickness absence and presenteeism costs businesses 38 days per employee in lost productivity.1

Short or long-term, staff absence hits companies hard. But how do you go about managing it?

Most companies are all too aware of the direct cost of sickness absence - statutory sick pay, occupational sick pay, paying overtime and for temporary cover. But there are also the knock-on (indirect) effects:

  • Lowers morale - Staff will often have to cover for absent colleagues, making their workloads shoot up and causing morale to fall.
  • Leads to mistakes - If staff are having to cover other people’s jobs, it can lead to mistakes which can jeopardise relationships with customers.
  • Lower productivity - If employees are regularly calling in sick, it can delay projects and mean there is no consistency within teams, leading to low productivity levels. Even those who rarely have sick days can suffer from low motivation if their colleagues are regularly absent.

The top causes of sickness absence

The Chartered Institute of Personnel and Development’s (CIPD) Health and Wellbeing report for 2020 showed that stress and mental ill-health are particular causes for concern.

While minor illnesses are still the most common cause of short-term illness, the number of people absent due to stress and mental health issues remains a major issue for employers in both the short and long term.

According to the CIPD's 2020 report, the main causes of sickness absence are:

Mental ill-health - Conditions like clinical depression and anxiety now top the three most common causes of long-term absence (59%), while three-fifths (60%) of organisations say common mental health conditions, such as anxiety and depression have increased in the past 12 months.

Stress - Stress-related illness is among the biggest causes of both short and long-term absence in the UK, with 37% of organisations reporting an increase over the past year. The CIPD’s report includes heavy workloads, management style and working relationships among the top causes of stress. Non-work factors such as family and relationship problems and health issues are also contributing to people’s stress levels.

Minor illnesses - More than three-quarters (93%) of organisations reported that minor illnesses such as colds, flu, stomach upsets, headaches and migraines were the most common form of short-term absence within their organisation.

Back pain and other musculoskeletal injuries - Back pain and musculoskeletal injuries such as neck strains and repetitive strain injury were cited as common causes of both short and long-term sickness for both manual and non-manual workers.

Recurring medical conditions - Recurring medical conditions such as asthma, angina and allergies are among the top causes of short-term absence, but can also lead to longer periods off too. 

Home/family responsibilities - Caring for children can also impact employees and remain among the top causes of short-term absence for almost a quarter (24%) of organisations.

Ways to manage sickness absence

Whether you’re trying to tackle short or long-term absence, the best starting point is to start monitoring your absences, if you don’t already - unless you know what you’re dealing with, it’s pretty impossible to manage.

The good news is that this doesn’t have to be difficult; if you’re a smaller company, it could be something as simple as setting up an Excel spreadsheet to monitor staff absence.

Fit Notes - If your employee is off work sick for more than 7 days in a row (including non-working days), they must give you a Fit Note. When doctors fill in a Fit Note, they can indicate whether the employee is not fit for work, or may be fit for work. If your employee ‘may be fit for work’, it’s a good idea to arrange to meet with them to talk about how you can help them come back to work. The Fit Note will help you with this conversation as the doctor will have selected one of the following four options to help guide you when it comes to what steps you’ll need to take to help get your employee back to work: phased return to workamended dutiesaltered hoursworkplace adaptations. They may also have made additional comments. Fit Notes are a useful starting point, but for longer absences you may want to think about introducing some of the following absence management measures which can encourage higher attendance rates and help cut the cost of staff absence.

Return to work interviews - According to the CIPD, return-to-work interviews are the most frequently used absence management intervention.2 They are used as a way of deterring non-genuine absences and ensuring that people’s return is managed smoothly. They also help to identify any underlying health issues which are causing absences and enable line managers or Human Resources (HR) to put measures in place to help workers avoid taking time off in the future. The Health and Safety Executive has this useful return to work interview template.

Attendance incentives - Some companies offer staff incentives to encourage higher attendance levels and discourage unnecessary absence. These could take the form of cash rewards or allowing an extra day’s holiday for anyone with 100% attendance or allowing staff to leave early on the last Friday of the month if they haven’t had a day off. However, the employer will need to ensure that these don’t discriminate against those taking time off sick because of a disability or pregnancy-related illness3.

Flexible working - Flexible working policies - which either allow staff to work from home or shift their working hours around - can help staff achieve a better work/life balance, reducing their chances of developing stress-related illnesses. 

Training - Training for both workers and their managers on how to cope with stress, mental health problems and other wellbeing issues can have a significant impact on absence levels. The CIPD’s research shows that just 60% of employers are training their line managers to help them identify and manage stress in their teams, suggesting more than a third of businesses are missing valuable opportunities. 

Promoting healthy lifestyles - Encouraging your workers to adopt a healthy lifestyle can reap rewards in terms of your absence rate. Perks like free gym membership or on-site sports facilities encourage workers to exercise. If you’re on a tight budget, organising a weekly work walking or running club is a great way to get employees exercising.

EAPs - Employee Assistance Programmes aim to help reduce absence by offering support to employees to help them cope with issues in either their work or personal lives. They typically offer counselling services which cover a range of issues including: stress management, dating and marriage, depression, family relationships, financial worries, work relationships.

For more information on ways to measure absence, take a look at this CIPD resource.

Be careful, absence management can go wrong

Absorbing the cost of sickness absence can be a problem for some organisations, so it’s important to think about how you’re going to manage it.

But there’s a fine line between effectively monitoring and managing absence and scaring or enticing employees into the office when they’re really not well enough to be there.

When creating your absence management strategy, it’s important to be aware of these less desirable outcomes:

Presenteeism and leaveism

According to the CIPD, the vast majority of businesses (89%) have seen presenteeism, where an employee comes to work even though they’re unwell, and 27% of organisations said this had increased. Coming into work when sick can also mean employees take longer to recover and are at greater risk of making mistakes.

Almost three-quarters (73%) of businesses also said they’d seen ‘leaveism’ – where employees use allocated time off, such as annual leave, to work or if they are unwell, or working outside contracted hours. Almost two-thirds (60%) said they were aware of employees working outside their hours to get work done, while a third (34%) said employees used allocated time off to work.

To combat presenteeism, companies can introduce workplace wellness strategies as they can help reduce absenteeism, presenteeism and leaveism.

Increased stress

This follows on from presenteeism: if employees feel under pressure to come into work, stress and mental health problems can be exacerbated, which can result in long-term absences.

Additionally, if you make return to work interviews too interrogating, some employees will try to avoid the stress they cause by coming into work when they should be at home in bed. To combat this, make sure that you welcome the employee back to work and, as well as finding out why they were absent, check that they feel they’re well enough to be back in the office.

Here are some things you can do to tackle the root causes of workplace stress.


Since 2014, all employees with 26 weeks’ service have the right to request flexible working4

Flexible working brings businesses a lot of benefits. Employees have a better work/life balance so feel more loyal to the company, they’re able to work even if they’re unable to travel to the office - and there’s less guilt, last-minute holiday and lost productivity if their childcare lets them down.

There’s also the benefit that if your employee is a bit under the weather, they’ll be more inclined to log on at home than they will to trek into the office.

More information

The CIPD offers a summary of how to manage absence, including:

  • Measuring absence
  • What absence policies need to contain
  • Managing short-term absence
  • Managing long-term absence
  • The legal position
CIPD – Health and wellbeing report 2020


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