Sickness absence management: a simple guide

Whether short or long-term, staff sickness absence hits companies hard. But why should you be bothered about it and how do you go about managing it?


How sickness absence affects companies

absence-management.jpgAccording to the Centre of Economic and Business Research (CEBR) and First Care, sickness absence accounts for a whopping £18 billion a year1 in lost productivity.

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 2018 showed that stress and mental ill-health are particular causes for concern.

absence-management-missing-puzzle.jpgFirst off, it’s probably best to be clear what we’re talking about here. As most employers will know, absences come in all shapes and sizes and can last anything from days to years. But what’s the biggest cause of absence?

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 2018 report, the main causes of sickness absence are:

  • Minor illnesses - More than three-quarters (81%) 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.
  • Stress -Stress-related illness is now only topped by acute medical conditions such as cancer or heart attacks as the biggest cause of long-term absence in the UK, with nearly 40% of organisations reporting an increase over the past year. The CIPD’s report includes heavy workloads, organisational changes and job insecurity as among the top causes of stress. Non-work factors such as family and relationship problems and financial issues are also contributing to people’s stress levels.
  • 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. According to the CIPD, businesses who reported an increase in both stress-related absence and mental ill-health also saw a rise in presenteeism, where an employee turns up to work but is not at their most productive. Coming into work when sick can also mean employees take longer to recover and are at greater risk of making mistakes. They also referenced the emergence of 'leaveism' - where employees use allocated time off, such as annual leave, to work or if they are unwell, or working outside contracted hours.
  • Home/family responsibilities - Caring responsibilities remain among the top causes of short-term absence for almost a third of organisations. Though more studies need to be carried out, those businesses that allow flexible working are less likely to report employees taking ‘illegitimate’ time off sick for family reasons.
  • Mental ill-health - According to the CIPD, more than half (55%) of organisations have noted an increase in reported mental health problems such as anxiety and depression among employees in the past 12 months.

Ways to manage sickness absence

sickness-absence-management.jpgWhether 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.

SMEs can monitor absence using the Health and Safety Executive’s free sickness management tool SART prototype.

  • 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 intervention2. 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. With 80% of UK employees saying that flexible working hours was in their top 3 employee benefits4, it’s well worth considering.
  • 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 less than half (48%) of employers are training their line managers to help them identify and manage stress in their teams, suggesting valuable opportunities are being missed.
  • 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 managementdating and marriagedepressionfamily relationshipsfinancial worrieswork relationships.

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

Be careful - sickness 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 is where employees come into work even when they’re not well enough to. It can happen for a number of reasons including feeling worried about job security, having a heavy workload or, ironically, because of attendance incentives.

Whatever the reason, presenteeism is rarely a good thing. The unwell employee is likely to make mistakes, be much less productive and spread their germs around the office causing more sickness. Colleagues who’ve booked holidays are also going to be less than happy having to sit next to their ill colleague when they’re due to jet off to Spain tomorrow.

To combat presenteeism, lots of companies are introducing workplace wellness strategies as they help reduce both absenteeism and presenteeism.

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 working6

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 bad weather prevents them from travelling 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.

Sickness absence and return to work trends

Drawing on our years of experience and expertise, our sickness absence and return to work trends report drills deeper into and mental health issues and suggests possible strategies employers can use to help ensure good mental health in the workplace.

Click here to download the report

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

1 Centre of Economic and Business Research and FirstCare - Change at Work: How Absence, Attitudes and Demographics are impacting UK employers – Mar 2017
2 CIPD – Health and wellbeing report 2018
3 http://www.xperthr.co.uk/faq/where-an-employer-wishes-to-reward-employees-for-low-sickness-absence-what-factors-must-it-take-into-account/68850/
4 BT Mobile Multiplier report – Oct 2016