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  • Writer's picturePAM Group

Mitigating the risk of increased absence, mental health issues, stress, and presenteeism

The joint document by the DWP (Department of Works and Pensions) and DoH (Department of Health) `Improving Lives: The Future of Work, Health and Disability’ outlined the role of employers to assist employees at thriving in the workplace, as well as to prevent unnecessary sickness absence, presenteeism and health-related job loss.

All employers have a common-law duty of care to their employees. This includes carrying out risk assessments and taking steps to eliminate or control risks and informing workers fully about all potential hazards associated with any work process, chemical substance or activity, including changing the way work is carried out, providing instruction, training and supervision.

The Health and Safety Executive (HSE) and the Institute of Directors guidance, leading health and safety at work, recognises that health and safety is critical to organisational success. Therefore, board members who do not show leadership in this area are failing in their duty as directors.

It also makes business sense to create a healthy, safe and supportive work environment. For example, if an accident occurs, there could be direct and indirect costs associated with that incident. The direct costs could include the time lost through sickness absence, the recruitment and training of temporary staff to cover the employee’s absence, potential compensation claims and resultant increase in insurance premiums. For indirect cost, a healthy workforce will likely provide better quality service, which in turn enhances the reputation of the organisation, promotes mental wellbeing and reduces presenteeism. Promoting and encouraging a healthy and caring work environment will likely be advantageous in recruiting and retaining staff. Organisational measures such as employer-funded interventions to prevent common physical and mental health conditions becoming a problem like funded health checks, a health and wellness programme or Employee Assistance Programmes (EAPs) could be implemented.

Initiatives to create healthy workplaces to mitigate the risks of sickness absences, psychological ill health, stress and presenteeism should be undertaken with staff consultation and agreement. Their ideas are to be encouraged, listened to and, where agreed implemented.

Commitment from the highest level of management is essential. Health and wellbeing initiatives need to be backed with strong leadership and visible support at the board/executive level. It is important that initiatives to create healthy workplaces to mitigate sickness absence, presenteeism, stress and psychological ill health are monitored and evaluated. Measures should be taken to address gaps in such workplace provision and review the effectiveness of such initiatives.

A regular theme in health and wellbeing surveys is the importance of good line management support. Line managers will require training, support and be provided with clear policies and resources for preventing and managing sickness absence, promote psychological health and be able to identify and mitigate the risks of presenteeism. Employers should ensure that managers and employees understand the relationship between absenteeism and presenteeism. Managers should be encouraged to adopt a more flexible approach to sickness absence in order to avoid causing further presenteeism.

Having access to competent advice is key. Occupational health advisers, health and safety specialists, reablement specialists (for example, physiotherapists, occupational therapists,occupational psychologists), human resource advisers and health promotion

experts can all provide advice and support to organisations in creating a healthy workplace to mitigate the risk of sickness absenceand presenteeism, whilst promoting psychological health in the workplace. Advisers need to work closely together and engage with

relevant stake holders.

The World Health Organization defines a healthy workplace as:

“A healthy workplace is one in which workers and managers collaborate to use a continual improvement process to protect and promote the health, safety and wellbeing of all workers and the sustainability of the workplace by considering the following, based on identified needs:

  • health and safety concerns in the physical work environment

  • health, safety and wellbeing concerns in the psychosocial work environment including organisation of work and workplace culture

  • personal health resources in the workplace

  • ways of participating in the community to improve the health of workers, their families and other members of the community. ”

The healthy workplace principle is one that actively promotes health, not just prevents ill health and reduces sickness absence. These guiding principals will help mitigate the risks of sickness absence, reduce stress in the workplace, reduce presenteeism and promote better mental wellbeing.

Work Environment (Physical)

If not managed, the physical working environment can lead to ill health. Physical hazards in the workplace can be wide ranging. In addition, the infrastructure and facilities within a work building can also lead to health problems and low morale. These include working in hot/too cold environments, high humidity and a lack of facilities.

There is wide ranging legislation which places a duty on employers to take action to eliminate or reduce exposure to physical hazards and reduce the risks to health. There is also a requirement to carry out periodic health checks, known as health surveillance for workers exposed to a number of physical hazards; for example, skin irritants; exposure to lead, asbestos, ionising radiation and respiratory allergens.

Work Environment (Psychosocial)

The psychosocial work environment includes how work is organised and the corporate culture; its attitudes, values, beliefs and practices that are demonstrated on a daily basis within the organisation. Such practices will likely determine what effect it has on the mental and physical wellbeing of employees. The HSE recognises a number of factors in the workplace that can lead to poor mental health and stress at work.

These include:

  • inability to cope with job demands

  • lack of control over their jobs

  • lack of information and support

  • having problems with relationships at work, or are being bullied

  • lack of full understanding of their role and responsibilities

  • are not engaged when the business is undergoing change.

Employers have a legal duty to assess the risks from psychosocial workplace hazards in the same way they do with physical hazards. There are tools and guidance available from the HSE to help. The HSE guidance provides a benchmark for continuous improvement of the psychosocial work environment.

Workforce Health Resources

It is increasingly accepted that organisations have an important role in promoting good health in the workforce and giving staff information, resources and opportunities to improve their own mental and physical health. Initiatives such as staff smoking cessation, offering discounts at the local gym, arranging walking meetings, subsidised development courses, offering flexible working and mindfulness training are examples.

It is important to recognise that work conditions can act as a barrier to improving health, for example, physical inactivity may result from long work hours and poor diet from inaccessibility to healthy snacks or meals at work, or time to take meal breaks.

Health promotion activities should be tailored to the needs of occupational groups and be accessible to staff working various shifts.

Participation Within A Community

There are opportunities to promote health and wellbeing initiatives beyond the employing organisations themselves and extend into their local communities. For example, in some parts of the country, the NHS Sport and Physical Activity Challenge, which aims to get NHS staff more active, has been extended to NHS workers families and the wider community. Such opportunities need to be explored but will require leadership and commitment from employers and community leaders.

Role of PAM

As a multi-disciplinary occupational health and wellbeing provider, PAM Group will be able to assist employers in providing occupational health advice, deliver health and wellbeing programmes, provide resource and training for managers on health and wellbeing matters, as well as health surveillance.

We offer Employee Assistance Programmes, psychological and physiotherapy treatment support. The multi-faceted approach of PAM Group will make a positive difference in reducing sickness absence, enhance awareness and mitigate the risk of presenteeism, mental health problems and stress in the workplace.



1) Guidelines on prevention and management of sickness absence - The NHS staff council.

2) Sickness absence and health in the workplace: understanding employer behaviour and practice (DWP and DoH); July 2021.

3) Centre for Mental health - Managing presenteeism.

4) World Health Organisation (2010), WHO healthy workplace framework and model.

5) HSE – Work-related stress and how to manage it.


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