New research from SOM shows it’s time to rethink how we use Occupational Health

From Amy McKeown for the Society of Occupational Medicine.

The Society of Occupational Medicine (SOM) has released a major report on sickness presenteeism: the act of working while unwell. It’s more common than sickness absence, more costly, and far less visible. Yet in most organisations, it goes unmeasured and unmanaged.

In the latest annual survey conducted by the Chartered Institute of Personnel and Development, involving over 1,000 HR professionals, 76% had observed presenteeism among their office-based staff and 78% reported observing it among remote workers. Employees are spending more than two weeks a year working while sick, costing upwards of £4,000 per person annually in lost productivity.

Mental health-related presenteeism is rising fast, but remains hidden due to stigma and silence. While the recent removal of the three-day waiting period for Statutory Sick Pay (SSP) is a positive step, it only addresses absence. Failing to tackle presenteeism means replacing one form of productivity loss with another.

The drivers of presenteeism

Unmanaged presenteeism can delay recovery, increase the risk of burnout and long-term absence, and damage overall performance. Presenteeism is driven by a mix of cultural and practical pressures: financial concerns, job insecurity, loyalty to colleagues, and a working culture that often values presence over recovery.

Rethinking Occupational Health

Too often, Occupational Health (OH) is only brought in when someone is already off sick. This misses a crucial opportunity to intervene earlier and support people to stay well enough to remain at work. OH professionals can provide tailored advice for employees who are still working but struggling. They can recommend adjustments, help pace workloads, and support individuals with long-term conditions, fluctuating mental health, or neurodivergent needs. Using OH strategically isn’t just about getting people back to work. It’s about keeping them well enough to avoid falling out in the first place.

A challenge – and an opportunity—for HR

HR teams are under growing pressure to reduce absence and maintain performance. In that context, presenteeism can look like a short-term win. But it isn’t. It’s often a warning sign of deeper issues: poor culture, lack of support, and systems under strain.

The organisations that will thrive in the coming years are those that take a systemic and inclusive approach to health at work. That means recognising when someone is struggling, not just when they are absent, and refusing to reward silent suffering.

Presenteeism is not a failure of individual resilience. It reflects organisational conditions. But it’s a solvable problem—if HR starts seeing Occupational Health not as the last resort, but as the first line of prevention.