Is the UK once again the ‘sick man of Europe’? With soaring inflation and interest rates and Brexit dragging on trade, the economy is clearly not in rude health.
Neither is the country’s workforce, according to recent ONS data that revealed we are taking more sick leave than ever. British workers missed a collective 185.6 million days of work due to sickness or injury in 2022, equivalent to nearly six days each. It’s the highest number of sick days per worker since 2004, and the largest number overall since records began.
That could be worrying news for employers. Worker absence can lead to lower productivity, more stress for other employees and even costly temporary cover. So what is driving the increase – and is there anything employers can do about it?
Why are workers taking more sick days?
The obvious answer – the pandemic – is certainly part of the picture. Last year there were almost 10.5 million confirmed cases of Covid cases in the UK, according to the World Health Organization. In addition, around 2 million people have ongoing symptoms of long Covid.
While the ONS figures do not split out Covid-related absences, infections are likely to have been counted under respiratory, minor or ‘other’ illness. Those three categories together accounted for two-fifths of days lost to sickness in 2019, but by 2022 that had increased to almost three in five.
In particular, the number of sick days blamed on respiratory illness has almost tripled compared to pre-pandemic, while minor illnesses – such as colds and flu – are up 40%.
Those increases have outweighed drops in other categories of illness. For example, workers took 5 million fewer days off work for musculoskeletal problems (like back and neck pain) in 2022 than in 2019. Although back issues are often linked to homeworking, Jon Boys, an economist at the CIPD, points out that the numbers have been falling for years. “Employers have started taking it incredibly seriously,” he notes, especially following the 2010 Equality Act which requires companies to make reasonable adjustments.
Is Britain getting sicker?
Case closed? Not quite. Efua Poku-Amanfo, a researcher at the IPPR think-tank, believes it’s “lazy” to put the blame for increased sickness absence solely on Covid and the shift to working from home. Worsening public health has had more of an impact, she argues.
“There’s lots of evidence that tells us that the UK was on the trajectory of increasing illness long before 2020,” she says. “People are generally getting sicker, and there isn’t much sign that that’s going to get radically better.”
New disability claims doubled between 2021 and 2022, while the UK has a higher rate of preventable illness than other European countries. In part that’s due to an ageing population. But many experts, including the BMA and IPPR, point to increased inequality as well as underfunding and backlogs in the NHS.
A sicker population shrinks the size of the workforce – long-term health conditions, such as cancer, depression or arthritis, are now the leading cause of economic inactivity, responsible for 2.5 million people being out of work. Meanwhile, those with a long-term condition take three times as many sick days as those without.
What occupations take the most sick leave?
What job you do also has an impact. Although sick leave increased between 2019 and 2022 in almost all occupation groups, those that tend to be lower paid saw the biggest jumps.
Workers in caring, leisure and service jobs took the most sick days in 2022, just over eight on average, followed closely by process, plant and machine operatives. Those in elementary roles – including cleaners, caretakers and rubbish collectors – also lost more days than the average worker.
At the other end of the scale, managers and senior officials were off ill for an average of just four days each, while associate professional and technical workers (such as engineers) were the second-least likely to call in sick. That’s unsurprising when healthcare is increasingly unavailable to lower-income people, experts say.
“Higher-paid, higher-skilled, more privileged people probably have the funds to manage their health,” says Boys. “We know that people are paying more out of pocket for private healthcare, and that’s something the professional classes are much more able to bear.”
White-collar workers are also more likely to be able to work from home some or all of the time. There is strong evidence that remote workers take fewer sick days – indeed, during 2020 and 2021, when more than a third of UK adults worked from home on average, sick days hit record lows.
One reason is obvious: mixing at a workplace increases the risk of catching a cold or flu. But the shift to hybrid work may be enabling employees to work through minor illnesses.
Jane-Emma Peerless, director of people at fintech company Caxton, says absences at the firm halved after they adopted hybrid working. “Anecdotally, the drop-off is in people not feeling well, but not ill either, but the thought of having to commute is too much for them so they decide to call in sick. That element has completely disappeared.”
Why presenteeism is problematic
Of course, there is a downside to employees ‘powering through’ illness. Working despite being sick can make minor conditions worse, and potentially lead to staff needing even more time off to recover. A 2019 Vitality study suggested the average full-time worker loses 16 days’ worth of productivity through presenteeism.
Peerless says she always encourages workers to call in sick when they need to. But that’s not the case in every workplace. Seven in 10 workers surveyed by the CIPD in 2021 reported using annual leave to recover from an illness, while remote workers may struggle to know when they are ‘sick enough’ to take time off.
“We’re placing the onus on employees to diagnose themselves in ways that they’ve never previously had to do,” says Jonathan Best, chief customer officer at GoodShape. “We know that that’s something that a lot of people are struggling with… Absence policies haven’t necessarily evolved or changed to reflect this new reality of working.”
If you’re going to lose out on a day’s pay, you’re going to think twice about calling in sick
That is particularly true when it comes to specific types of illnesses, such as mental health conditions.
“People definitely work through mental health issues much more frequently than they would if they had a physical health issue,” Best says. “That tells us that despite people being more comfortable talking about it, they’re still not fully comfortable taking time away from work for it.”
Other workers may not feel empowered to take any sick days at all. UK workers are entitled to less sick pay than many other European countries – just £109.40 a week – and those earning below £123 a week are not entitled to any.
“If you’re going to lose out on a day’s pay, then you’re going to think twice about calling in sick. So it suggests that [the data] might understate the rates of sickness in that [lower-paid] group,” Boys says.
In fact, although sickness rates have recently increased, zooming out to an international level, British workers take very few days off sick.
In Germany for instance, the average is 20 days per worker each year. In the Netherlands it’s 11 and in France, almost nine. That’s thanks to much stronger legislation which in Germany requires companies to pay workers 100% of their salary. Dutch workers are entitled to a minimum of 70% of salary for at least two years of illness.
However, culture plays almost as strong a role as legislation. Best says many European employers take a “hands-off approach”: in some countries it’s illegal to ask staff why they are taking sick leave. On the other end of the scale, it’s common for employers in many south-east Asian countries to frown on sick days, even for contagious illnesses.
Employers should take note: sick days are not always a bad thing. Instead, consider what kind of culture you are creating – one where people must struggle through and potentially get sicker, or one where they are confident in taking the time they need to recover.
