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ORIGINHealth Intelligence
Product in development. Page content pending sign-off by Dr Pamela Gellatly.

Product

Presenteeism Tool

Working name, subject to change

Most employers measure absence. Almost none measure the productivity lost by people who are at work but not working at capacity.

What is presenteeism?

Presenteeism is productivity loss that occurs while an employee is present at work. It covers visible loss, where reduced output can be seen by a manager or a colleague, and invisible loss, where the person appears to be working normally while performing below their own capacity. It is generally understood to cost employers more than absence, yet it is rarely measured, because most organisations record only whether someone attended.

Why absence data tells only half the story

Measured absence and unmeasured productivity lossAbsence, which is recorded, shown above a measurement line, and productivity lost by people at work but not working at capacity, which is not recorded, shown below it. The areas are illustrative and imply no proportion.AbsenceRecorded, reported, managedMEASUREMENT LINEPresenteeismAt work, not at capacityRarely recorded, seldom managed

Illustrative. The areas shown carry no proportion and no figure is implied.

Absence is a lagging indicator

It records that someone was away from work. It does not record what preceded the absence, or how long the underlying difficulty had been building.

The same risks act earlier than absence

The underlying risks that eventually cause absence also cause productivity loss. That loss begins long before anyone stops attending.

Interventions land at the wrong point

Where a benefit is bought on the strength of absence data, it is aimed at the end of the pathway. The point at which it could have changed the outcome has usually passed.

Obstacles to recovery go unassessed

Where the obstacles to recovery are not identified, people remain off work for longer than they need to. Those obstacles are rarely assessed at all.

What the tool records

This is a framework under development rather than a finished instrument. Every item below is subject to review before the tool is released.

Method pending sign-off

Self-reported productivity impact

  • Employee self-assessment
  • Manager observations
Method pending sign-off

Physical factors

  • Musculoskeletal symptoms
  • Fatigue, sleep length and quality
  • Physical activity, strength and conditioning
  • Weight and nutrition
  • Alcohol and drug use
  • Age and gender
  • Co-morbidities
Method pending sign-off

Psychosocial factors

  • Attitudes, beliefs and fears
  • Neurodiverse conditions
  • Stressors from family, hobbies, work and financial worries
  • Wellbeing
Method pending sign-off

Occupational factors, mapped to the HSE Management Standards

  • Demands
  • Control
  • Change
  • Role
  • Relationships
  • Support
Method pending sign-off

Obstacle flags, in the psychosocial flags framework

  • Yellow: beliefs and behaviours about the condition
  • Blue: perceptions of work
  • Black: systemic and financial obstacles
Method pending sign-off

Work and environment

  • Work type and work risks
  • Length of employment in the role
  • Length of employment in a similar role
  • Environmental exposures, including commute, home location and travel

What it produces

For the individual

A private summary of the person's own contributing risks, with a self-care pathway. It is not visible to the employer in identifiable form.

For the organisation

Aggregated and anonymised productivity loss by department, role type and age band, with drivers ranked by their contribution rather than by how often they appear.

For the benefits decision

Measured productivity loss correlated against existing benefit provision, so an employer can see whether what they buy addresses what they have.

Confidentiality and trust

What crosses the aggregation threshold and what does notIndividual responses on the left, an aggregation threshold in the centre, and the employer view on the right. Group level patterns cross the threshold. Individual responses, identities and free text do not.INDIVIDUALResponseResponseResponseResponseAGGREGATIONMinimumgroup size100EMPLOYER VIEWGroup level patternTheme by areaChange over timeNever: identities,individual responses,or free text as written.
  • Individual responses are confidential.
  • The employer receives aggregated insight, never identifiable personal health data.
  • A minimum group size threshold of 100 applies before any breakdown is reported.
  • Consent is explicit, and it can be withdrawn.

The commercial point is worth stating plainly. Employees do not answer honestly unless they trust the arrangement, so the confidentiality model is a condition of the data being worth anything at all.

Read the participant privacy notice

How it fits the wider platform

Presenteeism data flows into the integrated analytics platform alongside absence, occupational health, employee assistance and claims data. Productivity loss can then be read against the rest of the risk picture rather than on its own.

Integrated Workforce Health Intelligence

A stepped rocky ascent rising through mist, the obstacles on the route visible

Obstacles to recovery

Obstacles on a route can be identified and navigated once they are visible. The argument is about the route, not about the person.

Selected references on the biopsychosocial approach. Indicative, not exhaustive.

  • Burton, A. K. (2005). How to prevent low back pain. Best Practice and Research in Clinical Rheumatology. 19 (4). 541-555.
  • Burton, A.K., & Main, C.J. (2000). Obstacles to recovery from work-related musculoskeletal disorders. In International encyclopedia of ergonomics and human factors (Ed. Karwowski W): 1542-1544. London. Taylor & Francis.
  • Burton, A.K. & Waddell, G. (2004). Risk factors for back pain. In (Ed. Waddell, G.) The back pain revolution. Chapter 6. 2nd edition. Edinburgh. Churchill Livingstone.
  • Burton, A. K., Kendall, N. A., Pearce, B. G., Birrell, L. N., & Bainbridge, L. C. (2008). Management of upper limb disorders and the Biopsychosocial approach RR596 Research Report. London. Health and Safety Executive.
  • Burton, W. N., Chen, C.-Y., Conti, D. J., Schultz, A. B., Pransky, G., & Edington, D. (2005). The association of health risks with on-the-job-productivity. Journal of Occupational and Environmental Medicine. 47 (8). 769-777.
  • Engel, G.L. (1977). The need for a new medical model: A challenge for biomedicine. Science. 196:129-136.
  • Engel, G.L. (1980). The clinical application of the biopsychosocial model. Annals Psychiatric Association. Vol. 137. 5. 535-544.
  • Engel, G.L. (1989). The need for a new medical model: A challenge for biomedicine. Holistic Medicine. 4(1). 37-53.
  • Kendall, N.A.S., Linton, S.J. & Main, C.J. (1997). Guide to assessing psychosocial yellow flags in acute low back pain: risk factors for long-term disability and work loss. Wellington. Accident Compensation Corporation and the New Zealand Guidelines Group.
  • Kendall, N.A.S., Burton, A.K., Main, C.J. & Watson, P. (2009). Tackling musculoskeletal problems: a guide for clinic and workplace, identifying obstacles using the psychosocial flags framework. London. TSO.
  • Main, C. J., Sullivan, M. J., & Watson, P. (2008). Pain management. Practical applications of the biopsychosocial approach in clinical and occupational settings. Second edition. Philadephia. PA. Churchill Livingstone Elsevier.
  • O'Sullivan, K., & O'Sullivan, P. (2016). The ineffectiveness of paracetamol for spinal pain provides opportunities to better manage low back pain. British Journal Sports Medicine. 50. 197-198.
  • O'Sullivan, P. (2011). It's time for change with the management of non-specific chronic low back pain. British Journal of Sports Medicine.
  • O'Sullivan, P., Caneiro, J.P., O'Keeffe, M. & O'Sullivan, K. (2016). Unravelling the Complexity of Low Back Pain, Journal of Orthopaedic Sports Physical Therapy. 46(11): 932-937.
  • Rogers, D., Gardner, A., MacLean, S., Brown, G. & Darling, A. (2014). A retrospective analysis of a functional restoration service for patients with persistent low back pain. Musculoskeletal Care. 12(4): 239-243.
  • Sullivan, M.J. L. & Stanish, W. D. (2003). Psychologically based occupational rehabilitation: The pain-disability prevention program. Clinical Journal of Pain. 19(2):97-104.
  • Waddell, G. (2004). The back pain revolution. London. Churchill Livingstone.
  • Waddell, G. (2006). Preventing incapacity in people with musculoskeletal disorders. British Medical Bulletin. 109(1), 55-69.
  • Waddell, G., & Aylward, M. (2005). The scientific and conceptual basis of incapacity benefits. London. TSO.
  • Waddell, G., & Burton, K. (2005). Occupational health guidelines for the management of low back pain at work. Evidence review. Occupational Medicine. 51(2): 124-35.
  • Waddell, G., Burton, A. K., & Kendall, N. A. (2013). Vocational Rehabilitation. What works, for whom and when? London. TSO.
  • Woolf, A. D. (2000). The bone and joint decade 2000-2010. Annals Rheumatological Diseases. 59: 81-82.
  • Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bone and joint decade. Bulletin of the World Health Organisation. 81(9).
  • Woolf, A.D., Breedveld, F., & Kvien, T. (2006). Controlling the obesity epidemic is important for maintaining musculoskeletal health. Annals of the Rheumatological Diseases. 65 (11), 1401-1402.
  • Woolf, A. D. (2007). Healthcare services for those with musculoskeletal conditions: a rheumatology service. Recommendations of the European Union of Medical Specialists Section of Rheumatology. 66(3), 293-301.
  • Woolf, A. D. (2011). The bone and joint decade 2010.2020. How do we get policy makers to take musculoskeletal conditions seriously? The Global Alliance for Musculoskeletal Health.
  • Woolf, A. D. (2012). The bone and joint decade: Working together to make musculoskeletal conditions a public health priority. Arthritis Research (12).
  • Woolf, A.D., Erwin, J. & March, L. (2012). The need to address the burden of musculoskeletal conditions. Best Practice & Research Clinical Rheumatology. 26: 183-224.

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