What is triggering the U.K.'s record sickness absence rates and should employers be re-thinking their approach to absence management?

In the U.K. the rate of employee absence has risen to its highest level in a decade. According to the WTW Absence Survey 2023 this has reached 4% in 2023, with an average of 4.8 days lost per employee per year.

This upward trajectory appears to be reflected across Europe — from Sweden to Slovenia. Swedish employees took 11.4 days of sickness absence in 2022, compared to only 6.7 days in 2010, while absence rose from 12.3 days in 2010 to 18.1 days in Slovenia. 1

As one in three employers experience an increase in absence rates, the health issues behind absence have remained broadly similar in recent years. Minor illness remains the most common cause of short-term absence, while mental ill-health, musculoskeletal injuries, acute medical conditions and stress are most responsible for long-term absence. 2

The WTW Absence Survey 2023 took place in the autumn of 2023 and collected information from organizations in the United Kingdom and Netherlands. With representation from a broad cross section of industries and size of organization, the results give a view of how absence is impacting employers across Europe.

Mental health continues to dominate the headlines. Despite a surge in employer interest in the mind-body connection, 79% of U.K. employers still think they need to address mental health issues as the leading cause of employee absence.

Not only are absence rates increasing, the cost of absence is also escalating with many employers seeing a sharp increase in sick pay, disability claims costs and the cost of occupational health support services.

The growth in medical cost inflation may be projected to slow in 2024, but according to the WTW 2024 Global Medical Trends Survey, over half of insurers in Europe (57%) expect higher or significantly higher healthcare cost increases over the next three years.

Why are absence rates soaring?

The cultural shift to remote and hybrid working, while affording employees greater flexibility, can also be linked to increased levels of presenteeism. The blurred lines between professional and personal life can mean employees find it problematic to separate the two. The self-imposed belief that they always need to be available has the potential to cause burnout. Our Absence Survey revealed that nearly two-fifths (44%) of U.K. employers have experienced problems with employee burnout in the last year (figure 1).


Economic pressures on national health services, caught between the aftermath of COVID-19 and soaring demand from an aging demographic, are also having a significant impact on waiting lists (particularly for mental health). Half (52%) of U.K. employers report an increase in absence as a result.

With national public health services struggling, and sickness absence rates soaring across Europe, what measures can employers take to tackle the root causes?

Looking after your employees

Knowing your employees and responding to their needs are key in the drive to bring levels of absence down. Organizations can:

Target those most in need

The sickness absence rate for those with long-term health conditions increased to its highest level since 2008 3 and this is backed by our survey, which revealed that 51% of organizations cited long-term absence as a key cause of absence that they want to address.

Workforces are aging, and the latest figures reveal a record 1.468 million employees aged 65 and over — with the fastest growing segment of the U.K. workforce being women over 50.

These two demographics also have the highest rate of absence, and both are examples of employee groups that are susceptible to specific health issues.

This underlines the need for employers to re-focus their absence management strategies to better identify and then support employees at higher risk of absence, starting with workplace culture, policies and adjustments.

Adopt a lifecycle approach to wellbeing

There's an increasing emphasis on supporting employees through various life stages and challenges. This includes enhanced support for working parents, carers and individuals coping with reproductive health issues. This holistic approach acknowledges the diverse needs of the workforce and aims to provide targeted support where it's most needed.

Educate line managers

Our absence management survey revealed that 63% of U.K. businesses (figure 2) struggle with manager capability. Training should be given to ensure managers feel comfortable and confident in how to foster a culture of trust and open communication with employees experiencing ill-health, or those who are affected by the absence of a colleague.


Given the rising prominence of mental health issues, this should also involve equipping managers with the skills to recognize signs of mental distress and provide appropriate support or referrals to professional help both in the office and in a remote/homeworking environment.

Provide preventative workplace health services

Ensuring employees are supported in the workplace by introducing access to a wide selection of benefits is critical. Employee assistance programs and occupational health physicians are just two examples of support to keep employees in full health and in the workplace.

Our research shows 48% of U.K. employers have already reviewed the levels of service and general performance of their Occupational Health (OH) providers in 2023 – and a further third (33%) are planning to do so in 2024.

Consider alternatives

Organizations should explore flexible working, the option to work from home or in a different location, a review of existing leave policies, or permanent role changes for employees with long-term health conditions. Working from home on given days, for example, may help employees to attend appointments more easily, and taking longer and more regular breaks could aid concentration and improve mental wellbeing.

Address presenteeism

Companies are increasingly recognizing the need to establish clear boundaries and provide support to ensure employees can adequately disconnect from work and recover when needed.

Absence management process and policy

Preventative action to improve employee health and wellbeing must be matched by a firm commitment to the correct absence processes and policies.

Our absence survey revealed that the top priorities for businesses when it came to future change were heavily focused around a preventative approach, with reviewing and updating polices and enhancing absence tracking systems scoring highly (Figure 3).


Review and update policies and processes

Robust absence policies, protocols for reporting absences and notification periods should be reviewed regularly in response to evolving needs. They risk being undermined if they aren't accessible to employees and managers, and clear signposting must be in place to ensure support and benefit information is easily obtained.

It's key that both employees and key stakeholders involved in the process are aware of their responsibilities when managing absence. Absence policies and procedures should be mandated consistently across the business so that absence rates can be measured and changes monitored, including the success of any interventions.

Enhance absence tracking systems

Effective absence management relies on knowledge. Records of employee absences should be maintained for analysis and to identify trends. The use of employee absence data, overlayed with employee benefit and provider data, will enable employers to work toward creating an informed strategy that accommodates the needs of their workforce.

Leverage data to confirm where action should best be taken

Our Absence Survey 2023 revealed that only 16% of U.K. employers, score themselves as above average in how they use data to measure the cost of absence and inform their absence management strategies.

Reviewing sickness absence and productivity data by location or demographic, analyzing leave duration, frequency and reasons for absence and benchmarking this data by industry sector, can help a business see where it should focus interventions, introduce new processes, or consider wider wellbeing support to reduce active absenteeism.

What lessons can be learnt from employers at the leading edge of absence management?

Our recent research revealed a number of key behaviors shown by the most effective leaders (with correspondingly low absence rates). They appear to excel in five core areas:

  1. They have robust processes for recording, tracking and reporting on absence, and use modeling more than most to estimate the cost of absence to the business.
  2. They allocate appropriate internal or external HR resources to deal with absence and use condition-specific pathways and early interventions to help reduce long-term absence.
  3. They carefully manage their providers through regular reviews, renegotiating contracts to get the best value.
  4. They align absence support with benefits provision, integrating the services of insurers and occupational health providers into their disability process and providing enhanced leave to enable employees to deal with issues that may lead to absence.
  5. They are much better at supporting their managers by investing in good systems, having clear signposting of resources, keeping policies simple and clear and using third-party vendors.

How we can help your organization with absence management

We're trusted by some of the U.K.'s largest employers to help provide solutions to mitigate the cost of employee illness by measuring, managing and minimizing levels of sickness absence.

From absence strategy to absence management, Occupational Health to operational claims handling, we offer a unique combination of benefits knowledge and in-house medical expertise.

Our in-house team of medical professionals includes registered nurses, OH advisors, physiotherapists and OH consultant physicians. In fact, 10% of employees are medically qualified. The team of registered nurses look after the healthcare insurance needs of over 64,000 employees and dependents.

To find out more insights revealed by our recent research — including how employers are planning to tackle the evolving absence challenge — book a complimentary absence management discovery call with one of our absence specialists. Complete the form opposite, or below on a mobile device.


1. "Absence from work due to illness," OECD Health Status. Return to article undo

2. "Health and Wellbeing at Work 2023," CIPD (September 2023). Return to article undo

3. "Sickness absence in the UK labour market: 2022," ONS (April 2023). Return to article undo

To view the full article click here

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.