Employees may need time off for a variety of reasons, from short-term sickness to longer-term health issues. An effective absence management framework should support employees' health needs while providing clear and consistent guidance to avoid unauthorised absence or inappropriate use of sick pay schemes.

This factsheet takes a closer look at sickness absence, the reasons for it, and its implications for organisations. 

See the full A-Z list of all CIPD factsheets

Explore our viewpoint on employee health and wellbeing in more detail, along with actions for government and recommendations for employers. 

Read our recommendations for an effective sick pay system.

Developing effective return-to-work programmes, helpful workplace adjustments and offering flexible or hybrid working form part of an effective attendance management strategy. Employers should remember that most absence is genuine and that employees often need recovery support even after their return to work from illness.

Our Health and wellbeing at work survey report has data on sickness absence causes and management. It also looks at current practices in managing absence and attendance.

A focus on employee wellbeing and health promotion benefits people and their employers. It can help prevent ill health, and support people to balance work whilst minimising the impact of any ill health symptoms, where possible.

This factsheet focuses on sickness absence. For information on other forms of absence, see our working hours and time off work factsheet.

COVID-19 has significant ongoing implications. In our 2022 Health and wellbeing at work survey it was in the top three causes of short-term absence for two-thirds of organisations (67% up from 39% last year). Just over a quarter (26%) reported ‘long COVID’ as a top cause of long-term absence. Almost one in ten (8%) organisations lost over 25% of working time to COVID-19 related absence in the previous year.  

Managing Covid-19 absences

COVID-19 remains a life-threatening disease especially for the clinically vulnerable and unvaccinated. 

Employers will vary in how they manage on-going risk with some taking a stricter approach than envisaged under the government’s living with COVID-19 plan. In summary, most compulsory restrictions have been replaced with guidance, depending on whether testing has taken place. Free lateral flow testing is now only available for groups such as social care workers and NHS staff. Those with COVID-19 symptoms should stay at home avoiding contact with others until well enough to resume normal activities and any high temperature subsides. Those who do test positive should stay at home for at least five days, avoiding contact with others. Following a positive test people should avoid the clinically vulnerable for at least 10 days. 

Employers must maintain health and safety measures that are appropriate for their circumstances. Relevant pre-existing duties include statutory, common law and contractual duties to take reasonable care for employees’ safety and provide a reasonably suitable working environment. 

Sick Pay

The government’s temporary Statutory Sick Pay (SSP)  changes have now ended. Staff are entitled to SSP if they are unwell, but SSP is no longer payable from the first day of COVID-19 related sickness absence, but from day four, as before. Employees are no longer eligible for SSP for self-isolation unless they are unwell and off sick.

Organisations different approaches to  COVID-19-related absences in absence rates (such as suspected or confirmed cases, self-isolation, quarantine, shielding), mean we cannot provide valid average sickness absence rates in our 2021 or 2022 Health and wellbeing at work survey reports. 

Find out more in our Responding to the coronavirus hub.

Accurate measurement, monitoring, identifying trends and exploring the underlying causes are key in effective absence management. The different measurement methods include:

‘Lost time’ rate - expresses the percentage of total time lost due to absence. Separately calculations for different departments can identify areas of concern.

Total absence (hours or days) in the period x 100
Possible total (hours or days) in the period

Frequency rate - shows the average number of absences per employee expressed as a percentage. It doesn’t indicate the length of each absence or employees who take more than one spell of absence.

No of spells of absence in the period x 100
No of employees

Bradford Factor - measures the number of spells of absence and identifies persistent short-term absence. This is therefore a useful measure of the disruption caused by this type of absence. It's calculated using the formula:

S x S x D

where S = number of spells of absence in 52 weeks;

and D = number of days of absence in 52 weeks (taken by that individual).

For example:

10 one-day absences: 10 x 10 x 10 = 1,000

1 ten-day absence: 1 x 1 x 10 = 10

5 two-day absences: 5 x 5 x 10 = 250

2 five-day absences: 2 x 2 x 10 = 40

The Bradford Factor can unfairly penalise employees who have a health condition. The Equality Act 2010 means that processes and procedures related to absence should be adjusted for employees with a disability, as a person’s disability may predispose them to regular short-term absences. 

Absence management policies and procedures should be flexible highlighting health issues for example the menopause and Long COVID as potential long-term fluctuating health conditions that should be treated as such. 

Policies should clearly explain the rights and obligations of employees when absent due to sickness. Employers must inform staff of terms and conditions relating to sickness or injury, including sick pay. For example, policies should:

  • Provide details of contractual sick pay terms and their relationship with statutory sick pay.
  • Explain when and who employees should notify if they are not able to attend work.
  • Include provisions for return-to-work interviews.

Fit notes

When completing a fit note a doctor can choose:

  • Not fit for work.
  • May be fit for work.

Employers should arrange to meet with an employee who is assessed as ‘may be fit for work’ to discuss appropriate management of the return-to-work process and support the employee by making adjustments.

Amending regulations came into force on 6 April 2022 enabling fit notes to be issued digitally as well as in ink, as previously.

Absence interventions

Return-to-work interviews can help early identification of short-term absence. They also enable managers to start dialogue about any underlying issues causing the absence.

Promoting a positive attendance culture, while emphasising that genuine sickness absence will be supported, can help to ensure illegitimate absence is not tolerated.

The role of line managers

Line managers role in managing absence is key, but they need training and guidance in absence-handling and good communication skills. A trusting culture enables employees to flag issues at an early stage. If line managers can spot early warning signs, employees can be given appropriate support before matters escalate.

Long-term absence is usually defined as lasting at least four weeks and can be challenging to manage; the longer someone is off sick, the harder it can be for them to return. Organisations need to sensitively keep in touch with absent employees and have  formal return-to-work strategies for those returning after prolonged absence. Awareness of potential disability discrimination is crucial, and organisations should have a disability leave policy that treats absence linked to disability as distinct from sickness absence.

Line managers are vital in managing long-term absence, but other important interventions include:

  • Keeping sensitively in contact with unwell employees, to help prevent them feeling isolated.
  • The role of occupational health services.
  • A supportive case management approach, for example involving HR, occupational health and line managers.
  • Reasonable adjustments (where agreed) including flexible working and return to work plans.

Our ‘Manager support for return to work following long-term sickness absence’ guidance and checklist looks at the key behaviours managers need to support successful and lasting returns to work after long-term absence.

Used properly, the Acas Code of practice on disciplinary and grievance procedures, and the employer’s own absence management and other procedures, provide the main tools for addressing unacceptable absence. See more in our discipline and grievances at work factsheet.

Disability discrimination

Employers may need to make ‘reasonable adjustments’ under the Equality Act 2010 to support employees with disabilities or health conditions. For more on addressing these issues, see our factsheets on workplace disabilitystress and mental health.

Other relevant legislation 

Any employer requests for medical reports must comply with the Access to Medical Records Act 1988.

Employers must not to breach the Data Protection Act 2018 (DPA) when collecting or using employees’ absence information. Details of an employee’s health (physical and mental) are ‘sensitive personal data’ under the DPA. Read our data protection factsheet.

CIPD members can find out more from our Absence management law Q&As and our Data protection law Q&As.


Acas - Absence from work

Health and Safety Executive

GOV.UK - Statutory Sick Pay (SSP) - employer guide

Fit for Work

Workplace wellbeing tool

Books and reports

ASHBY, K. and MAHDON, M. (2010) Why do employees come to work when ill? : an investigation into sickness presence in the workplace. London: Work Foundation.

COOLE, C., HAMMOND, A. and WATSON, P. (2015) Getting the best from the fit note: investigating the use of the statement of fitness for work. Wigston: Institution of Occupational Safety and Health.

Journal articles

BURT, E. (2018) Britain’s presenteeism crisis. People Management (online). 24 May.

DORRINGTON, S. et al. (2018) Systematic review of fit note use for workers in the UK. Occupational and Environment Medicine. Vol 75, No 7, pp530-539. Reviewed in In a Nutshell, issue 91.

HOWLETT, E. (2021) Should HR be worried about long Covid? People Management (online). 28 January.

RYLEY, M. (2017) Managing ‘tricky’ absences from work. People Management (online). 4 December.

WHITEHOUSE, E. (2018) How to cure the long-term sickness headache. People Management (online). 13 December.

CIPD members can use our online journals to find articles from over 300 journal titles relevant to HR.

Members and People Management subscribers can see articles on the People Management website.

This factsheet was last updated by Rachel Suff: Senior Employee Relations Adviser, CIPD

Rachel informs CIPD policy thinking on health and wellbeing as well as employment relations. She has over 20 years’ experience in the employment and HR arena.

Explore our related content