Employee absence is a significant cost for many organisations, yet research suggests that only a third of employers monitor that cost. Employees may need time off for a variety of reasons, from short-term sickness to maternity leave or public duties. Effective absence management seeks to support the needs of employees 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. It offers guidance on how businesses can measure absence, what organisations should include in their absence policies, and practical advice on how to manage short and long-term absence. Finally, it outlines the legal position when addressing unacceptable absence.

Organisations need effective people management policies to promote engagement and attendance and therefore reduce absence. Employees need well-defined job roles, challenging but realistic targets, and support and training to help them achieve these targets. Creating a good work environment means employees are less likely to wake up and think ‘I don’t feel like going in to work today’.

Effective absence management is also about supporting employees with health problems to stay in or return to work. Developing effective return-to-work programmes and offering flexible working where possible form part of an absence management strategy. A focus on employee well-being and health promotion can help avoid absence problems developing. Employers should remember that most absence is genuine and that employees often need support in their recovery.

Employee absence is a significant cost to businesses. Our annual Absence management surveys have data on sickness absence causes, costs and the average number of working days lost. It also looks at trends and current practices in managing absence. While it’s been reported that sickness absence is at it's lowest rate since records began, the same official statistics suggest challenges ahead among older and part-time workers.

Fostering employee well-being is good for people and their employers. Promoting well-being can prevent problems from escalating and help create positive working environments where individuals and organisations can thrive.

Effective absence management involves finding a balance between providing support to help employees with health problems stay in and return to work, and taking consistent and firm action against employees who try to take advantage of organisations’ occupational sick pay schemes.

Types of absence

There are many reasons why people take time off work:

  • short-term sickness absence
  • long-term sickness absence
  • other authorised absences, including annual leave; maternity, paternity, adoption, or parental leave; time off for public or trade union duties, or to care for dependents; compassionate leave; educational leave
  • unauthorised absence or persistent lateness.

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

In our annual survey, the main causes of sickness absence have been identified as:

  • minor illness (includes colds/flu, stomach upsets, headaches and migraines)
  • stress
  • musculoskeletal injuries
  • home/family/carer responsibilities
  • mental ill health (for example depression and anxiety)
  • back pain.

Accurate measurement and monitoring, identifying trends and then exploring underlying causes are key elements in effective absence management. But according to our latest absence survey, just one third of employers say they monitor the cost of absence and our previous research found that just under half of organisations have set a target for reducing absence.

How to measure time lost

There are different ways of measuring time lost:

‘Lost time’ rate

This measure expresses the percentage of total time available which has been lost due to absence. It can be calculated separately for different departments to identify areas of concern.

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

Frequency rate

This measure shows the average number of absences per employee expressed as a percentage. It gives no indication of the length of each absence period or any indication of employees who take more than one spell of absence.

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

The calculation gives an individual frequency rate by counting the number of employees who take at least one spell of absence in the period, rather than the total number of spells of absence.

Bradford Factor

By measuring the number of spells of absence, the Bradford Factor identifies persistent short-term absence for individuals and 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 taken by an individual
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

It should be noted that the use of Bradford Factor scoring can be controversial and care should be taken when using this as a guide to identify issues with an employee’s absence record. The Bradford Factor can unfairly penalise employees who fall ill and then come back to work as quickly as possible. The reasons for an employee taking frequent periods of absence should be discussed with the employee before any disciplinary action is taken. The Equality Act 2010 ensures that processes and procedures related to absence are adjusted for employees with a disability. A person’s disability may predispose them to regular short-term absences, and this could potentially lead to tribunal action if the employee was unfairly disciplined as a result of receiving a high Bradford Factor score.

Organisations should have a clear policy that supports their business objectives and culture, and explains the rights and obligations of employees when absent due to sickness. The law requires employers to provide staff with information on any terms and conditions relating to incapacity for work due to sickness or injury, including any provision for sick pay.

The policy should:

  • provide details of contractual sick pay terms and its relationship with statutory sick pay
  • explain when and who employees should notify if they are not able to attend work
  • include when (after how many days) employees need to fill in a self-certificate form
  • contain details of when employees need to provide a fit note from their doctor
  • say that the organisation reserves the right to require employees to attend an examination by a company doctor and (with the individual's consent) to request a report from the employee’s doctor
  • include provisions for return-to-work interviews
  • explain that adjustments may be appropriate to assist the employee in returning to work as soon as is practicable
  • give guidance on absence during major or adverse events (for example, snow, pandemics or popular sporting events such as the Olympic Games or World Cup).

Fit notes

In April 2010 ‘fit notes’ replaced ‘sick notes’, though the system is being reviewed – read the blog Is the fit note fit for purpose?

When completing a fit note a doctor has the choice between two options:

  • not fit for work
  • may be fit for work.

If the doctor selects ‘may be fit for work’, one of the following four options also has to be selected:

  • phased return to work
  • amended duties
  • altered hours
  • workplace adaptations.

The doctor then has the option to make any additional comments.

Employers should arrange to meet with an employee who is assessed as ‘may be fit for work’ to discuss appropriate ways to manage the return to work process. If an employee has been off work for four weeks or more, the employer can refer them to Fit for Work (though the free assessment service will end soon).

Absence interventions

Effective interventions in managing short-term absence include:

  • return-to-work interviews
  • use of trigger mechanisms such as the Bradford Factor to review attendance
  • disciplinary procedures for unacceptable absence levels
  • restricting sick pay
  • giving sickness absence information to line managers
  • involving trained line managers in absence management
  • involving occupational health professionals
  • providing leave for family circumstances
  • offering flexible working.

Return-to-work interviews can help identify short-term absence problems at an early stage. They also provide managers with an opportunity to start a dialogue about underlying issues which might be causing the absence.

Disciplinary procedures for unacceptable absence should make it clear to staff that unjustified absence will not be tolerated and that absence policies will be enforced.

Cohesive leadership promotion of attendance can help to ensure illegitimate absence is not tolerated and attendance-focused initiatives are supported.

The role of line managers

Line managers have an important role to play in the management of absence. Managers need good communication skills and the ability to create a trusting culture where employees feel able to flag issues at an early stage. If line managers can spot early warning signs of potential problems, employees can be given appropriate support before matters escalate. However, our surveys show that around two-fifths of organisations train their line managers in the skills needed to do this effectively, and less than one third provide tailored support for line managers, for example by online support or a care conference with HR to help them manage long-term absence.

Line managers need to be trained in:

  • the organisation’s absence policies and procedures
  • their role in the absence management process
  • the way fit notes operate and how to act upon any advice given by the doctor
  • the legal and disciplinary aspects of absence, including potential disability discrimination issues
  • maintaining absence record-keeping and understanding facts and figures on absence
  • the role of occupational health services and proactive measures to support staff health and wellbeing
  • the management of complex cases, in particular 'myth-busting' about what they can, and cannot, do
  • the operation (where applicable) of trigger points
  • the development of return-to-work interview skills
  • the capabilities and confidence needed to raise and discuss potential issues, including those related to more complex or sensitive problems.

According to our past surveys, absence of eight days or more accounts for about one third of total absence, and absence of four weeks or more accounts for around a fifth. Consequently organisations need to have a formal return to work strategy for those returning after prolonged absence. Awareness of potential disability discrimination claims is also crucial. Our guidance Managing long-term sickness absence and incapacity for work offers advice to employers.

The role of the line manager is vital in managing long-term absence, but other interventions are also important. These include:

  • occupational health involvement and proactive measures to support staff health and well-being
  • trigger mechanisms to review attendance
  • risk assessment to help return to work after long-term absence
  • changes to work patterns or environment
  • return-to-work interviews
  • offering flexible working.

There are five typical elements in the recovery and return-to-work process:

  • keeping in contact with sick employees
  • planning and undertaking workplace controls or adjustments
  • using professional advice and treatment.
  • planning and co-ordinating a return-to-work plan
  • regular evaluation with the employee about how things are working.

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, together with the employer’s own 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’ to support employees who become disabled before they can return to their job, as dictated by the disability discrimination provisions of the Equality Act 2010. Employers should be aware that physical and mental conditions such as stress might be covered under this legislation. For more on how to address the issues, see our factsheets on disability, stress and mental health in the workplace.

Other legislation affecting absence management

If an employer requests a medical report from a health professional, it's essential to follow the Access to Medical Records Act 1998.

Employers must be careful not to breach the Data Protection Act 1998 (DPA) when they collect, use and store information about their employees’ absence. Details of an employee’s health, either physical or mental, are categorised as ‘sensitive personal data’ under the DPA. Read our data protection factsheet.

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


Acas - Managing absence

Health and Safety Executive

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

Workplace wellbeing tool

Books and reports

ACAS. (2014) Managing attendance and employee turnover. Advisory booklet. London: Acas.

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.

LALANI, M., MEADOWS, P. and METCALF, H. (2012) Evaluation of the Statement of Fitness for Work: qualitative research with employers and employees. Research report. [Sheffield]: Department for Work and Pensions.

STEADMAN, K., WOOD, M. and SILVESTER, H. (2015) Health and wellbeing at work: a survey of employees, 2014. London: Department for Work and Pensions.

Journal articles

ANSTIS, L. (2013) A step-by-step route to full role recovery. Employers' Law. July/August. pp18-19.

EMBLETON, S. and BROWN, L. (2014) Long-term sickness absence: five tricky issues for employers. Employers' Law. September. pp14-15.

FLEMING, F. (2015) Returning to work. Occupational Health. Vol 67, No 2, February. pp20-21.

FORD, C. (2014) Help with managing absence. Occupational Health. Vol 66, No 4, April. pp16-18.

WILLIAMS, N. (2013) Working below par. Occupational Health. Vol 65, No 9, September. pp22-23.

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 Lisa Ayling, solicitor and employment law specialist, and by Rachel Suff.

Rachel Suff

Rachel Suff: Employee Relations Adviser

Rachel joined the CIPD as a policy adviser in 2014 to increase the CIPD’s public policy profile and engage with politicians, civil servants, policy-makers and commentators to champion better work and working lives. An important part of her role is to ensure that the views of the profession inform CIPD policy thinking in ER areas such as health and well-being, employee engagement and employment relations.

As well as developing policy on UK employment issues, she helps guide the CIPD’s thinking in relation to European developments affecting the world of work. Rachel is a qualified HR practitioner and researcher; her prior roles include working as a researcher/editor for XpertHR and as a senior policy adviser at Acas.

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