Employee absence is a significant cost for many organisations, yet research suggests that only a minority of employers monitor that cost. 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 the health 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.

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

Effective absence management is about supporting employees with health issues to stay in or return to work. Developing effective return-to-work programmes and offering flexible working where possible form part of an effective attendance management strategy. Employers should remember that most absence is genuine and that employees often need support in their recovery from illness.

Employee absence is a significant cost to businesses. Our Health and wellbeing at work survey has data on sickness absence levels and causes. It also looks at current practices in managing absence and attendance. The 2020 report shows that sickness absence is at its lowest (5.8 days on average per employee per year) in the 20-year history of the survey. This doesn’t mean that all workplaces are necessarily becoming healthier or that people are at less risk of becoming unwell. As the workforce ages, for example, people are more likely to develop long-term health conditions and/or disabilities and so it’s important that employers develop supportive workplaces that help people to manage their health and work.

Effective attendance management involves finding a balance between providing support to help employees with health conditions stay in and return to work, and taking consistent and firm action in the minority of cases where employees could try to take advantage of their organisation’s occupational sick pay scheme.

A focus on employee wellbeing and health promotion is good for people and their employers. It can help avoid non-genuine absence problems developing, and support people to balance work in a way that minimises the impact of their symptoms, where possible.

Types of absence

There are many reasons why people take time off work:

  • Short- or long-term sickness. 
  • 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).
  • Musculoskeletal injuries, including back pain.
  • Stress.
  • Mental ill health (for example depression and anxiety).
  • Caring responsibilities for children.

The COVID-19 pandemic has significant implications for people’s health and wellbeing, and how employers effectively manage sickness absence. Employers have a statutory duty of care for people’s health and safety, and to provide a safe place to work. Public health measures and UK Government guidance mean that many people need to self-isolate. It’s vital that employers support their staff who have COVID-19 symptoms or live with someone with symptoms, to self-isolate to help curb the spread of the virus.

New legislation relating to COVID-19 means that Statutory Sick Pay (SSP) is available from day one (instead of day four) for those affected by coronavirus when self-isolating. Employers with fewer than 250 employees can also claim a refund for COVID-19 related SSP costs (up to two weeks per employee).

Employees can self-certify for the first seven days, as normal. Government advice is that employers should use discretion around the need for medical evidence beyond that for absence where an employee has to self-isolate in the current exceptional circumstances. The Government has introduced a temporary alternative to the fit note for the duration of the COVID-19 outbreak whereby those in self-isolation can obtain a notification via NHS 111 to use as evidence for absence from work. Employers can check if an isolation note is valid using an online service.

An alternative option to providing sick pay is to allow people who are asked to self-isolate, but are not unwell, to work from home wherever possible, and continue to pay as normal.

Many organisations are treating sickness absence related to COVID-19 (including that due to people self-isolating) outside of their normal sickness absence reporting system. Over the coming months some employees may need to self-isolate multiple times (for example, until they receive a negative test result for the virus) and should not be unfairly penalised as part of a trigger system that uses trigger points to highlight absence patterns that could be of concern.

Find out more in our Responding to the coronavirus hub.

Accurate measurement and monitoring, identifying trends and exploring the underlying causes are key elements in effective absence management.

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 their 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.
  • Explain how any review or trigger point system used by the employer operates.
  • Say that the organisation reserves the right to require employees to attend an examination by a company doctor or occupational health professional 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

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 should also 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 and support the employee by making adjustments.

Absence interventions

Effective interventions in managing short-term absence include:

  • Return-to-work interviews.
  • Providing leave for family circumstances.
  • Using of trigger mechanisms to review attendance.
  • Disciplinary procedures for unacceptable absence levels.
  • Changes to working patterns or environment, such as flexible working.
  • Employee assistance programme.
  • Training line managers in absence management.
  • Involving occupational health professionals.

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 any 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. It’s important that any underlying health conditions are taken into account as part of this process.

Promoting a positive attendance culture, while emphasising that genuine sickness absence will be supported, 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 managing absence, and our research shows that managers take primary responsibility for managing short-term absence in two-thirds of organisations. However, too few organisations train their line managers in the skills needed to do this effectively. 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 the early warning signs of potential problems, employees can be given appropriate support before matters escalate.

Line managers need to be trained in:

  • The organisation’s sickness absence policies and procedures.
  • Their role in the attendance 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.
  • How the trigger points system operates (where applicable).
  • The role of occupational health services and proactive measures to support staff health and wellbeing.
  • Managing complex cases with the support of occupational health professionals and HR.
  • Developing return-to-work interview skills.
  • The skills needed to raise and discuss potential issues, including those related to more complex or sensitive problems.

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

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

  • Return-to-work interviews that are supportive and discuss ongoing adjustments where needed.
  • Occupational health involvement and proactive measures to support staff health and wellbeing.
  • A supportive case management approach, for example involving HR, occupational health services and the individual’s line manager.
  • Risk assessment to help return to work after long-term absence.
  • Changes to work patterns or environment, including flexible working.
  • Return-to-work interviews.

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

  • Keeping in contact with unwell employees, in a sensistive manner, to help prevent them feeling isolated.
  • Planning and implementing workplace adjustments where necessary, in collaboration with the individual.
  • Accessing professional advice and treatment.
  • Planning and co-ordinating a return-to-work plan.
  • Regular evaluation with the employee about how they are adjusting to being back at work.

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 have a disability or health condition, as outlined in the disability discrimination provisions of the Equality Act 2010. Employers should be aware that physical and mental health conditions 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 1988.

Employers must be careful not to breach the Data Protection Act 2018 (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 - Absence from work

Health and Safety Executive

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

Fit for Work

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.

Journal articles

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

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

Rachel Suff

Rachel Suff: Senior Employee Relations Adviser

Rachel Suff joined the CIPD as a senior policy adviser in 2014 to help shape the public policy debate to champion better work and working lives. Rachel is a policy and research professional with over 20 years’ experience in the employment and HR arena. An important part of her role is to ensure that the views of the profession inform CIPD policy thinking on health and wellbeing and employment relations. She has recently led a range of policy and research studies about health and well-being at work, and represents the CIPD on key advisory groups, such as the Royal Foundation’s Heads Together Workplace Wellbeing programme. Rachel is a qualified HR practitioner and researcher with a master’s in Human Resource Management from Portsmouth University and a post-graduate diploma in social research methods from Sussex University; her prior roles include working as a researcher for XpertHR and as a senior policy adviser at Acas. 

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