Sick notes for one-day absences have not been mandatory in large companies (more than 50 employees) since November 2022. Research at over 23,000 companies now shows that one-day absences in large companies increased by over 44% in 2023. That is three times more than in small companies (15%). But the essence of the absenteeism story is not just about abolished sick notes. Our absenteeism expert Bart Teuwen emphasises the importance of prevention and the de-medicalisation of absenteeism.

One of the striking conclusions is that the number of one-day absences increased by over 44% at large companies. In smaller companies, the increase was 15%. Never before have so many employees been absent on a regular basis (16%).
In other words, sick more often but for shorter periods.

Frequent absenteeism increased by almost 6% in large companies, while it fell by almost 4% in smaller companies. One possible cause is the abolition of the sick note for one-day absences. That measure applies to larger companies and is intended to ease the workload of GPs, but at the same time, it seems to lower the threshold for employees to call in sick (briefly).

However, the link between the abolished sick note and rising absenteeism at large companies does not portray the entire cause-and-effect story. Absenteeism is a complex problem that affects the entire business world, regardless of the company's size. Bart: “Our own survey of 1,000 employers shows that only 3 in 10 companies have an absenteeism policy. I see the consequences of that every day.”

According to Bart, the (partial) abolition of sick notes is not the right focus of the problem. The Netherlands, for instance, does not work with sick notes but successfully keeps absenteeism rates manageable. So, there are other factors at play.

“Many companies fear that their absenteeism rates will explode without sick notes, and the rising figures seem to confirm this,” says Bart. “But that attitude is problematic because that's how you start medicalising absenteeism. Those who are sick need to stay home to recover. Companies should focus less on the medical cause of absenteeism and more on the employability of their people.”

Phasing out sick notes can be useful, but only if it is accompanied by awareness and prevention. Organisations need to put work into a clear vision and an absenteeism policy with clear roles and procedures. “If we start de-medicalising absenteeism and emphasise prevention, we can keep absenteeism under control,” says Bart. “Even if sick notes were abolished altogether.”

It is also important for employers to communicate their absenteeism policy to their employees so that everyone in the workplace knows how the employer invests in their well-being. That atmosphere of trust is essential, as a sick note can quickly mask underlying problems. For example, an employee may be unfit for work due to back pain that was co-induced by psychosocial problems.

“Conversations are crucial,” concludes Bart. “Have your managers discuss absenteeism and general well-being with all your employees, not just the sick ones, so they can quickly recognise and address problems. If someone is absent due to illness for an extended period, a well-thought-out collective reintegration policy will help that person make a smooth transition back into your company afterwards.”