Journal of Occupational Rehabilitation

, Volume 21, Issue 4, pp 501-512

First online:

Challenges to Remaining at Work with Common Health Problems: What Helps and What Influence Do Organisational Policies Have?

  • Rhiannon BuckAffiliated withDepartment for Health, University of Bath Email author 
  • , Carol PorteousAffiliated withDepartment of Primary Care and Public Health Sciences, Kings College London
  • , Gwenllian Wynne-JonesAffiliated withArthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University
  • , Katie MarshAffiliated withCentre for Psychosocial and Disability Research, School of Medicine, Cardiff University
  • , Ceri J. PhillipsAffiliated withCollege of Human and Health Sciences, Swansea University
  • , Chris J. MainAffiliated withArthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University

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Introduction: Common health problems have a significant impact on work productivity (presenteeism), and sickness absence. The aim of this study was to examine the attitudes and beliefs of employees in the public sector about common health problems and work using the Flags system as a conceptual framework to identify problems and potential solutions. Method: 63 employees took part in 14 focus groups in two public sector organisations. Discussions were audio-recorded, transcribed, and analysed thematically using NVivo. Results: The study confirmed the importance of heath-focused clinical factors (Yellow flags), perceptions of work (Blue flags), and more objective characteristics of work and organisational policies (Black flags), which emerged as major themes. The social and moral norms surrounding sickness absence and presenteeism were frequently discussed, including the impact of absence on colleagues, guilt, legitimising illness, and trust. There were interactions between the different Flags, often mediated by managers via their relationships with employees and their role in implementing organisational policy. Conclusions: The Flags system was useful as a conceptual framework in this context for identifying a number of obstacles to working with health problems, many of which were potentially modifiable on worker, workplace, or wider systems levels.


Common health problems Flags Work Presenteeism Absenteeism