A new report out this week from Simplyhealth and WPI Economics puts a number on something most SME owners already feel in their gut: poor workforce health cost the UK economy £87 billion last year, and small businesses are carrying a disproportionate share of it. Businesses with fewer than 50 staff accounted for around 47 million sick days between them, an estimated £5.6 billion in lost profit for SMEs specifically. If you run a small team, this isn’t an abstract economic statistic, it’s the empty desk that means someone else covers two jobs for a week.

The report’s most useful finding isn’t the headline cost, it’s the cause. A large chunk of the losses come from delayed access to healthcare rather than illness itself: employees losing an average of 2.1 working days a year simply waiting for appointments, referrals, or test results, and separately losing time to the admin of managing all of that. For a business with five or ten staff, one person stuck in a lengthy NHS waiting list isn’t just a health issue, it’s an ongoing gap in your rota with no fixed end date.

Why small businesses feel this harder than big ones

A 200-person company can usually absorb one person’s absence without much disruption. A ten-person business often can’t. When your bookkeeper, your only qualified electrician, or your sole customer service person is off, there’s no one else to quietly pick up the slack, and the work either doesn’t get done or gets rushed by whoever’s left. This is the structural reason SME losses per employee are running well ahead of the national average, not because small business staff are less healthy, but because there’s less redundancy built into a small team.

What you can actually do about it

Get sickness and health policies written down properly, even in a five-person team. A surprising number of small businesses handle sickness absence entirely informally, which works fine until it doesn’t, and then becomes a source of confusion, resentment, or a genuine legal risk if it’s handled inconsistently between staff. Smallprint provides UK-compliant HR policy templates, including sickness absence and flexible working policies, built for businesses too small to have a dedicated HR function drafting these from scratch.

Look at low-cost healthcare access benefits before assuming private healthcare is out of reach. Full private medical insurance is expensive, but health cash plans and GP access services that help staff skip NHS waiting times for minor issues are considerably cheaper and directly address the delay problem the report identifies, not just the illness itself.

Build in some slack for single points of failure. If one person leaving suddenly would stop a core part of your business functioning, that’s a bigger risk than any one sickness absence policy can fix. Cross-training a second person on critical tasks, even informally, is one of the cheapest forms of insurance a small business can buy.

Track absence patterns, not just individual days off. A single sick day rarely tells you much, but a pattern across several staff in the same few months might point to a workload, workplace, or morale issue worth addressing before it becomes a bigger cost.

The takeaway

Staff sickness absence isn’t just a wellbeing issue, it’s a measurable cost that’s hitting small businesses harder than large ones, largely because of healthcare access delays rather than the illnesses themselves. You don’t need a corporate HR budget to respond to that, a proper written policy, a realistic look at cheap healthcare access benefits, and a bit of deliberate cross-training will do more for a ten-person business than most large-company wellbeing programmes ever could.