Managing Stress & Well-being at Work - Royal United Hospital€¦ · Document name: Managing Stress...
Transcript of Managing Stress & Well-being at Work - Royal United Hospital€¦ · Document name: Managing Stress...
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 1 of 29
Managing Stress & Well-being at Work
Reference Number: 137
Author & Title: Jane Rowley HR Business Partner
Responsible Director: Human Resources
Review Date: 27 April 2020
Ratified by: Clare Buchanan Director of Human Resources
Date Ratified: 27 April 2017
Version: 5.0
Related Policies and Guidelines
Supporting Attendance Policy Working Life Policy Substance Misuse Policy Managing Performance Policy Managing Conduct – Trust Code of Expectations Managing Organisational Change Bullying and Harassment Policy Raising Concerns Policy
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 2 of 29
Index:
1. Policy Summary _______________________________________________ 4
2. Policy Statements _____________________________________________ 4
3. Definition of Terms Used _______________________________________ 5
4. Duties and Responsibilities _____________________________________ 6
4.1. Trust Board & Executive Team ______________________________________ 6
4.2. Employees ______________________________________________________ 6
4.3. Line Managers ___________________________________________________ 7
4.4. The Health & Safety Department _____________________________________ 8
4.5. The HR Department _______________________________________________ 9
4.6. The Occupational Health Department ________________________________ 9
5. Good Practice for Preventing Stressors __________________________ 10
5.1. Role Design – Job descriptions and Person Specification ______________ 10
5.2. Performance development review and the knowledge and skills framework 10
5.3. Managing Change _______________________________________________ 10
6. Process for Managing Stress within the Organisation _______________ 11
6.1. Stress Risk Assessments _________________________________________ 11
6.2. Sickness Absence attributed to Stress ______________________________ 12
6.3. Stress Audit ____________________________________________________ 12
7. Mediation and Support ________________________________________ 12
8. Monitoring Compliance ________________________________________ 13
9. Working in Partnership ________________________________________ 13
10. Review _____________________________________________________ 13
11. Training _____________________________________________________ 14
12. References __________________________________________________ 14
Appendix 1: Introduction to Stress Risk Assessments ________________ 15
Appendix 2: Possible Signs, Symptoms and Consequences of Stress _____ 17
Appendix 3: Stress Risk Assessments Process ________________________ 19
Appendix 4: Hints & Tips which may help people to cope better with stress 22
Appendix 5: Return to Work form following Absence due to Stress ______ 23
Appendix 6: Stress Audit Process ___________________________________ 26
Document Control Information ______________________________________ 27
Ratification Assurance Statement _____________________________________ 27
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 3 of 29
Consultation Schedule _______________________________________________ 28
Equality Impact: (A) Assessment Screening ____________________________ 29
Amendment History
Issue Status Date Reason for Change Authorised
3 Approved 20 January 2010
Planned Review Trust Consultative & Negotiating Committee policy sub-group
4.2 Approved 23 January 2013
Planned Review, minor amendment to appendices
Director of HR
5.0 Approved Not published
Review following restructuring of H&S team and procedures
5.0 Approved April 2017 Planned Review, minor amendments
Clare Buchanan – Director of HR
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 4 of 29
1. Policy Summary The Royal United Hospital, Bath NHS Foundation Trust places high value in creating a healthy and safe working environment. The purpose of this policy is for the Trust to minimise the causes of stress in the work place through effective stress management and risk assessment processes. This policy will reflect the Health and Safety Executive Management Standards for Work Related Stress and the Trust’s strategies for managing stress to minimise its impact on workforce.
This policy should be read in conjunction with several other Trust policies, including: Health and Safety Policies; Bullying and Harassment Policy, Employee Code of Expectations and Conduct Policy; Managing Performance; Substance Misuse; Working Life Policy.
This Policy and Procedure supersedes all previous policies and procedures in relation to managing stress at work.
Throughout this Policy and Procedure the Royal United Hospital Bath NHS Foundation Trust is referred to as the “Trust”.
2. Policy Statements This Policy is in place to ensure the Trust complies with the following legislation: Health and Safety at Work Act (1974), Health and Safety at Work Regulations (1999) and the Equality Act (2010). In this policy stress is defined as “the adverse reaction of people to excessive pressures or other types of demands placed on them” (HSE Tackling Stress: The Management Standards Approach, page 1).
There is a clear distinction between pressure which can create a “buzz” and be a motivating factor and stress, which can occur when this pressure becomes excessive or intolerable. Pressure is part and parcel of all work and can help to keep individuals motivated. But excessive pressure can lead to stress, which undermines performance (Reference: HSE 2006).
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 5 of 29
There are six key areas of work design that, if not properly managed, are associated with poor health and well-being, lower productivity, increased sickness absence and can be the primary sources of stress at work and are:
• Demands – includes issues like workload, work patterns and the work environment
• Control - how much say the person has in the way they do their work • Support - includes the encouragement, sponsorship and resources
provided by the organisation, line management and colleagues • Relationships - includes promoting positive working to avoid
conflict and dealing with unacceptable behaviour • Role - whether people understand their role within the organisation
and whether the organisation ensures that they do not have conflicting roles
• Change - how organisational change is managed and communicated in the organisation
As an employer the Trust has a duty to ensure that risks arising from work activity are properly managed to avoid or reduce excessive work related stress.
In the NHS it is believed that work place stress accounts for approximately 30% of sickness absence, costing the service £300 - £400 million per annum. The 2016 staff survey indicates that 37% of staff reported feeling unwell due to work related stress (NHS Employers 2017).
The aim of the policy is to support and promote positive attitudes towards health and wellbeing at work by outlining the responsibilities of managers and individual staff members and by providing a framework for the successful prevention and management of situations involving stress at work.
3. Definition of Terms Used
EAP: Employee Assistance Programme. The Trust’s independent, confidential, counselling & mediation service, available to staff & their families
HSE: Health & Safety Executive
Safer Staff Group: A sub-group of the Health and Safety Committee
KSF: Knowledge & Skills Framework
PDP: Personal Development Plan
SMART: Specific, Measurable, Achievable, Realistic, Timed
Stress: For the purposes of this policy stress is defined as “the adverse reaction of people to excessive pressures or other types of demands placed on them” (HSE Tackling Stress: The Management Standards Approach, page 1)
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 6 of 29
4. Duties and Responsibilities
4.1. Trust Board & Executive Team The Trust is committed to supporting ways to reduce stress in the workplace. It recognises that the key to managing stress is reliant on good management practice. The Trust Board and Executive Directors are working to ensure the culture of the Trust is one of support for all staff.
4.2. Employees All employees have a responsibility to take care for their own health and safety at work and that of others.
All staff should take reasonable measures to:
Identify factors in departments which may cause excessive stress and
discuss these with their manager Maintain and improve their health, for example by using the Trust
leisure facilities or accessing Bath University facilities with NHS discounts, healthy eating and reduced / non-smoking and seeking support through counselling for accumulating home and work related stress sooner rather than later
Comply with Trust policies, including health, safety & security.
When working with colleagues staff should be co-operative and their attitudes and behaviour aligned with the Trust Values and Code of Expectations to achieve good working relations
Use and access available support through the Trust’s Employee Assistance Programme.(EAP)
Report any illness or injury which they feel may be caused or exacerbated by work
Be aware of their own feelings and reactions to stressful situations and how they cope, accessing staff counselling services to help self- awareness
Staff should regularly communicate with their manager on important aspects of their work to ensure that any possible problems are highlighted at an early stage.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 7 of 29
4.3. Line Managers A low stress workplace will generally be a place where managers encourage staff to be effective, creative, decisive, alert and stimulated (Reference: NHS Employers “Creating a low stress workplace”).
Managers at all levels in the Trust should take all reasonable steps to identify and manage factors in their department that may cause excessive stress. Demands:
• Monitoring of workloads, hours and overtime to ensure that staff are not overloaded, prioritising workloads with staff to minimise the possibility of excessive pressure
• Ensuring recruitment procedures are followed to ensure an appropriate fit between an individual’s abilities and the needs of the post
• Employees’ concerns about their working environment are addressed Control:
• Ensuring everyone has the opportunity for regular job reviews and appraisal and has the opportunity for development in their role
• Employees are encouraged to use their initiative and skills to do their work • Employees are involved in and consulted on proposed changes to
working patterns Support:
• Ensuring new staff have induction training and that staff generally have adequate support and training to carry out their roles
• Informing employees about what support is available for them in the Trust and how they can access it (for example, the staff counselling service
• Ensuring good communication between managers and staff, particularly where there are organisational and procedural changes, and so that staff feel they can ask for guidance, help and support
Relationships:
• Ensuring employees are aware that the Trust has in place agreed policies and procedures to prevent or resolve unacceptable behaviours (for example, tackling Harassment and Bullying, Conduct and breaches of the Code of Expectations of Employees)
• Ensuring employees know that they are encouraged to report unacceptable behaviour
Role:
• Ensuring the employees have a job description that explains to them their role and responsibilities and line management structure
• Ensuring that individuals have clearly defined objectives and responsibilities
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 8 of 29
Change: • Ensuring that any change is managed in accordance with the Trust
Policy i.e. Managing Organisational Change and communicated clearly whether through formal or informal routes
• That staff can express their views on proposed change through formal or informal consultation
Managers should manage absence in line with the Supporting Attendance Policy, including the reporting of absences from work due to work related stress, and identify and manage poor performance in a supportive framework in line with the Managing Performance Policy. The Trust’s Substance Misuse Policy can also be referred to where applicable. In line with the Supporting Attendance Policy, where a manager has a cause for concern an employee can be referred immediately to occupational health. Managers will carry out risk assessments with support from the Health and Safety Department where a work activity is identified that may cause excessive work related stress. Managers should attend relevant training as provided by the Trust and identified via their personal development plans (PDPs) to ensure good management practice and good knowledge of the problems of stress in the workplace. Trust managers are required to follow this policy when they are aware of stress issues. Failure to do so may be in contravention of Trust policies, including Managing Performance and Managing Conduct.
4.4. The Health & Safety Department The role of Trust’s Health & Safety Department is to act as the Subject Matter Experts on Risk Management with regards to Stress within the organisation. As such, they are responsible for providing support and training on the purpose of, and methodology for risk assessments, including assessments in line with HSE requirements or guidelines. In addition, the Health & Safety Department is responsible for the monitoring of incidents related to stress, and the reporting of these to the Safer Staff Group as part of the report relating to staffing levels. The Health & Safety Department are responsible for providing training to enable HR administrators /advisors to administer the HSE stress questionnaires – used as part of the stress audit process - and for the subsequent statistical analysis of the results.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 9 of 29
4.5. The HR Department The role of the HR Department is to provide advice on policies and procedures to all employees and to advise managers on the appropriate course of action to take if a member of staff is believed to be suffering from excessive stress. The Education Centre will work to identify and implement management skills training programmes to support managers in managing / supervising staff. The department provides a range of training and development opportunities for staff to assist them to perform well in their roles and to achieve their career goals. The HR department will be responsible for administration the HSE stress questionnaires – used as part of the stress audit process - and for the subsequent statistical analysis of the results, as well as supporting the utilization of that analysis at a local level, in conjunction with HR management colleagues. Any questions regarding the interpretation of this policy shall be referred to the relevant HR Business Partner. Where further advice is required this should be referred to the Director of HR.
4.6. The Occupational Health Department The Occupational Health Department provides help and advice to managers on recognising stress amongst staff and therefore enabling them to offer the appropriate care and support for them. The Occupational Health Department provides a confidential service to staff who contact them for support and guidance on stress related issues.
Any sickness absence from work related to stress should be managed in line with the Trust’s Supporting Attendance Policy.
Advice should be sought by managers from occupational health in such cases, with support from the HR department where required.
The role of occupational health includes:
• To provide specialist advice • Support individuals who have been off sick with work related
stress and advise them and their managers on return to work • Refer staff to EAP or specialist counsellors as appropriate • Keep up to date with and inform Trust Management and the
Trust Health and Safety Committee of changes and developments in the field of managing workplace stress
The Trust has an Employee Assistance Programme (EAP) providing a confidential Counselling service for all staff. The Trust encourages staff to access this service by self-referral.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 10 of 29
5. Good Practice for Preventing Stressors
5.1. Role Design – Job descriptions and Person Specification
Stress can be caused by a lack of direction or uncertainty in work responsibilities. Therefore employees need to know and understand the requirements of their role and feel confident that they can do it properly.
All staff will have a job description when they commence in their post. All posts will have a clear job description and person specification which accurately describes both the role and the requirements of the post-holder.
The purpose of this is to ensure clarity of roles and responsibilities and to ensure that only candidates with the required competencies and capability are appointed to minimise potential causes of work related stress.
Key stressors within a role should be identified within the relevant Emotional Effort section of the person specification.
5.2. Performance development review and the knowledge and skills framework
In line with the Appraisal Policy all staff will have an annual appraisal with their line manager or for M&D staff their nominated Appraiser to review their performance, agree objectives that are clear and SMART, identify any areas for development or where additional support and /or training would be beneficial. Reference should be made to the Trust’s Managing Performance Policy which is available on the Trust’s intranet. The appraisal process is aimed at promoting effectiveness at work and to regularly review an individual’s work and performance. It is an opportunity for individuals to discuss with their manager any concerns they have and to make suggestions for improvements as well as managers recognising the contribution made by staff members.
5.3. Managing Change There can be significant effects on staff when organisational change takes place. Therefore any substantial change to an employee’s role or terms and conditions of employment should be managed sensitively in line with the Trust’s Managing Organisational Change Policy with regular communication with staff.
It is important that employees are kept informed by their manager of impending changes and any effect these may have on workload or working environment. Employees can express their views through the formal consultation process or through informal discussions with managers.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 11 of 29
6. Process for Managing Stress within the Organisation
There is a statutory duty to carry out stress risk assessments where significant risks have been identified. The Trust expects all staff and managers to be vigilant in identifying stressors within the organisation. Where a stressor is identified a stress risk assessment should be undertaken by the manager in conjunction with staff at a local level, potentially through an existing forum, such as a team meeting. The aim of the stress risk assessment is to identify stressors and minimize their impact.
6.1. Stress Risk Assessments It is the manager’s responsibility to ensure these are carried out – although the need for a risk assessment may be identified by an employee rather than a management colleague – and that they are properly documented with agreed actions being implemented to mitigate / resolve risks. Appendices 1 & 2 provides guidance to indicate when a stress risk assessment may be appropriate, and Appendix 3 outlines the process for a local stress risk assessment.
In carrying out this assessment with a representative group of employees, managers should focus on the factors identified, that are likely to cause intense or sustained levels of work related stress and agree an action plan to address these issues. Support in carrying out stress risk assessments is available from the Health and Safety Department and Human Resources Business Partners /Advisors. All risk assessments must be signed and dated. The risk assessment to be held by the commissioning manager in the Department, copied to HR to be files and available for review as appropriate. Methods that can be used to identify the presence of work related stress include qualitative and quantitative information:
Qualitative Performance Appraisal Focus Groups Return to Work interviews Exit interviews Informal talks to staff
Quantitative Sickness absence data Staff Turnover Staff surveys Number of Complaints
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 12 of 29
A partnership approach involving staff and trade unions is seen as vital in order to identify organisational causes of stress and explore how the risk factors might affect our staff and which areas should be targeted first. Risk Assessments should be carried out at a local level, with action plans monitored at that level, with assistance and support sought from the Health & Safety Department, as needed.
6.2. Sickness Absence attributed to Stress Where an employee identifies that a period of sickness absence has been attributable to stress, their return to work interview should include a stress risk assessment as outlined in Appendix 5. The employee’s Manager should also consider a referral to the Trust’s Occupational Health department and should consult the Trust’s Supporting Attendance Policy for further guidance. A record of the interview should be kept on file, either within their management file or Occupational health record.
6.3. Stress Audit Where an area is identified as having a high incidence of stress by the Safer Staff Group a stress audit will be commissioned. A stress audit involves giving staff a confidential questionnaire, following which the data is analysed and a benchmarked report produced using the Health and Safety Executive Stress Indicator Tool.
The process to be followed for a stress audit is outlined in Appendix 6. Following the production of audit feedback, key issues should be identified through representative focus group sessions and an action plan agreed by management and staff to address the issues highlighted. The action plan should then be implemented and a follow-up stress audit commissioned to measure the impact of the measures implemented. This process to be monitored by the Trusts Safer Staff Group.
7. Mediation and Support The Trust’s Mediation Service is available to all staff and is able to provide support in resolving problems with working relationships that are causing stress for individuals. The Trust’s Chaplaincy team are also available for support to staff.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 13 of 29
8. Monitoring Compliance All absence due to work-related stress will be recorded and monitored in the HR and Payroll Departments. Any incidents / incident reports related to stress will be recorded and monitored in the Health & Safety Department. Collated and anonymised information is available from these departments in line with Data Protection Act and Freedom of Information Act. Reports correlating this data on an anonymised and aggregated basis will be provided quarterly to the Safer Staff Group, where it will be reviewed to ensure that practice is in line with the policy and changes identified if this assurance is not found. The Trust’s Safer Staff Group (a sub-group of the Health & Safety Committee) has the responsibility for monitoring stress related absence and issues within the Trust and for identifying, commissioning and performance-managing actions to reduce work related stress. It will report its progress, risks and issues to the Health & Safety Committee. Where there are risks and issues the Safer Group will escalate these to the Health & Safety Committee. The Health & Safety Committee will consider such issues or risks and determine any further actions to mitigate or remove.
9. Working in Partnership Working in partnership with the Trust, staff side representatives have a key role to play in supporting staff and contributing to discussions and actions on matters concerning staff. Staff are represented by staff side representatives and H&S monitors on the Safer Staff Group who are an integral part of the stress management process.
10. Review The policy authors will review this policy in line with its agreed review dates or any significant amendments to legal or regulatory requirements. There shall be no variation to this policy except by joint agreement through the Trust Consultation and Negotiation Committee.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 14 of 29
11. Training Managers are responsible for ensuring all their staff receive the type of initial and refresher training that is commensurate with their role(s). Staff must refer to the Mandatory Training Profiles, available on the intranet, to identify what training in relation to Health and safety is relevant for their role and the required frequency of update. Further information is available on the statutory and mandatory training web pages about each subject and the available training opportunities. The Mandatory Training Policy identifies how non-attendance on training will be followed up and managed and is available on the intranet. Training statistics for mandatory training subjects are collated by the Learning & Development team, and are reported to the Strategic Workforce Committee. Staff must keep a record of all training in their portfolio. All staff and managers can access their mandatory training compliance records via the Trust’s mandatory reporting tool (STAR) available on the intranet.
12. References
Health & Safety Executive – www.hse.gov.uk
Health & safety at Work Act 1974 - http://www.hse.gov.uk/legislation/hswa.htm
NHS Employers – Creating a low stress workplace, available at www.nhsemployers.org
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 15 of 29
Appendix 1: Introduction to Stress Risk Assessments
Risk Assessment
Under existing health and safety legislation the Trust has a duty to undertake risk assessments and manage activities to reduce the incidence of stress at work. The stress risk assessment is like any other risk assessment – it is a tool to help you identify and control significant health and safety risks in the workplace. Six categories of potential sources of work-related stress (or, conversely, areas that can enhance well-being and performance if well managed) have been identified. These are:
Demand – being able to cope with the demands of the job Control – having an adequate say over how work is done Support – having adequate support from colleagues and superiors Roles – understanding roles and responsibilities Relationships – not being subjected to unacceptable behaviours Change – being involved in any organisation changes.
Employees should be involved in every step of the process: staff perceptions are important both for identifying risk factors and for designing solutions. Solutions or additional controls to manage stress at work should be reviewed within an agreed time frame to check they have been effective. If not further steps to manage stress should be considered and implemented so far as is reasonably practical. As well as gathering employee views, there is a range of data that can, and ideally should, be gathered/ analysed as part of the stress risk assessment process, including: sickness absence, staff turnover, productivity/ performance, accidents/incidents, grievances, use of occupational health and employee assistance programmes, and any other relevant statistics.
Pressure and stress There is sometimes confusion between the terms pressure and stress. It is healthy and essential that people experience challenges within their lives that cause levels of pressure and, up to a certain point, an increase in pressure can improve performance and the quality of life. However, if pressure becomes excessive, it loses its beneficial effect and becomes harmful and destructive to health.
Stress is the reaction that people have to excessive pressure or other types of demand placed on them. It arises when they worry that they cannot cope. The pressures of working life can lead to stress if they are excessive or long-term. For example, the frustration and anger that may be produced by an unhappy relationship with a manager or with a difficult customer, and the unhappiness of an unsuitable job.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 16 of 29
Stress and the employee Excessive pressure and problems can occur in an employee's personal life as well as at work. If an employee is facing a relationship breakdown; financial problems; difficulties with neighbours or bereavement, it is possible that these problems may affect the employee's ability to work effectively. Employees do not have to describe the nature of their personal problems to their manager or HR. However, if personal problems begin to affect performance at work then this will need to be raised and discussed with the employee. The objective of the meeting would be to identify the help that the manager or HR can give to the employee to return to effective working. Signs of stress The first signs that indicate employees may be suffering from excessive pressure or stress are changes in behaviour or appearance. A guide on the kinds of changes that may occur is given below.
Work performance
Declining /inconsistent performance
Uncharacteristic errors
Loss of control over work
Loss of motivation/ commitment
Indecision
Lapses in memory
Increased time at work
Lack of holiday planning/ usage
Aggressive behaviour
Criticism of others
Bullying or harassment
Poor employee relations
Temper outbursts
Regression
Crying
Arguments
Undue sensitivity
Irritability/moodiness
Over-reaction to problems
Personality clashes
Sulking
Immature behaviour
Withdrawal
Arriving late to work/
leaving early
Extended lunches
Absenteeism
Resigned attitude
Reduced social contact
Elusiveness/ evasiveness
Other behaviours
Out of character behaviour
Difficulty in relaxing
Increased consumption of alcohol
Increased smoking
Lack of interest in appearance/hygiene
Accidents at home or work
Unnecessary risk taking
Physical signs
Tiredness/lethargy
Stomach complaints
Tension headaches
Rapid weight gain or loss
Experience increase in minor illnesses
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 17 of 29
Appendix 2: Possible Signs, Symptoms and Consequences of Stress
Signs and symptoms of stress vary from one individual to another. Some of the signs and symptoms may include the following:
Behavioural
Short Term Long term
Over indulgence in smoking/alcohol/ drugs
Marital/family breakdown
Impulsive behaviour/apathy
Errors / accidents
Poor interpersonal relationships
Poor work performance/job loss
Physical
Short Term Long Term
Headaches Heart disease
Backaches Hypertension
Disturbed sleep patterns / tiredness Ulcers
Nausea / dizziness Poor general health
Indigestion Insomnia
Chest Pain
Emotional
Short Term Long Term
Anxiety / depression Chronic depression and anxiety
Lack of motivation Neurosis
Difficulty concentrating
Mental breakdown
Boredom Suicide
Irritability
Low self esteem
Panic attacks
Possible consequences of stress in the workplace:
• Reduced motivation & commitment to work
• Reduced morale
• Decreased productivity
• Poor judgement
• Reduced quality of patient care
• Increase in errors and accidents
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 18 of 29
• Tension & conflict between colleagues
• Increased absenteeism
• High staff turnover
• Effects on home / family life
• Whole teams, department and organisations can suffer from stress in the same way as individuals do. This can result in “fight, flight or freeze” reactions. Information on this is also available from EAP.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 19 of 29
Appendix 3: Stress Risk Assessments Process
The principles of risk assessment for stress are the same for any other hazard. However, it is recognised that it may be more difficult for managers to identify psychological hazards. Definitions Stressor A stressor is anything that is perceived by the member of staff to cause stress. The Health and Safety Executive have identified some common causes of work related stress which should be considered:
Demands
Control
Support
Relationships
Roles
Change Hazard A hazard is anything that has the potential to cause harm, i.e., a stressor. Risk A risk is the likelihood that someone may be harmed by a hazard that has been identified. Risk Assessment Process The risk assessment process involves the following steps:
1. identify / look for the hazards 2. assess the risk to health, i.e. decide who might be harmed and how 3. establish adequate control measures to reduce the risk to health 4. record the significant findings of the assessment 5. monitor the controls and periodically review the assessment
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 20 of 29
STEP 1 – IDENTIFY THE HAZARDS Examine existing data Information may exist which can assist in identifying if there is a potential problem, such as: Sickness absence data
Look at records of sickness absence – is this increasing? Are patterns emerging? Is stress cited as a reason for absence? Turnover data Review figures on staff turnover Exit interviews Examine reasons given from staff for leaving
Adverse incidents at work Is there an increase in accidents / near misses? Reports of Harassment / Bullying / Grievances What is the incidence of such reports? Is there a pattern in departments? Staff surveys Check the results of the annual NHS Staff Survey, which may help to identify areas of concern. Occupational health Has the occupational health department alerted you to any potential stress related issues affecting your staff and department? Ask Staff Managers should involve staff in the risk assessment process by asking their help in identifying potential hazards. Stressors The stress policy explains what stressors are and what measures can be taken to minimise these. STEP 2 – ASSESS THE HAZARDS Having identified potential areas of harm, the next step is to identify who is at risk and ways of reducing the risk.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 21 of 29
STEP 3 – IMPLEMENT CONTROL MEASURES Control measures will vary depending on the risk identified. Some examples are:
• Ensure all members of staff have job descriptions and understand their role
• Have a plan for appraisals and for setting objectives, and monitor performance
• Involve staff where possible in decision making
• Identify training needs and provide support for these
• Consider flexible working options where possible
• Provide support to staff in coping mechanisms
STEP 4 – MONITORING Monitor control measures put in place and revise as necessary.
STEP 5 – REVIEW Review the risk assessment in 6 months (moving to 1 year review cycle).
A risk assessment pro forma and support is available from the Health and Safety Department.
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 22 of 29
Appendix 4: Hints & Tips which may help people to cope better with stress In addition to support available from the occupational health department, including EAP and mediation, the following ideas may also help:
• Rest & relaxation – learning to relax (information on EAP intranet page)
• Take lunch break away from your work place
• Exercise – take regular exercise. The staff leisure facilities can be
accessed along with discounts available to NHS staff at Bath University.
• Lifestyle – making time for leisure activities and interests
• Talking – talking things through with friends or relatives can help
• Take time to think – thinking time each day can help to manage time
and priorities
• Good health – eating sensibly, getting enough rest & avoiding harmful
effects of alcohol and tobacco
• Not being afraid to ask for help
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 23 of 29
Appendix 5: Return to Work form following Absence due to Stress
Cause of stress Question Was it a problem for you? Use this space to detail what the problem was. If it was not a problem leave it blank
What can be done about it? Can we make any adjustments?
Demands Did different people at work demand things from you that were hard to combine?
Did you have unachievable deadlines?
Did you have to work very intensively?
Did you have to neglect some tasks because you had too much to do?
Were you unable to take sufficient breaks?
Did you feel pressured to work long hours?
Did you feel you had to work very fast?
Did you have unrealistic time pressures?
Control Could you decide when to take a break?
Did you feel you had a say in your work speed?
Did you feel you had a choice in deciding how you did your work?
Did you feel you had a choice in deciding what you did at work?
Did you feel you had some say over the way you did your work?
Did you feel your time could be flexible?
Could you decide when to take a break?
Did you feel you had a say in your work speed?
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 24 of 29
Support Manager Did your manager give you enough supportive feedback on the work you did?
Did you feel you could rely on your manager to help you with a work problem?
Did you feel you could talk to your manager about something that upset or annoyed you at work?
Did your manager give you enough supportive feedback on the work you did?
Did you feel you could rely on your manager to help you with a work problem?
Did you feel you could talk to your manager about something that upset or annoyed you at work?
Did your manager give you enough supportive feedback on the work you did?
Did you feel you could rely on your manager to help you with a work problem?
Peers Did you feel your colleagues would help you if work became difficult?
Did you get the help and support you needed from your colleagues?
Did you get the respect at work you deserved from your colleagues?
Were your colleagues willing to listen to your work-related problems?
Relationships Were you personally harassed, in the form of unkind words or behaviour?
Did you feel there was friction or anger between colleagues?
Were you bullied at work?
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 25 of 29
Were relationships strained at work?
Role Were you clear about what was expected of you at work?
Did you know how to go about getting your job done?
Were you clear about what your duties and responsibilities were?
Were you clear about the goals and objectives for this department?
Did you understand how your work fits into the overall aim of the organisation?
Change
Did you have enough opportunities to question managers about change at work?
Did you feel consulted about change at work?
When changes were made at work, were you clear about how they would work out in practice?
Other Is there anything else that was a source of stress for you, at work or at home that may have contributed to you going off work with work-related stress?
Factors outside work
This list of questions on return to work has mainly focused on factors at work. However,
there may be factors outside work, for example in your family life, which may have
contributed to or added to the pressures at work. These may have made it harder to
cope with demands at work that you would normally be able to cope with.
You may want to share these issues with your manager – they may be able to help at
work and make adjustments, for example, being more flexible with working hours or just
being sympathetic to the pressures you are under.
If you do not feel happy telling your manager about these things, is there anyone else you can turn to, for example, your human resources department or employee assistance programmes at work? You may also like to look at the links at http://www.hse.gov.uk/stress/links.htm on the HSE Stress website
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 26 of 29
Appendix 6: Stress Audit Process
Stress Review Commissioned
(Safer Staffing Group)
Risk Assessment (Line Manager, Senior Manager, HRM, and Stakeholders)
END Launch / parameter meeting
(HRM, Manager, Sponsor & Stakeholder)
HSE questionnaire & analysis (HR)
Review feedback
(Management / Local Team & Facilitator)
Action Plan 3 – 6 month delivery
(Management / Local Team & Facilitator)
Review Action plan (Safer Staff Group)
YES Audit Appropriate? NO
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 27 of 29
Document Control Information
Ratification Assurance Statement
Dear Claire
Please review the following information to support the ratification of the below named document.
Name of document: Managing Stress & Well-being at Work (137)
Name of author: J Rowley
Job Title: HR Business Partner
I, the above named author confirm that:
The Policy presented for ratification meets all legislative, best practice and other guidance issued and known to me at the time of development of the Policy;
I am not aware of any omissions to the Policy, and I will bring to the attention of the Executive Director any information which may affect the validity of the Policy presented as soon as this becomes known;
The Policy meets the requirements as outlined in the document entitled Trust-wide Policy for the Development and Management of Policies (v4.0);
The Policy meets the requirements of the NHSLA Risk Management Standards to achieve as a minimum level 2 compliance, where applicable;
I have undertaken appropriate and thorough consultation on this Policy and I have documented the names of those individuals who responded as part of the consultation within the document. I have also fed back to responders to the consultation on the changes made to the Policy following consultation;
I will send the Policy and signed ratification checklist to the Policy Coordinator for publication at my earliest opportunity following ratification;
I will keep this Policy under review and ensure that it is reviewed prior to the review date.
Signature of Author: Jane Rowley Date: 21 April 2017
Name of Person Ratifying this policy: Claire Buchanan
Job Title: Director of HR
Signature: Date: 21 April 2017
To the person approving this policy:
Please ensure this page has been completed correctly, then print, sign and post this page only to: The Policy Coordinator, Apley House, (E5), Royal United Hospital
The whole policy must be sent electronically to: [email protected]
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 28 of 29
Consultation Schedule
Name and Title of Individual Date Consulted
Occupational Health October 2006
EAP October 2006
Head of Patient Safety and Risk October 2006
Health and Safety Service Manager Feb 2016
HR Department December 2012
Safer Staff Group January 2013
Health & Safety Committee January 2013
TCNC Policy Sub-Group January 2013
Strategic Workforce Committee January 2013
HR Operational Team April 2017
Staff Side colleagues April 2017
The following people have submitted responses to the consultation process:
Name and Title of Individual Date Responded
Name of Committee/s (if applicable) Date of Committee
Document name: Managing Stress and Well-being at Work Ref.: 137
Issue date: 21 June 2017 Status: Final
Author: Jane Rowley – HR Business Partner Page 29 of 29
Equality Impact: (A) Assessment Screening
1. Title of document/service for assessment Managing Stress and Well-being at Work
2. Date of assessment April 2017
3. Date for review April 2020
4. Directorate/Service Human Resources
5. Approval Committee HR Operational Team
6. Does the document/service affect one group less or more favourably than another on the basis of:
Protected characteristic: Yes/No Rationale
Age N
Disability N
Gender reassignment N
Pregnancy and maternity N
Race N
Religion and belief N
Sex N
Sexual orientation N
Marriage and civil partnership
N
7. If you have identified potential discrimination, are the exceptions valid, legal and/or justified?
8. If the answers to the above question is ‘no’ then adjust the element of the document / service to remove the disadvantage identified.
9. If neither of the above is possible, take no further action until you have contacted your EIA Divisional / Directorate link for review and support
Signature of person completing the Equality Impact Assessment
Name Jane Rowley – HR Business Partner
Time
Date April 2017
Chair of decision making Board / Group / Committee approval and sign off
Name
Time
Date