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Perry Scott Nash House / Primett Road / Stevenage / Hertfordshire / SG1 3EE / Tel 01438 745771 / Fax 01438 745772

Email info@perryscottnash.co.uk / Website www.perryscottnash.co.uk

HEALTH & SAFETY MADE EASY - STRESS

Produced by: Janet Perkin August 2006

An IHS Guide

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PART 1.0: QUICK REFERENCE GUIDE What is Stress? In Japan there is a cause of death called Karoshi, it claims 10,000 lives a year, it is regarded as sudden death from over work. Stress related absence is said to have increased by 500% since the mid 1950s in the UK alone. It is the second-biggest cause of work-related illness in Britain, and costs employers about 400 million per year. The wider cost to society has been calculated at around 4 billion a year. Stress can mean different things to different people and is often a generic term for a set of symptoms which can be related to life, work and environmental situations. Much of the research carried out in relation to stress has shown that there is a link between poor work organisation and subsequent ill health of employees. The Health and Safety Executive (HSE) define stress as: the adverse reaction people have to excessive pressure or other types of demand placed on

them This definition makes an important distinction between pressure, which can be a positive state and improve performance if managed correctly, and stress, which can be detrimental to health. It is important to recognise that stress is not necessarily a bad thing. Within certain limits an individuals performance improves with increased levels of stress. When stress becomes excessive performance drops off. Research carried out by the HSE has shown that up to 5 million people in the UK feel very or extremely stressed by their work and approximately half a million people believe they are experiencing stress to such an extent that they are being made ill by it. It should also be remembered that in some cases stress can be a sign of medical problems and employees should always be advised to seek medical advice.

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What are the effects of stress on employees? There are various effects associated with stress. Each employee is individual and the reactions are likely to be different, both physically and mentally. Some of the common symptoms, which are often indicators that a person is suffering from stress, are as follows:-

Lack of concentration Unable to relax Cannot think clearly Distressed and irritable Lack of self esteem Does not enjoy work Depressed and negative about everything Tired and sleepy Reduction in effectiveness of immune system Heart disease Psychiatric illness Anxiety Headaches

These are just some of the symptoms which may occur. Each individual is different and the type, severity and number of symptoms will vary accordingly. Individuals are no longer able to keep going with their job. It tends to occur amongst highly motivated individuals. It is seen to be linked with trying to achieve individual and organisational objectives and becoming frustrated in not being able to achieve the desired outcomes. This frustration causes a spiral of increasing stress that leaves the individual exhausted. Burnout often manifests itself as poor performance, poor decision-making, negative attitudes and exhaustion. Stress may also result from home pressures, money, family etc. Managers must deal with these situations sympathetically. What are the effects of stress on the employer? If employees are suffering from stress while they are at work, the costs to the business and the performance will be affected. Work stress can result in:-

An increase in time off work due to ill health An increase in accidents at work, due to tiredness, which in turn leads to lost time,

stoppages and near misses. These may lead to an increase in civil claims, and increased compensation and insurance premiums.

An increase in staff turnover, which in turn adds to costs of recruitment and training. An increase in customer complaints, if staff are customer facing and are tired and

irritable. A decrease in overall performance and productivity

It is estimated that 30-40% of all sickness absence from work is attributed to some form of mental or emotional disturbance (whether work related or not!)

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People do not work effectively under stress and may induce stress into colleagues. Reducing stress is cost effective and will lead to lower sickness rates, improved performance and less staff turnover. Estimates from Self-Reported Work-Related Illness (SW101/02) Survey 2001/2 indicate that depression or anxiety account for an estimated thirteen and a half million reported lost working days per year. What is the law which relates to stress at work? There is no specific law relating to stress at work, and it not mentioned specifically in any health and safety legislation. It is recognised by the HSE as a serious work hazard and extensive guidance and standards have been issued by them, advising on how to deal with it. The HSE have set up a specific website specifically for stress related advice and information www.hse.gov.uk/stress The HSE argue that having a positive, satisfied and psychologically healthy workforce will produce economic benefits, through improved attendance, motivation and commitment. The law requires employers to tackle work related stress. Under the Health and Safety At Work etc Act 1974 employers have a general duty to ensure, so far as reasonably practicable, the health of their employees at work. This includes taking steps to make sure that they do not suffer stress-related illness as a result of their work. Employers must take account of the risk of stress-related ill health when meeting their obligation under the Management of Health and Safety Work Regulations 1999. The main provision of these Regulations, as far as stress is concerned is a duty to assess; a duty to apply the principle of prevention; a duty to ensure employees capability to provide training; duties towards young people. New landmark rulings were made by the Court of Appeal in the case of Sutherland V Hatton and others 2002. The court set out a number of practical propositions for the future claims concerning workplace stress:-

Employers are entitled to take what they are told by employees at face value unless they have good reason to think otherwise. They do not have a duty to make searching enquiries about employees mental health

An employer will not be in breach of duty in allowing a willing employee to continue

in a stressful job if the only alternative is to dismiss or demote them. The employee must decide whether to risk a breakdown in their health by staying in the job

Indications of impending harm to health at work must be clear enough to show an

employer that action should be taken, in order for a duty on an employer to take action to arise

The employer is in breach of duty only if he fails to take steps which are reasonable,

bearing in mind the size of the risk, gravity of harm, the cost of preventing it and any justification for taking the risk

No type of work may be regarded as intrinsically dangerous to mental health

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Employers who offer a confidential counselling advice service, with access to treatment, are unlikely to be found in breach of duty

Employees must show that illness has been caused by a breach of duty, not merely

occupational stress

Compensation will be reduced to take account of pre-existing conditions or the chance that the claimant would have fallen ill in any event

Are employers responsible for controlling stress at work? Yes, employers have a duty to ensure health, safety and welfare of their employees. Every employer should be concerned about stress not only because of the legal responsibilities, but also because of the moral and common-law responsibilities on employers to have a duty of care to their employees. All employers are increasingly at risk from being sued by their employees for stress and many cases have succeeded in the civil courts. It is the responsibility of the employer to show that he has discharged his duty of care to his employee. Civil claims for stress are increasingly successful and stress management is becoming a prerequisite for insurance cover under Employers Liability insurance. How to determine if there is a problem with stress in the workplace? There are five major categories of work related stress:

1. Factors intrinsic to the job 2. Role in the organisation 3. Relationships at work 4. Career development 5. Organisational Structure and climate

Factors Intrinsic to the Job

Working conditions e.g. changes in noise, lighting, speed of work, physical exertion and repetition

Shift work impacts on blood temperature, metabolic rate, blood sugar levels, mental efficiency, motivation, sleep patterns and social life

Long hours It has been suggested that beyond 40 hours a week, time spent working is increasingly unproductive and can create ill health

Risk and danger the individual may be in a constant state of arousal the associated adrenaline rush, respiration changes and muscle tension may all be threatening to long term health. Note that appropriate training and equipment may support the individual to cope with the situation

New technology the need to adapt to new ways of working may exert pressure Work overload quantitative overload refers simply to having too much to do.

Qualitative workload refers to work that is too difficult for the individual

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Work under-load not being sufficiently challenged by work e.g. repetitive, boring and un-stimulating

Role in the Organisation

Role ambiguity not having a clear idea about ones work objectives, responsibilities or others

Role conflict job demands may be conflicting, the individual may have to perform things they dont want to do or things they dont believe are part of the job. The individual may find themselves torn between different groups within the organisation. The ability to cope may vary with personality

Role incompatibility the person and the job may not fit Responsibility responsibility in organisations usually relate to people and things,

this in itself can cause stress Relationships at Work - possible stressors include:-

Relationships with superiors Relationships with subordinates Relationships with colleagues

Career Development - stress may be linked to:-

Opportunities for promotion and reward and perceived in equality Job security Retirement Performance review

Organisational Structure and Climate - Issues may include:-

Lack of participation Not identifying with the organisation Organisational structure of change/review

Unemployment Stress may arise from:-

Loss of identity Loss of social contact Loss of security Loss of income Loss of time structure

How to establish if there is a problem of stress in the workplace Consulting with employees is essential and this can be done via trade union representatives, employee representatives or at staff meetings. Remember to include everyone, it is not only management who can suffer from stress.

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Questionnaires can be a good starting point, and should be anonymous so as not to intimidate people. Check records for levels of absenteeism do certain departments or teams have a higher level of absenteeism than others. Employers should involve employees at every stage of the fact finding, they are the ones who know what is going on and can provide a true picture of the situation within the workplace. In effect this fact finding is like carrying out a risk assessment. Regulation 3 of the Management of Health and Safety Regulations 1999 requires employers to assess risks to health and safety from hazards at work. The five steps to risk assessment are as follows:- 1. Identify the hazards 2. Decide who might be harmed and how 3. Evaluate the risk by: Identifying what is being done; deciding whether it is enough;

deciding what more needs to be done 4. Record the significant findings of the assessment 5. Review the assessment at appropriate intervals Step 1 - Identify the Hazards Determining if there is a Problem

Informal talks with staff Performance appraisal Focus groups Managing and monitoring attendance including return to work interviews Sickness/absence data Productivity data Turnover Questionnaires

The HSE draw attention to seven broad categories of risk factors for work-related stress. 1. Culture of the organisation and how it approaches work related stress 2. Demands such as work load and exposure to physical hazards 3. Control how much say a person has in the way they do their work 4. Relationships covering issues such as bullying and harassment 5. Change how organisational change is managed and communicated in the organisation 6. Role whether the person understands their role in the organisation and whether their

organisation ensures that the person does not have conflicting roles. 7. Support and training - factors unique to the individual Step 2 - Decide Who Might Be Harmed Work-related stress can affect any member of your team, those exposed to the risk factors identified by the HSE may be affected.

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At particular times in their lives people may be more vulnerable to work-related stress e.g. major life event. The ability to cope with stress varies from individual to individual. Step 3 - Evaluate the Risk For each of the hazards identified in step 1, three questions need to be asked:

1. What actions are you already taking? 2. Is it enough? 3. What more do you need to do?

Regulation 4 of the Management of Health and Safety at Work Regulations 1999 states in controlling risks, the principles below must be applied in the following order: 1. Avoid risks (e.g. make the work environment safer so staff are not anxious about the

risk of violence) 2. Evaluate risks which cannot be avoided 3. Combat risks at source (e.g. organise work appropriately and clarify roles) 4. Adapt the work to the individual 5. Develop a coherent protection policy covering issues such as organisation of work,

working conditions and relationships 6. Give collective protective measures priority over individual protective measures (e.g.

by tackling risk at source rather than just providing information and training to individuals, or access to employee assistance programmes)

7. Give appropriate instruction to employees Step 4 - Record the Significant Findings of the Assessment The Management of Health and Safety at Work Regulations require employers to undertake a suitable and sufficient risk assessment. Regulation 3(6) requires that if an employer employs five or more employees they must record the significant findings of the risk assessment and any group of employees identified as being especially at risk. Step 5 - Review the Assessment at Regular Intervals Regulation 3(3) of The Management of Health and Safety at Work Regulations state that the risk assessment must be reviewed whenever there is reason to believe that it is no longer valid. The HSE suggest at first review the assessment every six months. If after a year this period is seen to be too frequent (i.e. no significant changes) move to an annual review period. Assessments should be revised if there are forthcoming changes that could affect employees.

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Changes in staff or individual employees circumstances may affect the risk assessment. What solutions can be put in place to control stress? The following table shows the risk factor and possible solutions associated with each risk. It should be used as a guide as to the possible solutions which could be implemented in the workplace, but remember each situation is different and a suitable solution should be agreed by all concerned. Risk Factor Areas included Possible Solutions Demands Workload

Working patterns Physical environment

Regular meetings Discuss anticipated workload and concerns Develop personal work plans Adjust working patterns Ensure people are appropriately trained for the task

Control Input by employees on the way they work

Implement systems where employees have a say Discussion forums Discuss employees skills and the way they are used

Support Level of support provided by managers and colleagues

Regular one to ones Team meetings to discuss pressures Ask how employees would like to have access to managerial support Develop training, including refresher training

Relationships Promoting positive working to avoid conflict Address unacceptable behaviour

Provide a written policy for dealing with unacceptable behaviour and communicate it Agree and implement procedures to prevent or quickly deal with conflict Encourage good communication

Role Understanding of individual roles with the organisation Conflicting roles within the organisation

Hold team meetings so that employees can clarify their roles Display targets and objectives Agree specific performance standards and review periodically Introduce personal work plans Develop suitable inductions

Change Managing and communicating organisational change

Ensure staff are aware of why change is necessary Define and explain key steps of change Ensure staff are aware of the impact of the change on their jobs

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All of the following set out to improve the overall situation in the workplace by implementing the actions revealed as necessary by the risk assessment process. This may include for example:

Stress Management Training Stress Awareness Training Complementary Training Self Help Staff Booklets A Stress Management Policy

Whereas the following deal with the treatment and rehabilitation of individuals who have already suffered ill health as a result of stress.

Support schemes for employees who want to discuss their problems confidentially with someone outside the organisation.

Personal counselling for staff either using an in house team or by referral to external providers.

Other strategies which could be implemented include:- Positive Organisational Responses to Stress

Job design e.g. make the job interesting, ensure it does not make unreasonable demands: are long hours and taking work home considered the norm

Involvement and communication people may gain a greater understanding of the

organisation and the rationale for actions, ambiguity may be reduced and sources of stress identified and acceptable strategies deve loped. This can be used as part of a strategy to cope with change

Awareness programs provide people with information on the existence,

manifestation and management of stress

Health programs boost the individuals capacity to cope with stress

Organisational design the physical structuring of the organisation

Personal development boost the individuals feelings of competence but also as a means of relaxation

Personnel policies flexible working, crche facilities

Procedural frameworks provide guidance to staff on how to deal with situations and

so reduce stress related to uncertainty

Improving the physical environment ensure that factors such as heat, light and ventilation are appropriate

Improving the psychosocial environment e.g. bullying and harassment

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Conflict Management

Planning plan workloads; provide clarity in relation to roles and responsibilities. Ensure that the workload is appropriate and that employees have the necessary capability and capacity. Remember under- load as well as overload can cause stress

Culture design create a supportive culture, encourage participation, communication,

support and mutual respect, recognise and deal with issues

Training and recruitment ensure that there is an appropriate fit between individuals and the job

Provision of support services e.g. counselling

Other Considerations Managers must be aware and communicate that:-

stress related problems are not a sign of weakness pressure of excess workloads can trigger illness stress and illness can be related

Managers should encourage:-

group problem solving to discuss perceived causes of stress develops supporting culture and improve coping techniques

Strategies for senior mangers include:-

Ensuring they are accessible to staff to discuss problems and anxieties. Taking lead in changing the view that being under stress is a reflection of personal

vulnerability. Revising effective induction and introduction programmes for new staff. Encouraging staff to talk about their feelings and effects of stress. Encouraging, commending and recognising supportive behaviour of others. Developing co-operative rather than adverse management styles. Engendering team spirit.

What other techniques are available for alleviating the symptoms of anxiety and reducing tension? 1. Relaxation:

deep muscle relaxation meditation breathing exercise yoga

2. Exercise:

reduces tension and enhances mood will also increase resilience to stress

3. Medication (can be useful in short term) 4. Interpersonal Skills:

communication 5. Support Groups:

enhancement of professional skills in house training

6. Lifestyle:

Maintain balance between work and non work related interests e.g. diet, holidays, hobbies etc.

7. Professional help and counselling Stress is not good for the work culture and employers must tackle it positively, assessing its risks and adopting organisational strategies. A more open and informed attitude to problems of stress will also help people emerge from the isolation of their own anxieties. It is important to talk

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Stress Monitoring Programme Personal Record Form

Date: .................................................................................................. Time: ........................ Employee: Manager: Work Activities giving rise to excessive pressure in employees opinion and why Other General Work Load (comments by Manager) Factors in work load identified by Manager which may cause stress at a high level for a prolonged period of time: Measures agreed to help reduce stress levels and exposure times:

Review Date (no later than 4 weeks): ...................................Time: ......................... Signed Manager: ......................................... Employee: ..........................................

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Stress Monitoring Programme

Review Form Date: .................................................................................................. Time: ........................ Employee: Manager: Effectiveness of measures agreed to reduce stress levels as discussed at meeting on ././. Further/continuing measures required? Yes/No If yes please detail:

FURTHER REVIEW REQUIRED? YES/NO If yes: Review Date (no later than 4 weeks): ...................................Time: ......................... Signed Manager: ......................................... Employee: ..........................................

PART 2.0 - Toolbox TalkStress

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Stress - What is it?

The Health and Safety Executive (HSE) define stress as:

the adverse reaction people have to excessive pressure or other types of

demand placed on them

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What are the effects of stress?

Symptoms include:- Lack of concentration Unable to relax Distressed and irritable Lack of self esteem Depressed and negative Tiredness

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How can this affect you?

Increase risk of accidents Increase in time off work due to ill

health Increase in customer complaints Decrease in overall performance and

productivity

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What are an employers duties?

Must take account of stress related illness, by carrying out a risk assessment

1. Identify the hazards2. Decide who might be harmed and how3. Evaluate the risk by identifying what is being done,

deciding whether it is enough and what more needs to be done

4. Record significant findings5. Review the assessment at appropriate intervals

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Stress Risk Assessment Divide into 2s and discuss what jobs or

activities could be considered stressful in your workplace.

Discuss what you think can be done to reduce possible effects of stress associated with those activities

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What can be done? Management to discuss anticipated workload and

concerns with employees Adjust working patterns Regular team meetings and individual discussions Company to provide appropriate training Encourage good communication in all directions Ask managers to display targets and objectives If you dont understand anything ASK!

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Some things to consider:-

Talk about the problems being experienced

Listen Be open-minded as to what could change Be flexible Encourage management to create a

supportive company culture

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Stress is not a weakness it is a symptom of something which needs to be improved

Manage your work patterns sensibly Generate some fun in the workplace!!

Some things to consider (continued):-

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Workplace stress can be a real issue, we want to make sure that you dont suffer

with it.

Remember; Talk to your manager if you are concerned that you may be suffering from the symptoms of stress, dont suffer

in silence

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