ALL YOU EVER NEEDED TO KNOW ABOUT TACKLING WORK RELATED STRESS IN ONE EMAIL!
Stress is still a major cause of sickness absence so we have put together a useful summary of the key issues to be aware of on the subject based on HSE guidance. Can we also remind you that we are here to help with a range of our own attendance management and stress management tools and training courses. Definition
1. HSE defines stress as the adverse reaction people have to excessive pressures or other types of demand placed on them. It arises when they perceive that they cant cope with those demands.
2. The stress response is natural and not in itself an illness. Its effects are often short-lived and cause no lasting harm. However, it is well established that stress can result in physical and psychological illness when exposure is excessive and prolonged. Work-related stress is not reportable under RIDDOR.
Scale and nature of the problem
3. The increased incidence and prevalence of work-related stress (WRS) over recent years is a real concern. Data given in a HSE report estimated that WRS costs British employers about £410 million to £530million based on 2001/2002 prices, and society about £3.75 billion per annum based on 1995-6 prices.
4. WRS, depression or anxiety are the leading causes of working days lost through work-related injury or ill health, with an estimated 12.8 million days a year lost in 2004/05. Figures from the 2004/05 Survey of Self-reported Work-related Illness (SWI04/05), indicate that each case of stress leads to an average of 30.9 days lost.
5. The findings of HSE sponsored research projects have provided important information about the sources of WRS demonstrates the links between psychosocial risk factors and subsequent ill health. The findings that have the most significance are that:
Factors concerned with work organisation are capable of inducing both psychological and physical ill health in members of the work force.
Management style has the potential to affect the health of employees. In particular there was clear evidence that social support, particularly from managers to their employees, has a protective effect on the development of future psychiatric disorder, health functioning and spells of sickness absence.
Interventions are only likely to be effective if applied to management systems and work organisation, rather than at the individual level.
Many groups of workers, but most often teachers, nurses and managers reported being highly stressed.
Management standards for work-related stress
6. Stress has been designated as an HSE Priority.
7. A key element of the HSE has been the development of the Management Standards for work-related stress (Management Standards / Standards) to provide duty holders with a framework to tackle WRS. The Standards were developed with input from a range of stakeholders including businesses, professional bodies and Trades Unions. They were launched on 3 November 2004 and are designed to help employers and employees work together to gauge stress levels in an organisation and identify locally relevant solutions to manage the risks from WRS.
8. The Standards are based on a risk assessment methodology with three core components:
An indicator tool (based on a short questionnaire) to give a broad overview of potential organisational issues . This has been designed and validated to specifically measure the six elements of work design which comprise the Management Standards ;
Consultation with employees to provide a mechanism to check back on the results of the tool and to develop locally relevant interventions to improve working conditions; and,
Implementation of interventions and subsequent review to evaluate their success.
9. The Management Standards look at six key areas of work design/organisation which if not correctly managed can lead to WRS. These are:-
Demands [work load (quantity, pace and content), work scheduling (shifts, breaks, uncertain hours), physical environment (violence, noise, thermal comfort, etc)].
Control [lack of control over work, low autonomy, little decision-making].
Support [skill shortfall, lack of support from organisation / management / colleagues].
Role [role conflict, role ambiguity, low perceived status, inappropriate levels of responsibility].
Relationship [interpersonal conflict and harassment].
Change [poor or absent strategies for involving staff and for minimising adverse effects of implementation].
10. There is a Standard for each of these six areas. Each Standard comprises of three elements:
The Stressor (e.g. Demands, Control, Support, Role, Relationship, Change);
The Standard e.g. for Demands is that employees indicate that they are able to cope with the demands of their jobs; and systems are in place locally to respond to individual concerns; and,
What should be happening / states to be achieved which define a desirable set of conditions to work towards, typical of characteristics of an organisation where this stressor is likely to be managed effectively.
The Standards provide a yardstick against which employers can measure their performance and encourage them to strive for continuous improvement.
11. It is important to recognise that organisational culture is likely to be a very significant contributor to the stress profile of an organisation but it pervades all aspects of management and cannot be considered in isolation. Poor culture is characterised by a lack of support for employees, poor communication, lack of commitment to employee well being, and employees not being valued etc.
12. The Standards and supporting guidance material are web-based products and can be accessed at www.hse.gov.uk/stress/standards/index.htm. Reference to further information on the Management Standards and the supporting evidence base can be found at http://www.hse.gov.uk/stress/index.htm. Further Guidance material is listed at Appendix 1.
13. The Standards, indicator tool and guidance, are known collectively as the Management Standards Approach. The Approach helps large organisations meet their legal duties under the Health and Safety at Work etc. Act 1974 (HSW Act), and the Management of Health and Safety at Work Regulations 1999 (MHSWR).
14. The Management Standards approach is one way that organisations can conduct their risk assessment this but it is not the only way and organisations are free to choose alternative approaches. Such alternative risk assessment approaches should include the following core features:
Employee consultation and involvement throughout;
Focus interventions at the organisational, not the individual level; and,
Based on gap analysis and strive for continuous improvement.
Intervention strategies available to employers
15. Stress researchers have found it convenient to categorise the types of intervention that employers can take to manage WRS as follows:
Primary interventions proactive organisational strategies aimed at reducing or eliminating exposure to stressors.
Secondary interventions – provision of training for employees to enable them to cope more effectively (normally described as stress management training).
Tertiary interventions – employee assistance programmes (EAPs) aimed at helping employees recover from illness (typically by provision of counselling).
These categories align conveniently with familiar health and safety concepts of prevention, control and mitigation.
16. HSEs policy for tackling WRS is to do so at an organisational level. This is in line with research findings that suggest that where workplace conditions are not managed correctly then this can give rise to perceived WRS across an organisation. Tackling individual experiences of WRS or seeking to increase the resilience of individuals will not tackle the underlying causes. HSE therefore encourages employers to concentrate their efforts on primary interventions that are more likely to have a significant effect in reducing the incidence and prevalence of WRS.
17. However it is accepted that secondary and tertiary interventions have an important part to play in situations where there is little scope to apply further primary interventions and to help identify and manage employees who report that they are having problems before they become ill.
Managing sickness absence and return to work (MSARTW)
18. The majority of long-term sickness absence is due to common health problems such as stress, depression, anxiety and musculoskeletal injuries. Common health problems are best addressed through an approach that considers not only the biological or health issues but also personal, social and work-related barriers that are preventing return to work. HSE has published HSG 249, a generic organisational approach to MSARTW that employers and managers can adapt for their use. Information on this can be found in Appendix 1 or at www.hse.go.uk/sicknessabsence].
19. MSARTW is largely an issue that cannot be enforced under the HSWA (there are legal duties for employers under Employment Rights and Disability Discrimination Acts). HSEs approach is very much a voluntary one to develop an overarching policy on what constitutes good return to work practices for people suffering from WRS.
20. Making sure organisations record and monitor sickness absence and keep in contact with people off sick are essential actions in managing any instance of sickness absence. Managers may not be confident in keeping in contact with employees off sick and can be helped by training and having access to professional advice as necessary.
21. Once somebody who has been off work due to WRS is ready to return, the Management Standards provide a framework around which to structure return to work interviews to discuss which obstacles could continue to have an adverse effect on the persons condition and to identify solutions to overcome them. After instances of long-term sickness absence, the Standards can play an important role in return to work plans by ensuring that employees are not subjected to excessive demands and pressures during their planned return.
22. Individual cases of ill health or WRS
Individual cases of ill health or WRS should not be investigated by the HSE or the Local Authority Environmental Health Officers unless the evidence for a breach of health and safety legislation is very clear-cut. A blanket policy of non-investigation would not be appropriate as there will inevitably be a few cases where the circumstances would indicate that further investigation might be appropriate. After considering the circumstances of the complaint, it may be appropriate for inspectors to advise complainants that they may have more success in achieving individual redress if they pursue the issue via other routes, e.g. using industrial relations procedures. Where the substantive issue is pay, pensions, disciplinary matters, racial or sexual matters and other conditions of employment, then other routes are particularly likely to represent the most effective option.
23. The types of issue for which Officers may offer support may be available include:
Judging the adequacy of risk assessments and risk assessment processes.
Help overcoming any problems in using and implementing the Management Standards.
Advice on determining the reasonable practicability of implementing particular control measures.
Equivalence or adequacy of alternative approaches.
Confirmation of diagnosis of ill health.
Legal and enforcement
24. Employers have duties under the Management of Health and Safety at Work Regulations 1999 (MHSWR) in particular, to assess the risks to health and safety from work activities, and this should include risks of stress-related ill health arising from work activities. Under MHSWR and HSW Act, employers should make appropriate arrangements to address these risks and should take measures to control that risk so far as is reasonably practicable.
25. Enforcement action should only be considered if:
There is indication of a pattern of stress-related ill health affecting a number of staff in an organization; or,
There is an indication that a number of staff are experiencing WRS and that this is intense and likely to be prolonged.
and, following advice from HSE;
the organisation fails to complete a risk assessment; or,
the risk assessment is inadequate; or,
the organisation is failing to take reasonable steps to address any issues that are identified in the risk assessment.
Guidance Materials on stress and managing sickness absence
1. HSE has produced some supporting guidance for the Management Standards. It was launched on the HSE website on 3 November 2004 and complements and supplements HSEs existing guidance. It explains in more detail how organisations might go about using the Management Standards to undertake a risk assessment for WRS.
2. HSG 218 Tackling work related stress: a managers guide to improving and maintaining employee health and well being, is no longer available as a stand alone priced publication but it is still available as part of Real Solutions Real People.
3. Real Solutions, Real People; a managers guide to tackling work related stress ISBN 0 7176 2767 5 is a priced support pack based on a series of case studies of effective interventions. It gives more detailed information on how organisations can develop locally relevant solutions to the stress issues identified by their risk assessment.
4. HSE is currently revising its printed guidance on WRS. The new guidance will not contain any radically different recommendations. It is intended to consolidate the various pieces of guidance issued since 2001 into one user-friendly document. We aim to publish the new guidance in Autumn 2006. Our web-based guidance will also be enhanced to reflect any changes.
Available from HSE books
1. Managing sickness absence and return to work. An employers and managers guide. HSG 249. ISBN 0 7176 2882 5. Priced.
2. Managing sickness absence and return to work in small businesses. INDG399. ISBN 0 7176 2914 7. Free download.
3. Off work sick and worried about your job? Steps you can take to help your return to work. INDG397. ISBN 0 7176 2915 5. Free download
4. Real Solutions, real people. A managers guide to tackling work-related stress. ISBN 0 7176 2767 5. Priced.
5. Tackling stress. The Management Standards approach. INDG 406. ISBN 0 7176 6140 7. Free download
6. Working together to reduce stress at work. A guide for employees. MISC 686. ISBN 0 7176 6122 9 This has been superseded by Working together to reduce stress at work – INDG424 [PDF 107KB]
7. Making the stress Management Standards work. How to apply the Standards in your workplace. MISC 714. ISBN 0 7176 6157 1. Free download ]