Managing Stress & Well-being at Work

Transcription

1 Managing Stress & Well-being at Work Reference Number: 137 Author & title: Alexandra Cudmore, Head of HR Responsible Director: Human Resources Review Date: 23 January 2016 Ratified by: HR Director Date Ratified: 23 January 2013 Version: 4.2 Related Policies Code of Expectations of Employees Conflict Resolution (Violence & Aggression) at Work Managing Substance Misuse Managing Organisational Change Appraisal: Performance & Review Smoke Free RUH Author: Alexandra Cudmore Page 1 of 29

2 Contents Policy Summary... 4 Policy Statement... 4 Definitions... 5 Aims and Objectives of this policy... 6 Duties & Responsibilities Trust Board & Executive Team Employees Line Managers The Health & Safety Department The HR Department The Occupational Health Department Good Practice for Preventing Stressors Role Design - Job descriptions and Person Specification Performance development review & the knowledge & skills framework Managing Change Process for Managing Stress within the Organisation Stress Risk Assessments Sickness Absence attributed to Stress Stress Audit Mediation & Support Monitoring Compliance Working in Partnership Review References Appendix 1: Introduction to Stress Risk Assessments Appendix 2: Possible Signs, Symptoms and Consequences of Stress Appendix 3: Stress Risk Assessments Process Appendix 4: Hints & Tips which may help people to cope better with stress Appendix 5: Return to Work form following Absence due to Stress Appendix 6: Stress Audit Process Appendix 7: Consultation Schedule Document Control Information Ratification Assurance Statement 28 Equality Impact: (A) Assessment Screening 29 Author: Alexandra Cudmore Page 2 of 29

3 Amendment History Issue Status Date Reason for Change Authorised 3 Approved 20 January 2010 Planned Review Trust Consultative & Negotiating Committee 4 Approved 23 January 2013 Planned Review, minor amendment to appendices policy sub-group Sue Smith Deputy Director of Human Resources Author: Alexandra Cudmore Page 3 of 29

4 Policy Summary The Royal United Hospital, Bath NHS 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, Violence & Aggression Policy, Employee Code of Expectations, Managing Performance, Appraisal, No Smoking Policy, Harassment & Bullying, Whistle Blowing, Flexible Working and Leave Policy & Staff Involvement 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 Trust is referred to as the Trust. Policy Statement 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 the NHS it is believed that work place stress accounts for approximately 30% of sickness absence, costing the service million per annum. The Health Care Commission staff survey indicates that more than 1 in 3 staff report that they have suffered from work pressure in the past year (NHS Employers 2006). To promote positive attitudes towards health 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. Author: Alexandra Cudmore Page 4 of 29

5 Definitions EAP: Employee Assistance Programme. The Trust s independent, confidential, counseling & mediation service, available to staff & their families. HSE: Health & Safety Executive. 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). 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). 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. Author: Alexandra Cudmore Page 5 of 29

6 Aims and Objectives of this policy Through this policy the Trust aims to assist staff in maintaining a work life balance in line with the standards of Improving Working Lives by addressing the issues of work place stress and its causes (stressors). Duties & Responsibilities 5.1 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. 5.2 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. Co-operate with colleagues to achieve good working relations Use and access available support 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. Author: Alexandra Cudmore Page 6 of 29

7 5.3 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 and Code of Expectations of Employees) Ensuring employees know that they are encouraged to report unacceptable behaviour. Role: Author: Alexandra Cudmore Page 7 of 29

8 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. Change: Ensuring that any change is managed 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 Managing Health and Sickness 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 Managing Health and Sickness 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. Where a Risk Assessment is carried out a copy should be supplied to the Health and Safety Department both at the time of the initial assessment and once all actions have been completed. 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. Author: Alexandra Cudmore Page 8 of 29

9 5.4 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 Staffing Group. The Health and Safety Department is also responsible for keeping a copy of all local risk assessments, progress against action plans and reporting against this to the Safer Staff Group on a bi-monthly basis. The Health & Safety Department are responsible for the independent administration of 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 management colleagues. 5.5 The HR Department The role of the HR Department is to provide advice on policies and procedures to all employee s 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, linking to KSF outlines. Any questions as to the interpretation of this policy shall be referred to the relevant HR Manager. Where further advice is required this should be referred to the Director of HR. Author: Alexandra Cudmore Page 9 of 29

10 5.6 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 Managing Health and Sickness 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 counselors 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. Author: Alexandra Cudmore Page 10 of 29

11 6. Good Practice for Preventing Stressors 6.1 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 what job it is they need to do and feel 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 with KSF outline 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. 6.2 Performance development review & the knowledge & skills framework In line with the Appraisal: Performance & Review Policy all posts (excluding medical and director posts) will have a KSF outline. All staff will have an annual appraisal with their line manager and objectives that are clear and SMART. Reference should be made to the Trust s Appraisal Policy which is available on the Trust s intranet. The appraisal process is aimed at promoting effectiveness at work and reviewing regularly 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. 6.3 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 Author: Alexandra Cudmore Page 11 of 29

12 line with the Trust s Managing Organisational Change Policy with regular communication with staff. It is important that staff are kept informed by their manager of impending changes and any effect these may have on workload or working environment. Staff can express their views through the formal consultation process or through informal discussions with managers. 7. 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. 7.1 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 to mitigate / resolve risks are implemented. Appendices 1 & 2 contains guidance as to 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 staff, 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. All risk assessments must be signed and dated and stored in a portfolio. 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 Author: Alexandra Cudmore Page 12 of 29

13 Quantitative Sickness absence data Staff Turnover Staff surveys Number of Complaints 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. Assessments and plans should be submitted to the Health & Safety Department at both the point of initiation and once all actions have been completed. 7.2 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 Managing Health & Sickness Policy for further guidance. 7.3 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 anlaysed 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 to address these issues should be agreed with staff. This action plan should then be implemented and following this completion that the staff are re-audited. This plan will be monitored by the Safer Staff Group. Author: Alexandra Cudmore Page 13 of 29

14 8. Mediation & 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. 9. Monitoring Compliance A copy of all local Stress Risk Assessments should be submitted to the Health and Safety Department at the point of initiation and once all actions have been completed. The Health & Safety Department will collate information concerning local risk assessments and report on this to the Safer Staff group on a bi-monthly basis. 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 bi-monthly 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 Staff Sub-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 these. Author: Alexandra Cudmore Page 14 of 29

15 10. 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 side are represented on the Safer Staff Group as well as staff being an integral part of the stress audit process. 11. 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. 12. References Health & Safety Executive Health & safety at Work Act NHS Employers Creating a low stress workplace, available at Author: Alexandra Cudmore Page 15 of 29

16 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. Stress and the employee Author: Alexandra Cudmore Page 16 of 29

17 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 Withdrawal Arriving late to work / leaving early Extended lunches Absenteeism Resigned attitude Reduced social contact Elusiveness / evasiveness Aggressive behaviour Criticism of others Bullying or harassment Poor employee relations Temper outbursts 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 Regression Crying Arguments Undue sensitivity Irritability/moodiness Over-reaction to problems Personality clashes Sulking Immature behaviour Physical signs Tiredness/lethargy Stomach complaints Tension headaches Rapid weight gain or loss Experience increase in minor illnesses Author: Alexandra Cudmore Page 17 of 29

18 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 Over indulgence in smoking / alcohol / drugs Impulsive behaviour / apathy Errors / accidents Poor interpersonal relationships Poor work performance/job loss Long term Marital / family breakdown Physical Short Term Headaches Backaches Disturbed sleep patterns / tiredness Nausea / dizziness Indigestion Chest Pain Long Term Heart disease Hypertension Ulcers Poor general health Insomnia Emotional Short Term Anxiety / depression Lack of motivation Difficulty concentrating Boredom Irritability Low self esteem Panic attacks Long Term Chronic depression and anxiety Neurosis Mental breakdown Suicide Possible consequences of stress in the workplace: Reduced motivation & commitment to work Reduced morale Decreased productivity Poor judgment Reduced quality of patient care Increase in errors and accidents Author: Alexandra Cudmore Page 18 of 29

19 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. Author: Alexandra Cudmore Page 19 of 29

20 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 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 Author: Alexandra Cudmore Page 20 of 29

21 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. 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. Author: Alexandra Cudmore Page 21 of 29

22 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 Author: Alexandra Cudmore Page 22 of 29

23 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 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? 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? What can be done about it? Can we make any adjustments? Author: Alexandra Cudmore Page 23 of 29

24 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 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? 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 What can be done about it? Can we make any adjustments? Author: Alexandra Cudmore Page 24 of 29

25 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 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 workrelated stress? What can be done about it? Can we make any adjustments? 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 on the HSE Stress website Author: Alexandra Cudmore Page 25 of 29

26 Appendix 6: Stress Audit Process Note: Stress Audits are commissioned by the Safer Staffing Group but are only undertaken once a stakeholder assessment has been undertaken to ensure that this is appropriate. This is referred to below as a Risk Assessment (Step 2). This is different form the Stress Risk Assessment undertaken by Managers as per section 7.1. Stress Review Commissioned (Safer Staffing Group) Risk Assessment (Line Manager, Senior Manager, HRM, and Stakeholders facilitated by Health & Safety) YES Audit Appropriate? NO Launch / parameter meeting (HRM, Manager, Sponsor & Stakeholder) END HSE questionnaire & analysis (Health & Safety) Review feedback (Management / Local Team & Facilitator) Action Plan 3 6 month delivery (Management / Local Team & Facilitator) Review Action plan (Safer Staff Group) Author: Alexandra Cudmore Page 26 of 29

27 Appendix 7: 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 Manager October 2006 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 Author: Alexandra Cudmore Page 27 of 29

28 Document Control Information Ratification Assurance Statement Dear Sue 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: Alexandra Cudmore Job Title: Head of HR 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: Date: 23/01/13 Name of Person Ratifying this policy: Sue Smith Job Title: Deputy Director of Human Resources Signature: Date: 23/01/13 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, John Apley Building. The whole policy must be sent electronically to: ruh-tr.policies@nhs.net Author: Alexandra Cudmore Page 28 of 29

29 Equality Impact: (A) Assessment Screening To be completed when submitted to the appropriate Executive Director for consideration and approval. Person responsible for the assessment: Name: Gabrielle Hucker Job Title: HR Manager Does the document/guidance affect one group less or more favourably than another on the basis of: Yes/No Race Yes No Ethnic origins (including gypsies and travellers) Yes No Nationality Yes No Gender (including gender reassignment) Yes No Culture Yes No Religion or belief Yes No Sexual orientation Yes No Age Yes No Comments Disability (learning disabilities, physical disability, sensory impairment and mental health problems) Yes No Is there any evidence that some groups are affected differently? Yes No If you have identified potential discrimination, are there any valid exceptions, legal and/or justifiable? Yes No None identified Is the impact of the document/guidance likely to be negative? Yes No If so, can the impact be avoided? Yes No N/A What alternative is there to achieving the document/guidance without the impact? Yes No N/A Can we reduce the impact by taking different action? Yes No N/A If you answered NO to all the above questions, the assessment is now complete, and no further action is required. If you answered YES to any of the above please complete the Equality Impact: (B) Full Analysis Author: Alexandra Cudmore Page 29 of 29