Stress Management at Work Policy
Executive Director lead
Author/ lead
Feedback on implementation to
Director of Human Resources
Carol Borrill, Organisational Psychologist
Deputy Director of Human Resources
Date of draft
Consultation period
Date of ratification
Ratified by
Date of issue
Date for review
May 2012
January to May 2012
June 2012
Executive Directors Group
June 2012
June 2015
Target audience
All Trust employees and the Trust Board
Version 2
This policy is stored and available through the SHSC intranet (accessed via HR intranet
pages).
This policy updates the first version of this policy which was ratified on 8 January 2009.
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1
Contents
Section
Page
3
4
4
4
5
5–6
6–7
7
7
8
8
Flowchart
Introduction
Scope of this policy
Definitions
Purpose of the Policy
Duties
Stress Risk Assessment
Dissemination, storage and archiving
Training and other resource implications for this policy
Audit, monitoring and review
Links to other policies, standards and legislation
1
2
3
4
5
6
7
8
9
10
Appendix
Employee Counselling Service – Workplace Wellbeing
A
Appendix
Stress Risk Assessment Tool & Risk Assessment Grid
B
9
10 – 27
28
Supplementary Section A - Equality Impact Assessment Form
Supplementary Section B - Human Rights Act Assessment Form
29 - 30
NHSLA Level 1
(A)
Duties – section 5.
(B)
How staff can access information on the management of work-related stress – Paras 5.7 & 5.9,
Appendix A provides specialist WWB service and signposting, section 6 provides link to HSE website.
(C)
How workplaces stressors are identified – Paras 3.3 and 3.4, 5.8, 5.10.2, section 6 - 1 para which
enables employees to identify issues by using HSE tool, and Appendix B para 1b and 1d.
(D)
How the organisation carries out risk assessments for the prevention and management of work-related
stress – Paras 5.5 and 5.6, section 6, and Appendix B particularly 1e.
(E)
How the organisation monitors compliance with all of the above – Para 5.3 plus section 9.
st
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2
FLOWCHART – Stress Management
Examples of sources
of information:
Significant
planned
change e.g.
restructuring
Managers assess need for
risk assessment within
area / team
Employee /
Team
requests
-
Staff Survey
Sickness absence
Turnover
Grievances
Team Governance
Exit interviews
Need
identified
Yes
Apply Risk Assessment
Tool (see Appendix B)
No
Keep under review at
regular intervals /
Consider and apply any
alternative action
Analyse results and
identify action
Draw up and implement
integrated plan including:
- the identified risk
- management action required
- support/expert advice needed
- key target dates
- arrangements for feedback
- date for review
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3
1. Introduction
1.1 Workplace stress can be a major factor in reducing staff performance, commitment and
motivation, and productivity, and increasing sickness absence and absenteeism. The
Health and Safety Executive (HSE) considers stress to be consistently one of the most
commonly reported work-related illnesses. Current legislation also encompasses
requirements to manage stress at work.
1.2 The Trust is committed to protecting the health, safety and welfare of its employees. It
recognises that workplace stress is a health and safety issue and acknowledges the
importance of identifying and reducing the causes of stress in the work place.
1.3 This policy sets out the Trust’s aims in relation to the management of workplace stress,
and in ensuring that, where reasonably practicable, employees who experience stress are
helped, whatever the cause of that stress.
1.4 The initial implementation of the policy will be monitored through the Trust’s Workforce
Plan and associated governance processes. On an ongoing basis, regular audits will take
place to monitor compliance with the policy.
2. Scope of this Policy
2.1 This policy applies to all employees of the Trust.
3. Definitions
3.1 ‘Stress’ - ‘the adverse reaction people have to excessive pressures or other types of
demand placed upon them’ (Health and Safety Executive). This makes an
Important distinction between pressure which can be a positive state if managed correctly
enhancing job satisfaction, motivation and performance, and excessive or negative stress
which can be detrimental to health.
3.2 The effect of pressure on any individual is moderated by a variety of factors including
support systems at home and work, personality and coping mechanisms. What may be
too much pressure for one person at a specific time may not be for another, or even for
the same person at a different time.
3.3. The symptoms of stress include those that are emotional (depression, anxiety, tension,
irritability, fatigue and low self esteem), physical (headaches, high blood pressure,
disturbed sleep patterns) and behavioural (absence from work, avoidance of tasks,
withdrawal / isolation, and poor job performance).
3.4 ‘Workplace stress’ – the adverse reaction people have to excessive pressures or other
types of demand placed upon them in the workplace.
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4
4. Purpose of the Policy
4.1 This policy sets out the Trust’s aims in relation to the management of workplace stress,
and in ensuring that, where reasonably practicable, employees who experience stress
are helped, whatever the cause of that stress.
4.2 The Trust aims:
4.2.1 To increase levels of understanding and awareness in the Trust about the causes and
effects of stress, and the actions that can help to reduce workplace stress.
4.2.2 To support managers to identify the possible sources of workplace stress at the earliest
opportunity through timely, effective risk assessment, in addition to other sources of
information.
4.2.3 To support managers to effectively manage the causes and effects of workplace
stress.
4.2.4 To provide information and training that will assist employees in identifying and
managing stress in others and themselves
4.2.5 To encourage employees to seek help and support, and to see this as a positive step.
4.2.6
To provide a confidential employee counselling service.
4.2.7 To improve attendance rates and reduce sickness absence relating to workplace
stress through early identification and avoidance of absence, and supporting the return to
work of employees who have experienced absence due to stress.
5. Duties
To ensure the effective implementation of this policy the following responsibilities are
identified:
5.1 The Executive Director of Human Resources will take overall executive responsibility for
and lead on the implementation of the policy.
5.2 The Human Resources and Workforce Group will monitor the initial implementation of
the policy through the Workforce Plan.
5.3 The Executive Director of Human Resources will ensure regular analysis takes place to
monitor stress at work by means of the annual Staff Survey or otherwise, and will ensure that
the policy is reviewed on a regular basis.
5.4 The Executive Director of Human Resources will ensure that the service provided by
Occupational Health and Workplace Wellbeing through contract negotiations and service
specifications supports the implementation of the policy.
5.5 Following implementation, managers are responsible for carrying out stress risk
assessments as appropriate, and that as far as reasonably practicable, appropriate and timely
____________________________________________________________________________________________________________
5
actions and strategies are put in place to reduce or remove the causes of workplace stress.
Where identified risks cannot be managed at a local level, this should be reported to the
relevant Director for further consideration.
5.6 Following implementation, Service, Clinical and Support Directors and where appropriate,
Executive and Associate Directors are responsible for ensuring that stress risk assessments
are carried out within their areas of responsibility as appropriate, and that as far as reasonably
practicable, appropriate and timely actions and strategies are put in place to reduce or
remove the causes of workplace stress.
5.7 Directors and managers must be aware of the employee support services available,
particularly the employee support service provided by Workplace Wellbeing, and be in a
position to direct employees to such services.
5.8 Employees have a responsibility to recognise pressure and where possible to take early
action before it develops into stress. Employees should notify their manager if they feel that
stress is affecting their health and/or work performance, and whether this relates to workplace
stress.
5.9 Employees should also be proactive in seeking support and utilising the available sources
of support as appropriate.
5.10 Human Resources Department staff will:
5.10.1 Give advice to Directors and Managers on the Stress Management at Work policy as
appropriate, assist Managers in liaison with Occupational Health colleagues and staff side
representatives as appropriate
5.10.2 Assist in Identifying potential ‘stress hotspots’ in the Trust from sickness absence
statistics, feeding back to line managers and advise on actions and strategies
5.10.3 In collaboration with or addition to other qualified sources of expertise, advise
managers on interventions to support the management of workplace and other stress
5.10.4 Support Managers as appropriate to facilitate the return to work of employees following
periods of stress related illness.
5.10.5 Provide advice and guidance to Managers in organisational change processes on how
to minimise the occurrence of workplace stress.
6. Stress Risk Assessment
A risk assessment tool that identifies the sources of stress experienced by individual staff
members is available from the Health and Safety Executive website: www.hse.gov.uk. This tool
is available to be used by individuals or teams where they feel that this would be helpful in
considering whether an issue exists which requires action. It may be particularly useful when
looking at arrangements to facilitate a return to work during a sickness absence.
In Appendix B there is copy of the ‘Stress Risk Assessment’ tool that managers can use to
assess risk in the work environment. Full instructions on how and when to use the tool are
included in Appendix B. The tool assesses risk on the six stress factors included in the HSE
risk assessment model as set out below:
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6
Demands This factor relates to the demands of the job as a whole. Jobs have many features
or characteristics such as how much work they involve, the amount of control over tasks, the
variety of tasks involved, the support and help available and feedback provided.
Control This factor refers to the amount of say staff have over how their work is carried out.
Relationships This factor refers to the way we interact with other people at work. Relationships with
managers, peers and others at work can have a major influence on how an individual feels at the end
of the working day.
Role This factor refers to the individual’s understanding of their role in the organisation, the
group or the team which should be clearly defined and understood
Support This factor refers to the range of formal and informal activities undertaken by
management that support the work of staff
Change This factor refers to organisational change, whether large or small, and how this is
managed and communicated in the organisation.
Where management action is required to address the risks identified this will be included in an
integrated plan which should include the following information:
•
•
•
•
•
•
The identified risks
Management action required
Support/expert advice needed
Key target dates for actions to be taken
Arrangements for feedback to employees, team/department
Date for reviewing action plan
Where stress risk assessments are carried out, the outcomes will be reported by Managers to
the relevant Director to enable the Director to carry out their duties as detailed above.
7. Dissemination, storage and archiving
This policy will be posted on the Trust intranet and available to all employees within 7 days of
its ratification.
All employees will be informed of the new policy. In addition Clinical, Service and Support
Directors will be instructed to ensure that all teams and areas are made aware of this new
policy and how to apply it as part of the implementation.
8. Training and other resource implications for this policy
All stress risk assessments will be carried out by appropriately trained Managers.
Implementation of the policy will include training on carrying out stress risk assessments.
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7
9. Audit, monitoring and review
The policy will be subject to regular review and monitoring (see “Duties”, 5.3 above).
NHSLA Risk Management Standard – Monitoring Compliance Template
Minimum
Requirements
Process
for
Monitoring
Responsible
Individual /
group /
committee
Frequency
of
Monitoring
Review of
Results
process
(e.g. who
does this?)
Responsible
Individual /
group /
committee
for action
plan
development
Responsible
Individual /
group /
committee for
action plan
monitoring and
implementation
Duties
Appraisal /
Supervision
Line
managers
Annual /
Monthly
Appraisal /
Supervision
Line
managers
On going
Line
managers /
Appraisers
Line
managers /
Appraisers
Line managers
How staff can
access
information on
the
management
of work related
stress
How
workplace
stressors are
identified
Line
managers /
Appraisers
Line
managers /
Appraisers
Review of
staff survey
results
HR
Department /
Directorate
Management
Teams
Annual
Ward / Team
managers
HR & Workforce
Group / Quality
Assurance
Committee
How the
organisation
carries out risk
assessments
for the
prevention and
management
of work related
stress
Undertake
stress risk
assessment
tool
Ward / Team
managers
Ongoing
HR &
Workforce
Group /
Directorate
Management
Teams
Directorate
Governance
Groups
Ward / Team
managers
Directorate
Governance
Groups
Line managers
10. Links to other policies, standards and legislation
Bullying and Harassment Policy and Managers’ Guide
Incident Reporting and Investigation Policy
Managing Sickness Absence Policy and Managers’ Guide
Occupational Health Referral Guidelines
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8
Appendix A
Employee Counselling and Consultation Service – Workplace
Wellbeing (WWB)
The Trust offers a confidential counselling and support service in person or by phone to staff
who may be experiencing personal or work difficulties. Further information on this service is
available on the Intranet / Internet together with the Trust’s Health and Wellbeing web page.
For mild to moderate difficulties up to six individual sessions are usually offered; such
difficulties might include:
• Anxiety and worry
• Stress
• Low mood/depression
• Bereavement or loss
• Relationship problems
• Alcohol or drug related problems
• Distressing events
• Return to work after illness or other absence from work
• Formal/informal proceedings at work
• Issues of bullying, harassment and conflict at work
• Issues relating to organisational change
Service users are signposted to more specialist services, as appropriate.
In addition to providing a counselling and support service to individual members of staff, WWB
aims to actively address the wellbeing of its staff by offering the following:
• Formal workshops addressing “Understanding Stress” and “Coping with
Organisational Change”
• Bespoke group work for staff groups with a shared concern around their wellbeing,
intra-group dynamics or the effects of an organisational issue
• Early support after a traumatic or serious incident
• Advice and consultation to managers about general sources of stress in staff and
specific issues
• Work role consultation
Address
30 Wilkinson Street
Sheffield
S10 2GB
Contact No.
E-mail:
(0114) 22 61810 (24 hour voicemail)
Opening hours
Monday and Friday, 9.00am – 5.00pm
Early appointments
8.00 am
Wednesday and
workplace.wellbeing@shsc.nhs.uk
Thursday
Evening appointments
up to 7pm
Tuesday
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9
Appendix B
Stress Risk Assessment Tool:
Guidance on completing a risk assessment
for workplace stress factors
____________________________________________________________________________________________________________
10
Contents
Section
1
Introduction
a. What is stress?
b. What factors cause stress at work?
c. How can I assess stress risk factors?
d. Sources of information that can be used to make a risk assessment
e. Using the stress risk assessment tool
Page
10
10
10
10
11
11
2
Step 1 - Assess Risk
a. Demands
b. Control
c. Relationships
d. Role
e. Support
f. Change
12
12 – 14
14 – 15
15 – 17
17 – 18
18 – 19
20 - 21
3
Step 2 – Risk Assessment Record Score Sheet
a. Example of risk assessment score sheet
b. Risk assessment scores: next steps
22
23
24 - 25
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11
1. Introduction
The Management of Health and Safety at Work Regulations 1999 require employers to
assess the risks from workplace hazards, and record significant findings. A hazard is anything
that can cause harm and the risk is the likelihood that someone will be harmed by the hazard.
The risk of work related stress is one of the hazards that has to be assessed.
a. What is stress?
• Stress is the adverse reaction people have to excessive pressure or other types of
demands.
• Stress is a psychological and physiological condition, it is the automatic response of
‘fight’ or ‘flight’ we have when exposed to circumstances or stimuli, such as excessive
pressures, that are perceived by the individual to be unpleasant, threatening or
dangerous.
• Stress at work is part of everyday working life.
• Individuals vary in what they perceive to be ‘unpleasant, threatening or dangerous’, so
the causes of stress for each of us are different.
• Stress at work results from an accumulation of factors, but it can be a single incident or
action that can trigger a stress response.
b. What factors cause stress at work?
Different work factors will be experienced as stressful for different people at different times.
Factors in the work environment that can be the causes of stress relate to the features of an
individual’s job, how work is organised and managed, the amount of control in a job, the
physical work environment, working relationships, the culture of the organisation where an
individual works, and organisational change.
c. How can I assess stress risk factors?
The HSE have produced a management standard (HSE Management Standards on Work
Related Stress) to identify work related stress, and help with the identification of appropriate
risk assessment and measures that can be used to prevent or control stress. The risk
assessment tool and additional guidance has been developed so that managers can identify
stress factors and take appropriate action to control stress.
The six stress factors used in the risk assessment model are taken from the HSE
Management Standards on Work Related Stress. The stress factors are demands, control,
support, relationships, role and change.
Demands This factor relates to the demands of the job as a whole. Jobs have many features
or characteristics such as how much work they involve, the amount of control over tasks, the
variety of tasks involved, the support and help available and feedback provided.
Control This factor refers to the amount of say staff have over how their work is carried out.
Relationships This factor refers to the way we interact with other people at work.
Relationships with managers, peers and others at work can have a major influence on how an
individual feels at the end of the working day.
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12
Role This factor refers to the individual’s understanding of their role in the organisation, the
group or the team which should be clearly defined and understood.
Support This factor refers to the range of formal and informal activities undertaken by
management that support the work of staff.
Change This factor refers to organisational change, whether large or small, and how this is
managed and communicated in the organisation.
A more detailed break down of each of the factors is provided in Section 1, with questions that
you can use to assess the risk factors on each.
d. Sources of information that can be used to make a risk assessment
♦
♦
♦
♦
♦
♦
♦
♦
One to one meetings
Supervision meetings
Team meetings
PDRs meetings
Job descriptions
Feedback from users and carers
Observation
NHS staff survey results
e. Using the Stress Risk Assessment Tool
There are two main steps in assessing risk:
Step 1: Assess Risk
Identifying factors in the work environment that might cause stress
The stress factors – demands, control, relationships, role, support and change are listed in
Section 1, with questions that you can use to assess the extent to which staff might be
exposed to stress risk factors. Information is also provided about systems and support that
you can use to help improve the work environment and reduce stress risk factors – the
‘controls’ available.
Work through the questions on each of the stress factors. If you cannot answer some
questions, or are not sure, gather information from the sources suggested above.
Step 2: Completing the Risk Assessment Record Score Sheet
Identify the factors that present the greatest risk and taking action
When you have completed Stage 1 and answered the questions on all of the stress factors,
complete Step 2, the Risk Assessment Record Sheet and use this to assess the severity of
the risk of the factors identified in Stage 1.
Risk assessment must be carried out as set out in Section 5.5 and 5.6 above. If there are changes that might
increase the stress risk factors, for example – increase in sickness absence, the client group changes, work load
increases - the impact of these and the use of this tool should be considered.
____________________________________________________________________________________________________________
13
2. Step 1: Assess Risk
(identifying factors in the work environment that might cause stress)
The stress factors – demands, control, relationships, role, support and change are listed
below with questions that you can use to assess the extent to which staff might be exposed to
these stress risk factors.
Work through the questions on each of the stress factors and rate the extent to which
staff might be exposed to each.
On each question: 1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
On some dimensions a low score is bad and suggests this is a risk factor (for example, low
support from colleagues or manager, low involvement in decision making). On others is it a
high score that is bad (e.g. high physical demands, high experience of harassment).
a. Demands
Demand refers to the demands of the job as a whole. Jobs have many features or
characteristics such as how much work they involve, amount of control over tasks, the variety
of tasks involved, the support and help available and feedback provided.
Demands takes account of these features together and their effect on the well being and
health of staff.
The HSE standard is that:
• Employees are able to cope with the demands of their job, and
• Systems are in place locally to respond to any individual concerns
The following features of job demands should be considered in the stress risk assessment
process.
Q1. The amount, difficulty and pace of the workload
To what extent do staff:
a. Carry out a number of different tasks?
b. Have intense workload – includes complex tasks, emotional
demands, and tight deadlines and targets?
c. Have tight timescales for achieving deadlines and targets?
[1] [2] [3] [4] [5]
[1] [2] [3] [4] [5]
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q2. The demands of working with others and with the client group
To what extent is work with the client group:
a. Physically demanding?
[1] [2] [3] [4] [5]
b. Emotionally demanding?
[1] [2] [3] [4] [5]
Comment____________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
____________________________________________________________________________________________________________
14
Q3. Working patterns
To what extent do staff regularly work:
a. Long hours?
b. Over contracted hours?
c. At home to complete work related tasks?
d. Across multi sites and off site?
[1]
[1]
[1]
[1]
[2]
[2]
[2]
[2]
[3]
[3]
[3]
[3]
[4]
[4]
[4]
[4]
[5]
[5]
[5]
[5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q4. The physical working environment
To what extent are staff:
a. Dealing with violence?
b. Abusive behaviour?
c. Working alone?
d. Working in poor environmental conditions?
[1]
[1]
[1]
[1]
[2]
[2]
[2]
[2]
[3]
[3]
[3]
[3]
[4]
[4]
[4]
[4]
[5]
[5]
[5]
[5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q5. Support and help available from management and colleagues
To what extent is practical support available:
a. From managers?
[1] [2] [3] [4] [5]
b. From colleagues?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q6. How clearly roles and responsibilities are specified within the job
a. To what extent are roles and responsibilities specified in
up-to-date job descriptions?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q7. The amount of control staff have over the way they do their job
To what extent do staff have:
a. Control over their pace of work?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
____________________________________________________________________________________________________________
15
Q8. Lack of resources
a. To what extent do staff have the resources they need (e.g. IT, equipment, required
staffing levels, office space) to do they job effectively?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
Make a note of your scores on the RISK ASSESSMENT GRID
b. Control
Control refers to the amount of say staff have over how their work is carried out.
The HSE standard is that:
•
•
Employees are able to have a say about the way they do their work
Systems are in place locally to respond to any individual concerns
The following features of control should be taken into account when completing a stress risk
assessment.
Q1. Staff have an opportunity to have a say about the way work is carried out
a. To what extent do staff participate in decision making processes?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q2. Adequate resources and support are available during periods of high
activity levels or when undertaking new tasks
a. To what extent are staff able to access the resources they need?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q3. Degree of control over working hours and when breaks are taken
To what extent can staff:
a. Decide when they take a break?
[1] [2] [3] [4] [5]
b. Choose the hours they work?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
____________________________________________________________________________________________________________
16
Q4. Encouraged to make suggestions to improve the work environment
To what extent:
a. Are there opportunities for staff to contribute their ideas about
how to improve the work environment?
[1] [2] [3] [4] [5]
b. Are the suggestions staff make implemented?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
Q5. The pace of work activity is driven by an external source
To what extent are:
a. Deadlines and targets imposed by external sources?
b. Is there pressure to accept unsuitable clients or clients into
unsuitable environments?
[1] [2] [3] [4] [5]
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
Make a note of your scores on the RISK ASSESSMENT GRID
c. Relationships
This factor describes the way we interact with other people at work. Relationships with
managers, peers and others at work can have a major influence on how we feel at the end of
the working day.
The HSE standard is that:
• Employee are not subjected to unacceptable behaviours, e.g. bullying at
work
• Systems are in place locally to respond to any individual concerns
The following factors should be considered in any risk assessment of work related stress:
Q1. Unfair treatment by managers and decision makers
To what extent do staff feel they are treated unfairly:
a. By managers?
b. By decision makers?
[1] [2] [3] [4] [5]
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
____________________________________________________________________________________________________________
17
Q2. Harassment of certain categories of staff by managers, other staff, clients,
carers and visitors
a. To what extent have staff members been subject to harassment?
[1] [2] [3] [4] [5]
Comment___________________________________________________________
____________________________________________________________________
Q3. Bullying, intimidation or other victimisation from managers, other staff,
clients, carers and visitors
a. To what extent have staff members felt they have been victimised or intimidated?
[1] [2] [3] [4] [5]
Comment____________________________________________________________
____________________________________________________________________
Q4. Conflict with colleagues
a. To what extent has there been conflict between staff members? [1] [2] [3] [4] [5]
Comment____________________________________________________________
____________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
Q5. Dealing with heavy emotional demands
To what extent are staff dealing with heavy emotional demands:
a. From users and/or carers?
b. From colleagues?
[1] [2] [3] [4] [5]
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q6. Lack of line management support
a. To what extent are staff receiving sufficient line
management support?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
____________________________________________________________________________________________________________
18
Q7. Isolation within separate sections/groups/teams
a. To what extent are there opportunities for staff to meet to
discuss common issues and problems?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q8. Poor communication in the organisation (team, directorate, trust wide)
a. To what extent do staff feel communication within the
Trust is effective?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q9. Lack of a social space/time-out area to be away from the activity in the
workplace
a. To what extent do staff have a place to meet and relax away
[1] [2] [3] [4] [5]
from the work area?
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
Make a note of your scores on the RISK ASSESSMENT GRID
d. Role
A person’s role in the organisation, the group or the team should be clearly defined and
understood, and the expectations placed on them must not be conflicting.
The HSE standard is that:
• Employees understand their role and responsibilities
• Systems are in place locally to respond to any individual concerns
There are two potentially stressful areas associated with a person’s role in an organisation.
These are role conflict and role ambiguity.
Q1. Role Conflict This exists when a person is torn between conflicting job demands, or has
to complete tasks that they do not believe are part of their job.
To what extent do staff experience:
a. Demands and expectations from different team members that are
conflicting
[1] [2] [3] [4] [5]
b. An overly patient centred culture where the demands of the client are
allowed to out-weigh the safety of the staff.
[1] [2] [3] [4] [5]
____________________________________________________________________________________________________________
19
Comment____________________________________________________________________________
______________________________________________________________________________________
Q2. Role Ambiguity This is where a person does not have a clear picture of their work
objectives, often as a result of their responsibilities changing without being incorporated in
their job description.
To what extent do staff?
a. Experience lack of clarity about their roles?
b. Have unclear job description?
c. Experience job changes without consultation?
d. Organisational change without consultation?
[1]
[1]
[1]
[1]
[2]
[2]
[2]
[2]
[3]
[3]
[3]
[3]
[4]
[4]
[4]
[4]
[5]
[5]
[5]
[5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
Make a note of your scores on the RISK ASSESSMENT GRID
e. Support
Management support refers to a range of formal and informal activities undertaken by
management that support the work of staff.
The HSE standard is that:
• Employees receive adequate information and support from their
colleagues and superiors
• Systems are in place locally to respond to any individual concerns
The following support factors are causes of work related stress:
Q1. Lack of career development and promotion routes
a. To what extent are there career development and
promotions opportunities available?
[1] [ 2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q2. Few or no training opportunities
a. To what extent is it possible to meet staff’s training needs?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
____________________________________________________________________________________________________________
20
Q3. Staff feel undervalued
a. To what extent do staff feel valued by managers?
b. To what extent do staff feel valued by colleagues?
[1] [2] [3] [4] [5]
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q4. Staff given responsibility without the authority to take decisions
a. To what extent do staff have the authority to make decisions?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q5. Poor communication throughout the team /directorate
a. To what extent is communication effective in your area?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
Q6. Lack of consultation with staff
a. To what extent are the opinions and views of staff taken into
account
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q7. An over competitive culture
a. To what extent is the culture competitive?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q8. A blame culture
a. To what extent do staff feel they work in a blame culture?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
____________________________________________________________________________________________________________
21
Make a note of your scores on the RISK ASSESSMENT GRID
f. Change
The Trust, the service and the client group has undergone many changes in the last few
years. There have been changes in strategy at national and local level, changes to a range of
standards and guidance that we are expected to meet, restructuring and reorganisation,
closure of old services and the provision new ones. These changes are all likely to have an
impact on work roles as the Trust strives to provide the best possible service and could lead
to increased pressure at work including concerns about job security and work related stress.
The HSE standard is that:
• Employees indicate that the organisation engages them frequently when
undergoing an organisational change, and
• Systems are in place locally to respond to any individual concerns
Factors that should be considered in a risk assessment on the impact of change include:
Q1. The pace and intensity of change
a. To what extent have changes been introduced in the previous
12 months?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
b. To what extent have these changes had an impact on staff and
how they work?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q2. The number of new initiatives that staff have to deal with
a. To what extent have staff experienced new initiatives?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q3. Job insecurity experienced as a result of any restructuring, mergers etc.
a. To what extent have changes impacted on job security?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
____________________________________________________________________________________________________________
22
Q4. The impact of any restructuring on workload and job responsibilities
a. To what extent has change resulted in restructuring staff job
roles and responsibilities?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q5. The relocation of jobs
a. To what extent has change required staff relocation?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q6. The provision of resources and time to manage new initiatives and change
a. To what extent have staff had sufficient resources and time to accommodate each
change and initiative as these where introduced?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
Q7. Failure to consult over changes
a. To what extent were staff consulted about the changes that have
been introduced?
[1] [2] [3] [4] [5]
Comment____________________________________________________________________________
______________________________________________________________________________________
1 = very low, 2 = low, 3 = medium, 4 = high, 5 = very high
Make a note of your scores on the RISK ASSESSMENT GRID
____________________________________________________________________________________________________________
23
STEP 2: RISK ASSESSMENT SCORES RECORD SHEET
Make a note of your scores for each section on the grids below.
If there is more than one score for a question, write the question number (e.g. a, b) in the
appropriate box SEE EXAMPLE BELOW
A) DEMANDS
Score
1
B) CONTROL
2
3
4
5
Score
Q1
Q1
Q2
Q2
Q3
Q3
Q4
Q4
Q5
Q5
1
2
3
4
5
1
2
3
4
5
2
3
4
5
Q6
Q7
Q8
C) RELATIONSHIPS
Score
1
2
D) ROLE
3
4
5
Score
Q1
Q1
Q2
Q2
Q3
Q4
Q5
Q6
Q7
Q8
Q9
E) SUPPORT
Score
1
F) CHANGE
2
3
4
5
Score
Q1
Q1
Q2
Q2
Q3
Q3
Q4
Q4
Q5
Q5
Q6
Q6
Q7
Q7
1
Q8
____________________________________________________________________________________________________________
24
a. Example of risk assessment score sheet
A) DEMANDS
Score
B) CONTROL
1
2
3
Q1
4
ac
Q2
a
Q3
a
Q4
5
b
b
c
d
Q5
Q6
1
2
d
3
4
Q1
a
Q3
ab
Q4
ab
Q5
5
a
Q2
b
c
Score
b
a
b
a
b
a
a
Q7
a
Q8
a
Scores that are in red boxes show the aspects of Demand, Control, Relationships etc
that are a stress risk factor.
• In the example shown the scores suggest that for Demands the stress risk factors are:
- the amount and pace of work (Q1a, b and c)
- working patterns (Q3d)
- the physical work environment (Q4a and 4b)
- the amount of control staff have over the way they do their job (Q7a)
- lack of resources (Q8a)
• The scores suggest that there are two stress risk factors for Control:
- the degree of control over working hours and when breaks are taken (Q3b)
- the pace of work activity driven by an external source (Q5a)
b. Risk Assessment Scores: Next Steps
You need to decide how to prioritise the sources of stress that most urgently need attention.
This can be achieved by:
•
•
•
Talking to staff to get their views on the sources of stress.
Considering whether there are already initiatives planned / being introduced that could
contribute to reducing or removing some sources of stress. You can then focus on the
sources of stress that are not affected by the initiatives.
Considering which sources of stress could be quickly and easily addressed, for
example, meeting staff more frequently or providing regular updates.
How can I reduce stress risk factors?
1. Make the working environment safer - reduce risk by decreasing or eliminating
the causes of stress.
2. Combat stress factors at source - organising work so demands and
expectations are achievable, and give staff clear roles.
3. Adapt the work to the individual, especially in the choice of working methods,
and working practices
____________________________________________________________________________________________________________
25
4. Use the resources and support available in SHSC to develop a coherent
overall preventative approach that covers the organisation of work, working
conditions, social relationships and the influence of factors that can increase
work demands.
5. Give collective approaches to reducing stress priority over individual protective
measures (e.g. by tackling stress at source, rather than just providing
information and training to individuals, or access to an employee assistance
programme such as Workplace Wellbeing)
Methods for reducing work demands and responding to concerns
Appropriate and practical policies and procedures, (e.g. violence at work and
lone working policies and procedures).
Analysis of workload and tasks for particular jobs leading to a workload
agreement. The redistribution of workload/tasks.
Clear role boundaries
Analysis of working patterns – (e.g. working hours ref: working time directive),
re-allocation of tasks, an agreement on multi site and off site working including
travelling time.
Clear job descriptions
Adequate resources and support to carry out the job, including appropriate
manpower and
equipment.
Participation in decision making processes
Work life balance initiatives, (e.g. flexibility of working patterns)
Safe working practices
Methods for increasing control and responding to concerns
Realistic assessments of what is achievable regarding admissions, caseloads,
deadlines and targets
Strategies to increase participation in decision making processes
Improvements in working patterns, (e.g. control over working hours and
breaks)
Two way communication strategies
Reallocation of resources and support during periods of high activity
Work life balance initiatives
Provision of information and training
Safe working practices discussed, agreed and documented
Team development
Building trust and respect
Conflict management training
Methods for addressing relationship issues and responding to concerns
Harassment and bullying policy and procedure.
Zero tolerance campaign for unacceptable behaviour
Complaints procedure – treated seriously and acted on swiftly.
Equal opportunities policy
Better communication systems – both vertically and horizontally.
Safe working practices adopted and good practice shared.
Staff development and professional development opportunities
Methods for addressing role conflict and role ambiguity
Clear, up-to-date job descriptions
Analysis of job tasks and re-allocation of responsibilities
____________________________________________________________________________________________________________
26
Ensure that expectations / demands of the job, as well as deadlines and
targets set are achievable.
Improved consultation measures with other departments
Measures to value the staff’s contribution
An effective appraisal system and regular feed back meetings.
Methods for increasing support and responding to concerns
Systems in place for better communications
Staff are consulted and participate in decision making.
Identification of training needs and the provision of training for staff
Staff development opportunities
Work life balance initiatives
Management show concern and empathy for those they manage
Career development strategies in place
Recognition of staff achievements
Efficient and practical safe working practices in place
Management training
Methods for reducing the adverse impact of change and responding to concerns
Staff involved in the planning process before change
Staff development sessions on new initiatives.
The allocation of sufficient time and resources for staff engaged in new
initiatives.
Consultation about changes ‘in good time’ with the recognised unions.
Staff development needs analysed and acted on.
Consultation about how jobs/roles may change as the result of reorganisation
or restructuring.
Measures to ensure that workloads do not increase as a result of change.
Communication about new developments/change.
____________________________________________________________________________________________________________
27
Supplementary Section A - Stage One Equality Impact Assessment Form
Equality Impact Assessment Process for Policies Developed Under the Policy on Policies
Stage 1 – Complete draft policy
Stage 2 – Relevance - Is the policy potentially relevant to equality i.e. will this policy potentially impact on staff, patients or the public? If NO – No further action required –
please sign and date the following statement. If YES – proceed to stage 3
This policy does not impact on staff, patients or the public (insert name and date)
Nigel Donaldson 25-06-12
Stage 3 – Policy Screening - Public authorities are legally required to have ‘due regard’ to eliminating discrimination , advancing equal opportunity and fostering good
relations , in relation to people who share certain ‘protected characteristics’ and those that do not. The following table should be used to consider this and inform changes
to the policy (indicate yes/no/ don’t know and note reasons). Please see the SHSC Guidance on equality impact assessment for examples and detailed advice this can be
found at http://www.shsc.nhs.uk/about-us/equality--human-rights
Does any aspect of this policy actually
or potentially discriminate against this
group?
Can equality of opportunity for this
group be improved through this
policy or changes to this policy?
Can this policy be amended so that it works
to enhance relations between people in this
group and people not in this group?
AGE
DISABILITY
GENDER REASSIGNMENT
PREGNANCY AND
MATERNITY
RACE
RELIGION OR BELIEF
SEX
SEXUAL ORIENTATION
Stage 4 – Policy Revision - Make amendments to the policy or identify any remedial action required (action should be noted in the policy implementation plan section)
Please delete as appropriate: Policy Amended / Action Identified / no changes made.
Impact Assessment Completed by (insert name and date)
____________________________________________________________________________________________________________
28
Supplementary Section B - Human Rights Act Assessment Form
and Flowchart
You need to be confident that no aspect of this policy breaches a persons Human Rights. You
can assume that if a policy is directly based on a law or national policy it will not therefore
breach Human Rights.
If the policy or any procedures in the policy, are based on a local decision which impact on
individuals, then you will need to make sure their human rights are not breached. To do this,
you will need to refer to the more detailed guidance that is available on the SHSC web site
http://www.sct.nhs.uk/humanrights-273.asp (relevant sections numbers are referenced in grey
boxes on diagram) and work through the flow chart on the next page.
1. Is your policy based on and in line with the current law (including caselaw) or
policy?
Yes. No further action needed.
No. Work through the flow diagram over the page and then answer questions 2
and 3 below.
2. On completion of flow diagram – is further action needed?
No, no further action needed.
Yes, go to question 3
3. Complete the table below to provide details of the actions required
Action required
By what date Responsible Person
____________________________________________________________________________________________________________
29
Human Rights Assessment Flow Chart
Complete text answers in boxes 1.1 – 1.3 and highlight your path through the flowchart
by filling the YES/NO boxes red (do this by clicking on the YES/NO text boxes and then from the
Format menu on the toolbar, choose ‘Format Text Box’ and choose red from the Fill colour option).
Once the flowchart is completed, return to the previous page to complete the Human
Rights Act Assessment Form.
1.1 What is the policy/decision title? …………………………………………………………………………..
1
1.2 What is the objective of the policy/decision? ……………………………………………………………..
1
1.3 Who will be affected by the policy/decision? ……………………………………………………………..
1
Flowchart exit
Will the policy/decision engage
anyone’s Convention rights?
2.1
There is no need to continue with this checklist.
However,
o Be alert to any possibility that your policy may
discriminate against anyone in the exercise of a
Convention right
o Legal advice may still be necessary – if in any
doubt, contact your lawyer
o Things may change, and you may need to
reassess the situation
NO
YES
Will the policy/decision result in the
restriction of a right?
2.2
NO
YES
YES
Is the right an absolute right?
3.1
NO
Is the right a limited right?
4 The right is a qualified right
NO
3.2
YES
Will the right be limited only to the
extent set out in the relevant
Article of the Convention?
3.3
YES
Policy/decision is likely to be
human rights compliant
YES
1) Is there a legal basis for the
restriction? AND
2) Does the restriction have a legitimate
aim? AND
3) Is the restriction necessary in a
democratic society? AND
4) Are you sure you are not using a
sledgehammer to crack a nut?
NO
Policy/decision is not likely to be human rights
compliant please contact the Head of Patient
Experience, Inclusion and Diversity.
BUT
Get legal advice
Access to legal advice MUST be
authorised by the relevant Executive
Director or Associate Director for policies
(this will usually be the Chief Nurse). For
further advice on access to legal advice,
please contact the Complaints and
Litigation Lead.
Regardless of the answers to these questions, once human
rights are being interfered with in a restrictive manner you
should obtain legal advice. You should always seek legal
advice if your policy is likely to discriminate against anyone in
the
exercise of a convention right.
____________________________________________________________________________________________________________
30