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Management of stress in the workplace policy

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					                                             Croydon Community Health Services




                            Management of

                        Stress in the Workplace

                                 Policy


 (Identifying Signs and Symptoms of Stress. Details of support services,
     processes and procedures in place including pro-forma for Risk
                             Assessment)




Revised:                October 2009
Review Date:            October 2011
Lead director:          Director of Community Health Services
Lead Manager:           Occupational Health Manager




041343/1579594                                                               1
                                           Index of Policies and Guidance

   1      Introduction ............................................................................................................... 3
   2      Purpose .................................................................................................................... 3
   3      Definitions ................................................................................................................. 3
   4      Accountability ........................................................................................................... 5
   4.1 Employer .................................................................................................................. 5
   4.2 Chief executive ......................................................................................................... 5
   4.3 Trust Board and Directors........................................................................................ 5
   5      Role and Responsibilities in policy implementation ................................................ 5
   5.1 Management ............................................................................................................ 5
   5.2 Employee.................................................................................................................. 6
   5.3 Occupational Health ................................................................................................. 6
   6      Monitoring ................................................................................................................. 7
   7      Training ..................................................................................................................... 7
   8      Implementation ......................................................................................................... 7
   9      Causes of Stress ...................................................................................................... 8
   10     Useful links: .............................................................................................................. 8
   11     Useful telephone Numbers ...................................................................................... 8
   12     Appendices ............................................................................................................... 9
   12.1 Appendix 1: Individual Stress Risk Assessment ..................................................... 9
   12.2 Appendix 2a: Guidance for identifying causes of stress ....................................... 10
   12.3 Appendix 2b: Employee self awareness of stress ................................................ 11
   12.4 Appendix 3:Stress Risk Assessment Form ........................................................... 12
   12.5 Appendix 4: Risk assessment process flow chart ………………………………....13




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  1       Introduction
Croydon Primary care Trust (PCT) is committed to maintaining a safe and
healthy work environment at all times for its employees. This policy aims to
support both employees and managers in the positive management of work
place stress to minimise the impact upon the individual and the organisation
whilst taking into consideration any problems in their personal life.
 The Trust is committed to identifying sources of stress in the workplace through
a variety of sources and providing appropriate training and interventions with
consideration to the Health and Safety Executive Management Standards for
Work Related Stress. A manageable level of stress is healthy and leads to
improved motivation, job satisfaction and performance.
  2       Purpose
The aim of this policy is to reduce the harmful effects of stress upon all PCT
employees
through a risk assessment process, to:

           Meet our statutory and corporate obligations on stress reduction
           Raise awareness of the impact of unwanted stress on performance,
            productivity and associated costs to the organisation
           Identify the cause through risk assessment, audit and data analysis
           Create a working environment in which stress is openly discussed and
            managed
           Provide appropriate professional support
  3       Legal Obligations

      3.1
The PCT has a legal duty to take reasonable care to ensure that the health of its
staff is not put at risk by excessive pressures or demands arising from the way
work is organised.

      3.2

This Policy acknowledges the PCT’s obligation under the Health and Safety at
Work etc Act 1974, Management of Health and Safety at Work Regulations 1999,
Employment Rights Act 1996, and Protection from Harassment Act 1997,
Working Time Regulations 1998, and Disability Discrimination Act 1995.
  4       Definitions
      4.1    Policy
This policy covers all individuals working for the PCT at all levels and grades
including senior managers, officers, directors, employees, staff contracted to
work on behalf of NHS Croydon, trainees, home workers, part-time and fixed-
term employees, agency and bank staff. Its aim is to ensure a consistent
management approach to support employees with work related stress or
personal stress that impacts upon their work.


041343/1579594                                                                      3
This policy aims to improve the quality of working lives minimise the incidence
and impact of stress and to reduce organisational risk by reducing sickness
absence and litigation of an employment tribunal.

    4.2     The Health and Safety Executive defines Stress at Work as
            follows:
    “the adverse reaction of people to the excessive pressures or other
    types of demands placed upon them”
    Every job brings its own pressures and demands. However what might be
    deemed stressful to one individual may not be to another and is a perception.
    Perception must not be criticised but discussed in order to evaluate if the
    perception is reality.
    It is important to make a distinction between positive and negative pressures.
    Most people need a degree of pressure to maintain motivation, providing a
    sense of achievement and job satisfaction.
    4.3 Stress can be broken down into two principal areas
         Work: An adverse pressure directly caused by the work someone is
          employed to undertake for example; high workload, role ambiguity, work
          environment, work relationships.
         Personal: An adverse pressure or health condition which may be a
          specific event or an accumulation of events in someone's
          personal/domestic life that is having a negative impact upon their health
          and which may spill over into the workplace e.g. accidents, illness,
          bereavement, family breakdown or financial worries.
         Although this policy focuses on work related stress, it is important to
          recognise the impact of stressors outside the work environment which
          may have a significant impact upon an employees ability to cope with
          work and maintain a reliable and regular performance and attendance at
          work
         What triggers stress and the capacity to deal with stress varies from
          person to person. Individuals react to similar situations in different ways.

    In line with the HSE standards there are six principal areas of work that, if
    managed effectively can help reduce work related stress:
     WORK STYLE– workload, work patterns and the environment
         CONTROL – how much say the individual has in the way they do their
          work
         SUPPORT – encouragement, mentorship, resources and sponsorship by
          line management, the team and the organisation
         RELATIONSHIPS – promoting positive working relationships avoiding
          conflict and prompting fast and effective management of unacceptable
          behaviour
         ROLE – individual role unclear or within the team or the wider
          organisation



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           CHANGE – how departmental and organisational change is managed
            and communicated
      4.4    Signs and symptoms of Stress
It is important to establish if the stress is caused by work or personal concerns or
a combination of both.
Symptoms of stress can be broken down into three main categories. An
employee may demonstrate changes in one or all of the areas listed below which
are likely to indicate they are suffering with stress.

          PHYSICAL - i.e.; poor sleep, loss of appetite, unkempt appearance, tired
          BEHAVIOURAL - i.e.; changes in mood or behaviour, irritability, poor time
          keeping
          WORK PERFORMANCE AND ATTENDANCE - increased sickness
          absence, poor performance, and poor concentration


  5       Accountability
      5.1    Employer
   As the employer, Croydon PCT has a duty to assess and manage the risk of
   stress upon its workforce, promoting a positive working environment.
    5.2 Chief Executive
   The Chief Executive holds the principal responsibility for the health, safety
   and welfare of its employees and to those working on behalf of the PCT. The
   Chief executive is responsible to the Board of Directors for compliance to this
   policy.
    5.3 Trust Board and Directors
   Have a responsibility to identify, reduce and evaluate stressors with the
   support of Occupational Health, Human Resources and Health & Safety.
   They will discharge the day to day responsibility of this policy onto line
   managers and employees.
  6       Role and Responsibilities in policy implementation
      6.1    Management
   All line managers within the PCT must take responsibility to ensure their
   department takes appropriate steps to manage stress effectively.

   Line managers are expected to:
     Participate in a culture of open communication and encouragement
           Undertake a risk assessment where identified (appendix 1 )
           Ensure all employees are trained to undertake the duties and
            responsibilities of their role
           Monitor working hours, overtime and annual leave to ensure staff are not
            working excessive hours, reallocating work where necessary




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        To ensure the individual has clear and manageable objectives devised
         through the PDP process
        To deal with bullying and harassment fast and effectively and ensure
         employees understand the standards of behaviour expected of them and
         others
        To be aware of the signs and symptoms of stress so they can offer
         appropriate support
        Seek to understand if the employee’s stress is caused by work or
         personal problems
    Managers may require specialist advice to help them manage a situation,
    which can be sought from both the Human Resources and Occupational
    Health departments.

   6.2     Employee
   Employees are expected to
    Familiarise themselves with the Policy and act in accordance with its aims
      and objectives
        Take responsibility to manage their own personal stress and to seek
         support from their line manager or other appropriate support services
         such as Occupational Health or Human Resources
        Identity factors to the line manager, Human Resources or Occupational
         Health which may cause ill-health to either themselves, colleagues or the
         general public through work activity
        Plan and organise their work to meet personal and organisational
         objectives
        Attend the Occupational Health department if a referral is made by their
         line manager
        To be aware of the impact of their behaviour upon others and be willing to
         make changes
        In order for management to give the employee appropriate support, make
         them aware if it relates to work or personal life

   6.3     Occupational Health
   Occupational health are expected to

        To support line managers to manage employee’s ill-health including joint
         delivery of sickness absence training with the Human Resources
         department
        To identify trends of stress through the department activity and sickness
         absence data in conjunction with Human Resources
        To provide guidance on the risk assessment process




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           To provide specialist advice on the Disability Discrimination Act 1995
            amended 2005
           To provide both a self referral and management referral service to the
            PCT and external customers purchasing OH services
           To provide specialist advice and appropriate referral onto counselling or
            other appropriate external health agencies
           Identify to managers if there are safety concerns regarding an employee’s
            ill-health that may have an impact upon the wider community or for their
            personal safety
           To provide specialist advice to line managers to facilitate a prompt return
            to work following anytime absent from work with stress
           Provide periodic health promotion events to all PCT staff throughout the
            year.

      6.4     Human Resources
Human resources are expected to
    To support line managers to manage employees’ stress in the workplace
     both informally and formally
           Provide guidance on formal policy and procedures and ensure staff are
            aware of this Policy.
           To provide specialist advice on employment practice and legislation


  7       Monitoring
Implementation of this policy will be monitored by the Occupational Health
department in conjunction with Human Resources analysing sickness absence
data, utilisation of the Occupational Health department’s activity data, staff
survey results, staff focus groups and informal talks with employees.
An annual survey will be undertaken of five staff have used the policy and stress
risk assessment tool to monitor its effectiveness.
  8       Training
Training can be provided to line managers either on a one to one basis or
workshops facilitated by Occupational Health. Training will also be included on
sickness absence management training.
Additional advice can be sought from Human Resources and Health & Safety.
  9       Implementation
This policy is for both employees and managers. The long-term aim is for this
policy to be used pro-actively at the start of the year as part of personal objective
setting. By using the policy in this way managers should be able to identify any
likely stressors and implement an appropriate strategy to minimise the risk of ill-
health.
Any employee can use this policy in a situation in which they have work related
stress as a means to open up communication with their line manager.



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    10 Audit
The effectiveness of this policy will be reviewed with line managers who have
referred their member of staff to the Occupational Health department and used
the policy and tool to address a work related stress. Adjustments will be made to
the appendix tools if identified.
    11 Useful links:
   Other relevant policies:
       Dignity at work
       Capability
       Grievance & Disciplinary
       Substance miss-use
       Health & Safety
       Mental Health in the Workplace
       Sickness Absence Policy
       Mind- www.mind.org.uk
       Rethink- www.rethink.org.uk
       Stonewall- www.stonewall.org.uk
       Samaritans- www.samaritans.org.uk
       HSE- http://www.hse.gov.uk/stress/index.htm




    12 Useful telephone Numbers
     HR Department, Lennard Road:                     0208 274 6038
     Occupational Health Service, Lennard Road:       0208 274 6321
     Risk Manager Dr Mohammed Sheikh                  0208 274 6331




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  13 Appendices
    13.1 Appendix 1: Stress Risk Assessment
    13.1.1 Reasons for undertaking a stress risk assessment
The HSE expects organisations to carry out suitable and sufficient risk assessment for
work related stress, and to take action on any of the issues identified by the risk
assessment
Croydon PCT believes that the most effective way of managing stress is to identify root
cause through a process of individual risk assessment. The signs and symptoms of
stress set out at paragraph 3.4 of the policy may indicate the need for a risk assessment
to be undertaken. The assessment has been split into two parts one for the employee to
use to help them identify their stress and one part for the line manager. Occupational
stress can be defined as an adverse reaction to additional pressure beyond an
individual’s normal capability. This is more common after a sustained period of pressure
rather than a specific incident and can be of a mental or emotional nature. This can
affect job satisfaction, performance efficiency and mental well being. Many contributory
factors may affect an individual’s ability to cope with additional demands and
consideration needs to be taken regarding any domestic stressors.
A risk assessment is used to identify a hazard, then remove the hazard or minimise the
effect it has upon the individual or the organisation.
    13.1.2 The Process
There are 4 steps in the process for carrying out a risk assessment:
   1. Identify the hazards/cause – this could be both inside or outside work
   2. Determine the risk – consider the impact on the individual and organisation
   3. Minimise the risks– once you have identified relevant risks, use this tool to
       discuss with your employee/manager and agree appropriate actions
Review the effectiveness of actions taken –agree a date before the end of the
assessment.
    13.1.3 Rating the stressor
Please use the scale below to determine the severity of the problem. You can use
Appendix 2a, b to help identify possible stressors and possible solutions
    Rating of factors
             1            No identified impact on the individual at this time
             2            Some impact but not to the detriment of the individual at this time
             3            Significant impact requiring some form of intervention on the Action
                          Plan.
Document your findings in writing on the action plan and additional sheets of paper if
necessary
    13.1.4 The action plan
Use Appendix 3 to write down the action plan and agree a date for review.
Should issues arise of a personal nature, which are not directly applicable to the role, the
line manager should seek to provide what support they can e.g. by facilitating some
flexibility in working arrangements etc for a short agreed period. However managers
should avoid entering into counselling and where needed, advise the individual to seek
professional advice through Occupational Health or Human Resources departments.
Managers should make two copies of the form
Managers should retain the original for their records
A copy should be given to the individual




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    13.2 Appendix 2a: Guidance for identifying causes of stress
STRESSORS                                       POSSIBLE INTERVENTIONS
    1. Demands of the job/ work style
   Too much to do in too little time              Break down the time each activity takes, how many of each
   Too little to do or boring work                 type and if there is sufficient time to undertake the activity
   Constant interruptions                         Can interruptions be stopped, a quieter place to work?
   Difficulty prioritising workload               Help staff to prioritise their work
    2. Control over work
   No participation in decisions                  Encourage participation in decision making and allow
   An inability to influence                       individuals to plan their own work
   Monitored output                               Facilitate training on influencing skills
   A lack of control over the pace of work        Allow staff control over the pace of their work and only
   Lack of control of environmental factors        monitor their output if essential
    within work area                               Make sure that a suitable risk assessment has been
                                                    conducted to control the physical hazards and risks
    3. Relationships with colleagues
   Bullying                                       Create a culture where members of the team trust each other
   Harassment and/or discrimination                and bullying, harassment and discrimination is not accepted
   Relationship difficulties with colleagues      Seek to understand the issue, tackle inappropriate behaviour
   Supervisory responsibilities                   Encourage people to talk about stress issues, and recognise
   A lack of, or closed, communication             the importance of a balance between work and home life
   Management style                               Adopt a flexible style to suit each employee, listen to
   Abuse from service users                        feedback, seek personal training if identified
    4. Change
   Changes in role or organisation                Involve staff in changes at an early stage
   Changes in responsibility                      Communicate new developments quickly and provide the
   New technology                                  opportunity for questions
   Lack of job security                           Provide adequate training and time to learn new technology
    5. Role
   Career stagnation                           PDP’s are maintained and positive stretch objectives set
                                                
   Being on call or remote working             
                                                Make sure that staff understand how their role fits into the
   Works feels undervalued                     organisation, and the contribution that they make to the
   Excessive work travel                       business
   Shift work                                 Ensure that working hours are known in advance and that
   Lack of flexible hours                      sufficient recovery time is allowed
   Role ambiguity                             Monitor the amount of time staff are spending on travelling for
                                                work if becoming excessive, discuss this and consider
                                                alternatives
    6. Support, training and factors unique to the individual
   Lack of training to do the job                 Give support and encouragement to staff
   Too much/too little supervision                Provide mentorship/coaching specific for each individual
   Lack of feedback on performance                Provide induction and training as needed and review it’s
   A lack of, or closed, communication             effectiveness
   Lack of action by manager on concerns          Do staff have sufficient tools and equipment to be able to
    raised                                          carry out duties?
                                                   Meet staff regularly




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    13.3 Appendix 2b: Self assessment of stress
This form can be used by an employee to help them identify stressors and open up dialogue with
their line manager. List any possible solutions you have on a separate sheet if necessary.
Potential Hazard                           Applicable?      What is the impact?
Lack of job security                            Y/N

Ambiguous role                                  Y/N

Role changes                                    Y/N

Career stagnation                               Y/N

Relationship difficulties with
                                                Y/N
colleagues

Management style                                Y/N

Training overload or required                   Y/N

Work held in low regard by others               Y/N

Limited access to supervisor                    Y/N

Abuse from service users                        Y/N

Inflexible working hours                        Y/N

Low input in decision making                    Y/N

Limited influence over prioritising
                                                Y/N
workload

High/low workload                               Y/N

Poor working environment                        Y/N

Shift work                                      Y/N

Lone or remote working                          Y/N

Disruption at home from work related
                                                Y/N
calls

Shortage of tools or appropriate
                                                Y/N
equipment

Supervisory responsibilities                    Y/N

Personal/home life difficulties                 Y/N

Home relationships/bereavement                  Y/N

Financial                                       Y/N

Personal Ill-health or family member            Y/N



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    13.4 Appendix 3: Stress Risk Assessment Form
Name ……………………………..........                      Job title………………………………

Manager……………………………                                     Date…………………………

Reason for carrying out Risk Assessment …………………………………………………

                          Impact on the        Support/Action plan
Identified concern        individual
                           1,2 or 3




1= No identified impact. 2 = Some impact but not detrimental   3 = Intervention required


List here any problems raised in the employee's home life/health conditions




Date to be reviewed………………………………………………..

Signature of employee……………………………………………..

Signature of Team Leader/Manager…………………………….                   Date………………

To be kept by the line manager and a copy given to the employee




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13.5 Appendix 4: Stress risk assessment process flow chart


  Employee has concerns about stress               Line manager has concerns about
  affecting them                                   their employee




  Read policy in particular section 6.2            Read the policy in particular section
  and use form 13.3 Appendix 2b.                   6.1 and arrange a meeting with the
  Circle as many of the statements they            employee to explain the concerns
  feel applies to them at that time and
  try to explain the impact upon them




  Arrange a discussion with their line             Use form 13.3 appendix 2b to help
  manager to discuss each concern                  give structure to the conversation.




                                Use form 13.2 2a to help
                                identify possible interventions




                                Make an agreed action plan
                                and set a review date




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