1. Listening to you, working for you www.bexley.gov.uk Managing Stress

2. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Housekeeping Emergency exits Fire alarm Toilets Break times and refreshments Mobile telephones

3. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Course aims & objectives Aim To raise awareness of stress at work, enabling organisations to effectively manage the issue of stress in their workplace Objective Delegates will be able to: –Have an understanding and awareness of the causes of stress –Understand their legal duties and obligations as employers under health and safety legislation –Obtain knowledge on relevant claims –Develop strategies for prevention and management

4. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Course aims & objectives –Have an awareness of Bexley's guidance on managing stress –Have an awareness of the role of managers in managing stress –Have an awareness of the role of Occupational Health Service,. Health and Safety Service and HR

5. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Agenda The importance of managing stress What is stress? Scale of the problem Effects of stress Relevant cases Hatton propositions Investigations Risk assessment HSE risk factors Stress policy Rehabilitation Summary

6. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Relevant legislation Health and Safety at Work etc. Act 1974 Management of Health and Safety at Work Regulations Other non-safety legislation –Sex Discrimination Act –Race Relations Act –Disability Discrimination Act –The Employment Rights Act –The Working Time Regulations –Human Rights Act Common Law - Negligence

7. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk The importance of managing stress

8. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk What is Stress Various definitions Health and Safety Executive: “Stress is the adverse reaction people have to excessive pressures or other types of demand placed upon them. It arises when they worry they can’t cope.” “

9. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk The scale of the problem About half a million people in the UK experience work related stress at a level they believe is making them ill Up to 5 million people in the UK feel “very” or “extremely” stressed by their work A total of 12.8 million working days were lost to stress, depression and anxiety in 2004/5 Costs GB in excess of £530,000,000 (HSE commissioned research)

10. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk The importance of managing stress To prevent ill health and accidents Avoid prosecution and tribunals Demonstrate you are taking reasonable precautions Demonstrate compliance Retain staff Protect your reputation Improve morale

11. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk What are the effects of stress? A member of your team is suffering from work related stress Describe the effects on that individual and the effects on the organisation

12. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Effects of stress PHYSICAL –Headaches –Migraine –Irritability –Becoming withdrawn –Lack of response –Hostility / aggression –Inability to concentrate –Drugs / alcohol –Absence –Dizziness –Aching muscles –Digestive problems –Raised blood pressure MENTAL –Tension –Anxiety –Fatigue –Depression BEHAVIOURAL –Irritability –Becoming withdrawn –Lack of response –Hostility / aggression –Inability to concentrate –Drugs / alcohol –Absence

13. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Effects on the organisation Increased sickness absence Extra pressure on remaining staff Domino effect created Leads to further employee absence Morale of entire workforce adversely affected Employee work performance reduced Staff seeking employment elsewhere Loss of valuable and irreplaceable experience Costs of recruiting and training new staff Recruitment difficulties Potential prosecutions Civil claims for compensation

14. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Legal aspects- Relevant cases Walker -v- Northumberland County Council (1995) Walker was the first successful claim for psychiatric damages caused by stress to an employee with normal fortitude There was no distinction between proving breach for a physical accident and a psychiatric injury Foreseeability - he suffered two breakdowns. He was awarded damages following his second breakdown and not his first

15. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Relevant cases Page -v- Smith 1995 ….“you have to take a victim as you find them” The “eggshell skull” principle now extends to the “eggshell personality”

16. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Relevant cases In 2002, 4 cases were taken to the Court of Appeal on behalf of the Defendants –Hatton -v- Sutherland –Barber -v- Somerset County Council –Bishop -v- Baker Refractories –Jones -v- Sandwell

17. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk The Hatton Propositions (16) (3) Foreseeability depends upon what the employer knows (6) The employer is generally entitled to take what he is told by his employee at face value (11) An employer who offers a confidential advice service with referral to appropriate counselling or treatment services is unlikely to be found in breach of duty (15) Where the harm suffered has more than one cause, the employer should only pay for that proportion of the harm suffered which is attributable to his wrongdoing Consequence = Fewer stress cases & successful defences of claims alleging failings on your part

18. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Bexley Council Bexley Council is committed to improving the work environment to create healthy workplaces, placing high value on positive mental health for all, as well as supporting employees

19. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Stress Code of Practice Recognition of stress at work as an issue Commitment to the CoP from senior management Agreed with Trade Unions or staff representatives Applies to everyone Outlines roles and arrangements for –Recognition and assessment –Prevention –Investigation and reviewing –Rehabilitation Support CoP with a OH and counselling service

20. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Bexley Council This does not mean: not setting targets not managing poor performance not changing Its about how we do these things

21. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Risk Assessment

22. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Risk Assessments Standard approach can and should be applied to stress in the same way as for other health and safety risks 1. Identify the hazards 2. Decide who may be harmed 3. Evaluate the risks 4. Record your significant findings 5. Monitor and review the assessment

23. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Identify the hazards Harassment / Bullying Intimidation Job insecurity/dissatisfaction Inadequate or lack of training Introduction of new systems Relocation / reorganization Job demands and workload Personal / domestic problems Information overload Lack of control Thwarted ambition Discrimination Personality clashes Perfectionism E-mail rage Increased workloads Not enough work Long hours Lack of supervision Role ambiguity Relationships with colleagues Organisational change Service user expectations Irate / difficult service users Violence - actual or threat Deadlines Outdated / faulty / defective / inadequate equipment General working environment Other agencies Bad relationship with line manager

24. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Control measures Staff appraisals Stress audits/Staff survey Monitoring of workloads Team briefings Intolerance to harassment / bullying Stress management training Job competence training Guidance - internal and external Support and counselling services Positive management and supervisory culture Communication between key players Flexibility in working arrangements Sickness absence recording

25. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Recognising Stress A pattern of uncharacteristic behaviour that continues for some time MAY indicate stress such as: Absenteeism Significant mood changes Unusual deterioration/changes in standards of work Frequent complaints of tiredness Poor morale/ cooperation

26. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Stress Management Standards The new HSE Guide Real Solutions - a managers’ guide to tackling work related stress suggests 6 broad risk categories to adopt in risk assessments 1. Demand 2. Control 3. Support 4. Relationships 5. Role 6. Change

27. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Roles

28. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Roles Health Professionals Occupational Health Service GP Psychiatrist/ Psychologist/ Counsellor Employee Line Management Health & Safety HR

29. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Occupational Health Service Providing general advice on a range of health issues and fitness for work. Developing specific health based Policies, e.g.. Drugs and Alcohol, No Smoking, Work Related Injury etc Encouraging a Corporate vision of a healthy workforce through the promotion of employee well being Counselling Immunisations for employees at risk, to preserve good health

30. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk What help can you expect from the OHU? Referral PrognosisOHU reportConsultation Reasonable adjustments

31. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Accessing OH Service and support The referral If a significant mental health problem is suspected a referral should be made – even if there has been no absence. Referrals are made through HR Service A standardised form is available on the OH intranet site. It is important to use this form Provide as much information as possible about how the condition is affecting the person at work. The referral must be discussed with the employee before an appointment is made

32. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk What information can I expect? Advice about how the condition affects the employee’s ability to work. Whether they are fit for ‘full duties’. Whether adjustments need to be made on a temporary or permanent basis Whether the DDA may apply Whether an Work Related Injury may have occurred. Advice regarding rehabilitation after absence, such as a phased return to work. Review arrangements.

33. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk What information can I expect? Advice about where to find practical help Occupational Health and Safety Service Disability Employment Adviser If the employee would benefit from Counselling Whether a case conference may help in the management of the case

34. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Issues of Confidentiality The diagnosis of any underlying medical condition Sensitive/Personal information about how the condition affects the individual, other than in relation to their work The treatment process, other than whether this is appropriate and whether the employee is compliant This information is confidential (A solution to management issues!) example

35. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Successful Rehabilitation Individual needs to feel in control Advice from OHS Return to work interviews and pre-return discussions. On-going relationships between all parties DDA 1995 - Reasonable adjustments Agree monitoring of progress

36. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Other Issues Disciplinary hearings Redeployment / Ill health retirement Insurance claims / Industrial injury scheme

37. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk DDA 1995 as Amended Reasonable adjustments –Temporary reduction in workload or duties –Phased return to full duties –Specialist equipment to enable a disabled employee to do his/her job –Time off for counselling or to attend medical appointments –These must be reasonable i.e. the employer should be able to continue to provide a service

38. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Investigation A member of your team has advised you that they are suffering from work related stress –What information do you need to establish from them? –What documents do you need to refer to and/or obtain? –Who else might you want to get information from?

39. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Management Review Questions to ask when Stress is highlighted: Describe in detail conditions suffered and results of any diagnosis When were the symptoms first suffered? What action has been taken by the employee? Has the matter been reported to the GP? What did they advise? Over what period has the stress occurred? Can you identify the work practices and environmental conditions leading to negligence and /or breach of duty?

40. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Investigation Documents to refer to and/or obtain: Employees personnel and occupational health record Attendance record Salary /overtime records Relevant risk assessment Organisation’s Stress Code of Practice Management / union meeting minutes

41. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Investigation Any supporting evidence Management Fellow employees Occupational health nurse

42. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Review & rehabilitation

43. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Review and Rehabilitation List the measures you would put in place when an employee returns after a period of absence due to work related stress?

44. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Review and Rehabilitation Continue the commitment Supporting the individual after a period of illness Assessing their workloads / needs prior to return to work Keeping in contact with the individual Returning to work plans Remembering to deal with the causes, not treating the symptoms Recorded, agreed & implemented

45. www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Listening to you, working for you www.bexley.gov.uk Further help and advice OH Service –Tel: 0208 294 6356 Ext 2356 –Email: H & S Service –Tel: 0208 836 8202 or 8019 –Email: health&safety@bexley.gov.uk Health and Safety Executive (HSE) –HSE infoline: 0845 345 0055 –www.hse.gov.uk