1. Staff & Management Responsibilities – Managing Stress
Nick Nurden
Business Partner – The Ridge Medical Practice

2. The story so far We Have: Understood what is an unreasonable complaint
Considered strategies to avoid unreasonable complaints
Considered how best to manage unreasonable complaints
Learnt some techniques to deal with difficult behaviour
Looked at some communication skills

3. We can’t eliminate stress!
Despite all these steps to minimise and manage unreasonable behaviour it will happen, and it will be stressful!
We need to understand the impact unreasonable complaints have on staff
We need some tools to manage that stress
Focus on the role of organisational culture in such situations

4. Types of unreasonable complaint
We have already identified some general types of unreasonable complaints
Persistent Complainers
Complaints with unreasonable content
To complain purely to cause annoyance rather than genuinely to seek redress
Abusive, threatening or violent complainants
These will affect different employees in different ways and bring different types of Stress

5. Two types of staff to keep in mind
Complaints handling teams who deal with the complainants
The complaints team
Staff (clinical or administrative) who are the subjects of unreasonable complaints
The “ordinary” staff

6. Key management responsibilities
We have an obligation to provide our employees with a safe place of work
We have a responsibility to safeguard our employees health and wellbeing
Develop policies and procedures for staff to follow that will achieve this, without compromising the integrity of the complaints process

7. Achieving our responsibilities
Minimise the risk of stress
Maintain a commitment in our approach to dealing with unreasonable conduct
Provide staff with adequate supervision and support in dealing with unreasonable conduct
Give staff sufficient time and resources to deal with unreasonable conduct
Provide staff with adequate training and guidance

8. Staff responsibilities
Remain calm at all times
Show respect for all complainants, whether acting unreasonably or not
Act impartially in all matters
Demonstrate professionalism in dealing with complainants

9. Complainant stress
Most complainants genuinely believe they are being reasonable
If we behave calmly and professionally it will reduce the chance of aggression and conflict
Consistent and firm application of process should support complainants and staff alike
Important to make sure the organisation does not hide behind process though

10. Tools for reducing stress
Focus in the conduct and not the person
Unreasonable complaint or unreasonable conduct NOT an unreasonable person!
Separate out the behaviour from the issue
Is it a reasonable complaint with unreasonable conduct
Deal with the complaint and manage the conduct

11. Established processes reduce stress
Have model Ground rules
Follow established procedures
Keep Good Records
Have a checklist
Spot the warning signs

12. Preventing unreasonable conduct
Manage Expectations from the beginning
Ownership and control
Communicate clearly and promptly
Consistent and firm
Insist that the complainant shows respect. Set boundaries in terms of not tolerating rudeness, anger or aggression

13. How you support the staff
Staff welfare process embedded in the culture of the organisation
Need management awareness of what is happening on a daily basis
Simple established responsive mechanism in place for immediate needs
Ongoing periodic review of processes

14. Management commitment
Will allow staff to respond confidently and appropriately
Staff can then act confidently and robustly knowing that they will be supported
Supporting staff does not mean “taking over” or “giving in” to complainants
Managers should remain “invisible” to complainants

15. Supporting Staff & the Team
Support and protect your complaints staff
Meet with staff regularly to agree a plan
Stick to the plan wherever possible
Limit access of complainant if required
Give them the autonomy and authority to act
Be realistic – it will be hard work at times!

16. Provide enough time Always our biggest enemy!
But very important in this potentially very stressful environment
Be well trained with ongoing training
Time to prepare
Time to follow process
Time to debrief

17. Signs of critical incident stress
Exposure to incident stress can have a serious effect on staff physical, emotional, professional and social wellbeing; signs include:
Lack of engagement
Physical illness symptoms
Interpersonal issues/social withdrawal
Substance misuse

18. Managing this stress Providing regular debriefing
Encourage a supportive team environment
Ensure staff know that they will be supported
Be clear that getting stressed (and admitting to it) is not a sign of weakness
Be observant and don’t ignore the signs

19. Impact of unreasonable complaints on the organisation
Potentially destructive
Time sapping
Morale sapping
Staff feel they are not appreciated
Potentially divisive within and between teams
Adversely affect future behaviour
Leads to increase in absenteeism

20. Mitigating the impact of such issues
Debriefing very important
Clear and formal process for this
Well facilitated by trained staff
Establish a peer support system
Debriefing components:
Prompt – 24/72 hours after incident
Be aware reaction may be delayed
Private and discussions confidential
Provide ongoing support

21. Stress for staff complained about
Most staff are very conscientious and get distressed about complaints against them (whether reasonable or unreasonable)
Staff may over react initially to a complaint against them
May lead to competent or excellent staff questioning their own capability
Could adversely affect their working life whilst the situation is resolved

22. Support for these staff
Ensure that communication with them is effective
Timely
Detailed
Supportive
Using the chain of command where appropriate
Guide them through the process of responding
Flag up to others any signs of stress

23. The importance of Organisational Culture
The integrity of the complaints process is important and staff must be accountable for their actions achieved either by:
A blame culture that seeks to find scapegoats and excuses or sees complaints as a chore
A learning culture that seeks to support staff in helping the organisation to learn and improve

24. Managing Stress - Summary
Mitigate and Prepare to minimise stress
Can support the team and staff without undermining the integrity of the process
Thorough training essential
Excellent processes crucial
Be consistent and confident
Establish a supportive culture