WORK RELATED STRESS: CASE STUDIES

1. WORK RELATED STRESS: CASE STUDIES

2. Next 10 minutes: • Detail actions taken by NHS Trusts and a County Council to tackle stress • Summarise the resulting outcomes Objective: • Highlight that it is possible to tackle stress successfully to the benefit of staff • Secure your backing

3. West Dorset General Hospitals NHS Trust • Complaint regarding work related stress 2003 • Investigation identified concerns were valid • Trust unwilling to take action to address issue • Improvement Notice issued requiring risk assessment of work-related stress • HSE provided support to comply with Notice

4. Action taken by Trust Surveyed staff to seek their views on: • Forms and degrees of stress; • Contributory factors; • Changes that could cut stress. Identified concerns with: • Inadequate information; • Inadequate support; • Lack of involvement in change; • Job demands; • Inappropriate behaviour.

5. Action taken by Trust • Set up a steering committee • Shared results of survey with staff • Consulted staff on specific issues • Produced a SMART action plan

6. Action taken by Trust • Utilised more permanent staff and less agency staff; • Training for managers on stress risk assessments; • Took action on long standing bullying issues - better implementation of bullying and harassment policies and procedures; • Allowed locally owned rota scheduling; • Devolved more budget to ward/unit level to increase control at local level

7. Outcomes • Trust Chief Executive and HR Director vocal in support of the benefits of the work carried out • Safety and Union representatives applaud the changes, particularly in attitudes • New enthusiasm amongst staff and reps for health and safety – volunteers for dept health and safety leads and committees

8. Hinchingbrooke Healthcare NHS Trust • NHS National Survey – Trust in the 20% of trusts with the highest degree of work pressure felt by staff • Perception middle management acted as a “damp proof course” inhibiting both downward and upward communication flows • Action plan produced backed by Trust’s board involving staff at all levels

9. Action taken • Surveyed all staff using HSE’s indicator tool • Survey analysed and results shared widely with staff • Report for each managerial area sent out to Directorates to discuss with staff, identify solutions and produce action plans

10. Action taken • Produced booklet Managing stress at Work: Support for Managers and Staff • Measures taken to improve predictions of patient demand and to provide appropriate staffing levels • Every job advertised now has a recently reviewed job description and candidate specification, followed by careful recruitment and selection, to ensure right person, right job

11. Action taken • Expectation management will thank staff – measured by a question in the annual survey • All staff to have a quality annual Performance Development Review – sets joint objectives, job targets and personal development plans supported by routine meetings over the year • Introduced communication strategy; • Chief Executive monthly “walkabout” meetings • All mgrs hold monthly one hour briefing group meetings with staff for two way communication • Weekly staff newsletter and monthly staff magazine

12. Action taken • Mgrs all required to undertake effective attendance management to maximise staffing levels, manage return to work and support staff • Emphasis on management development: • Introductory Core Management Skills programme (3 days) • Essential Management Skills programme (7days)

13. Outcomes • Staff sickness absence down from 6% (Oct 03) to 3.8% (Oct 05) • Repeated survey 05 – huge improvement in demands • Hospital now in the 20% of Trusts with the lowest degree of work pressure felt by staff (was the in the 20% highest) • Number of reports to OH of stress went up reflecting greater awareness of the issue and willingness to seek help

14. Somerset County Council • High levels of absence and particularly health-related sickness • Enthusiasm from Trades Unions and Elected Members within the Council to provide a healthy place to work to encourage high performance standards, but not at the cost of its people • Ran a Quality of Working Life Audit 2001/02 to assess levels and causes of work-related stress • Project team (including TU representation) formed to draft corporate action plan responding to issues raised by audit – involved consulting management and staff on possible solutions

15. Action taken Corporate wide action: • Guidance and training for mgrs on Managing Pressure and Stress • Revised process for performance review and development – training for both mgrs and staff in new process to maximise its effectiveness • Conflict resolution training for staff who interface with the public • Updated flexible working policy to enable more flexible deployment of staff via secondments/job rotation/job swaps • Sickness absence management training for mgrs

16. Action taken Directorate specific action – Social Services: • Working hours of Social Workers actively monitored by management • Training social workers in post qualifying qualifications enabling them to be appointed to senior social worker roles • Better locum cover for social care vacancies

17. Outcome • Reduction of sickness absence from 10.75 days in 2001/02 to 8.29 days in 2003/04 • Net cost saving of £1.57 million

18. Any questions?