Risky business

Prevention
is better than cure in the case of stress. And with HSE management guidelines
on how to conduct a thorough stress risk assessment, organisations should be
grappling with the problem before further working days are lost. nic paton
reports

Managing
stress can feel a bit like sailing a ship through waters where the maps are of
the old-fashioned ‘here be dragons’ variety. Stress may be an increasing menace
in the workplace, but when it comes to tackling it, much of the work being done
is still in its infancy.

It
is not hard to see the scale of the problem: the Health & Safety Executive
(HSE) estimates that about 13.5 million working days a year are lost to it. But
how to curb it effectively and fairly is something that employers, and the HSE,
are still struggling to grapple with.

The
stress management standards being introduced by the HSE early next year, and
its decision in August to order West Dorset General Hospitals NHS Trust to
reduce the levels of stress faced by staff or face unlimited fines, has put the
onus firmly on prevention.

In
normal circumstances, the management of any health and safety-related problem
will start with the risk assessment. But, with stress, even the process of risk
assessment becomes much more problematic. Stress is not a medically defined
condition; people react to different stressors and different levels of stress
in different ways. Stress can also occur because of unpredictable, one-off
events, such as having suddenly to cover for an absent colleague. And employers
need to recognise that unforeseen stresses and strains can be brought into the
workplace from the home environment. All these elements can make it hard, if
not impossible, to predict, and so extremely challenging to manage.

Often
the best course of action, suggests Laurie Anstis, associate at employment
lawyer Boyes Turner, is to look back at any clusters of absence and try to
predict from there what types of roles, scenarios or business decisions might
become workplace stressors.

“Looking
back over patterns and saying ‘this was a risky situation’, or ‘doing that was
valuable’, will at least give you something to go on,” he says.

“Unless
you have a look at the figures, you may not realise that there are kinds of roles
that can be particularly stressful or where people may be vulnerable.”

Absence
data and staff turnover can both be invaluable and can help to flag up bullying
managers, says Joan Lewis, of Advisory, Consulting and Training Associates.

“If
you have a particular person who is causing a bullying problem you can often
track them through the company because when they change jobs there is often an
increase in short-term absence in the department they have moved to. With
stress, people who can, tend to leave and those that can’t go off sick,” she
says.

It
is also worth being aware that presenteeism, as much as absenteeism, may be a
clear sign of stress, she adds. Staying at your desk until all hours can show
that a person feels their workload is out of control, that they are not
managing their time or productivity well and, sometimes, that they are scared
to be seen to leave because of a bullying culture.

In
drawing up its management standards, the HSE has put on its website a model of
how it believes a stress risk assessment should be carried out. This suggests
four steps:


identifying the hazards


establishing who might be harmed and how


developing an action plan


taking action and evaluating and sharing work.

It
suggests there are seven central stressors that firms should look at: demands
of the job, levels of control, support, relationships; roles, chang, and
culture.

Bristol
City Council is one of 24 organisations putting in place pilot schemes before
the standards go live next year. Its experiences, and any feedback from the
wider community, will be incorporated into the final standards when they are
published next year.

The
council, which employs 18,000 staff, has been developing a two-stage pilot
using 45 to 50 volunteers from its neighbourhood housing department. A briefing
plan was drawn up and the volunteers received a two-stage anonymous paper
questionnaire, which had an 87 per cent response rate.

The
questions asked about the demands on them, levels of control and support, their
office relationships, their individual roles within the organisation and how
the organisation deals with change.

The
team behind the pilot is now feeding that information into the HSE’s analysis
tool, where it will be transformed into coloured charts and graphs, and where
anything below a red line is seen as being of issue.

The
standards estimate that about 20 per cent of employees in an organisation are
likely to be very or extremely stressed at any one time. To meet the standards,
at least 85 per cent of an organisation’s employees will need to be satisfied
with the demands put on them, the level of control that they have and the
support on offer.

When
it comes to managing relationships, roles and change, the standard will be
achieved if at least 65 per cent of employees indicate they are satisfied. 

At
this early stage, the analysis is more at a departmental than a company-wide
level, and is more about assessing what sort of stress levels there are and
whether further intervention is required. But by suggesting acceptable and
unacceptable percentages, the HSE standards set helpful benchmarks towards
which organisations can aspire.

If
needed, a second questionnaire will follow. It will be designed to tackle areas
of concern, and includes a range of more detailed questions. Monitoring and
reviewing is most likely to be carried out through conventional audits,
employee review meetings and reviewing of the risk assessment process.

The
council has had a stress policy in place since January 2001 and is
incorporating its own experiences during that time into the pilot process, says
senior safety adviser Simon Hayward.

“When
it came to developing a risk assessment, it was very hard for us to get our
heads around it. How do we look at something that should be almost on an
individual basis? Normally you need to look at tasks, then assess them, but
with stress it’s down to the individual,” he says.

It
was impractical to examine each role in every department, so a departmental
approach was needed. A bespoke risk assessment process was developed – designed
to “let us dip a toe in the water”, says Hayward – to enable the council to
assess whether a particular area or department was high, medium or low risk.

The
process consisted of four steps: a preliminary assessment with line managers;
formulating where the hazards might be; assessing and trying to quantify the
risk factors; and drawing up an action plan (with action to follow where
necessary).

Areas
that needed to be looked at included the management culture, shiftworking
patterns and job design, he says, accompanied by issues such as their severity,
what harmful effects might be likely and the effect of that exposure.

“For
instance, in my job as safety adviser one of the big things is the reactive
nature of the job. It can be a problem if you get a call at 4pm asking you to
come down to a site. You feel that things are out of your control,” he says.

“A
few years ago there was a decision to decentralise the team, but it was found
that made it much harder because there was not the support mechanism anymore.
It’s now been pulled back together so there is always someone on hand to help
and they have tried to make sure that, if you are out of the department, you do
not feel on your own.”

It
has also been a question of making it clear to employees that a stiff upper lip
and simply trying to soak up the pressure until it becomes too much are not
always the best ways forward.

“There
is a process of educating both parties about the difference between stress and
pressure, but there is a long way to go. We are trying to instil a general
awareness that saying you cannot cope does not necessarily mean you have failed
and is not necessarily a bad thing,” Hayward says.

Another
firm piloting the stress management standards is utility company Innogy, the
name behind NPower, which manages coal, oil and gas-fired power stations around
the country.

Innogy
recognised the need for a risk assessment for stress sometime ago, formally
launching the process in October 2002, says Claire Forty, senior occupational
health nurse.

The
risk assessment tool was drawn up by an external occupational psychologist and
combines an online scoring tool with a risk assessment tool.

“It’s
like a traffic light system, with either red, amber or green. Groups of people
are given little red bars if there is an issue that needs investigating,” says
Forty.

In
the first stage of the process 
department managers, after an initial briefing by an OH nurse, receive
training to help them understand how stress manifests itself, what the common
symptoms and causes are and advises on what to do next.

The
course also advises on how to conduct a stress-based risk assessment, covering
areas such as appropriate interventions, what sort of reasonable adjustments
might they be expected to make and so on.

The
assessment is carried out online, usually taking 10 minutes, and is assessed
externally. The data is fed back to the manager, who is expected to meet the
staff as a group and discuss the findings.

The
questions are divided into six sections, all linked to the scoring system, and
mainly follow the HSE-set categories. They look at: culture; demands (what is
their workload and how much are they exposed to physical hazards?); control
(how much say do they have?); relationships (are there any issues of bullying
and harassment?); role (do they understand their role in the organisation?);
and support (what training is available, what support is there from peers and
line management?).

The
process has been piloted among 500 staff and nine managers but, says Forty,
Innogy hopes to roll it out across the company, which employs about 14,000
staff, later this month.

The
process is supposed to be left a minimum of three months before being repeated
online to assess whether actions taken have worked, she adds.

For
both the HSE and the pilot organisations, it is early days and much work is
still to be done. What is clear is that, however good the process, stress is
such a nebulous thing that trying to show which stressors are the most harmful
in the workplace, exactly how they operate and how you reduce them, is a real
challenge.

There
is no right or wrong answer, no right or wrong way to carry out a risk assessment
for stress. That’s why HSE’s efforts in trying to set benchmark standards is so
vital, points out ACT’s Lewis.

What
is also clear is that doing nothing is no longer an option. Employers are most
at risk from litigation when it can be shown that harm could reasonably have
been foreseen, but that nothing was done to prevent it. Similarly, employers
need to be wary in assuming that simply offering a confidential counselling
service – in line with the Court of Appeal’s decision in Sutherland v Hatton –
is enough by itself.

“Illnesses
that arise from stress are in exactly the same category as if it is a broken
leg from tripping over a loose wire. You have to have a mental picture that
asks ‘have we got a guard in front of the machine?’,” says Lewis.

“The
risk has to be significant, but the only way you are going to find out is by
doing an assessment. You have to show evidence that you have tried to carry out
a risk assessment and that you have tried to address those issues. If you don’t
do it, you are going to get clobbered,” she says.

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