The Ladbroke Grove train disaster put one Sainsbury’s trauma programme to
the test, with the onus placed on counselling for its staff who had been first
on the scene of the appalling crash. By
Olivia Walpole
The ink was barely dry on the new occupational health trauma care programme
when staff at Sainsbury’s supermarkets were caught in the immediate aftermath
of the horrific Ladbroke Grove train crash.
A small team of employees, readying the store for opening, became first hand
witnesses to the crash and ensuing fire last October. These colleagues acted
with great bravery and resourcefulness, assisting many of the injured from the
track to the relative safety of the coffee shop. This was transformed into a
first aid station, and general comfort area.
The OH team was proud of their colleagues during the incident and over the
following days as the emergency services carried out their rescue and removal
work. But it was apprehensive about the nature and level of trauma support it
would need to offer. The occupational health manager and senior manager of HR
operations made the decision to go ahead and trial the proposed new model of
trauma care practice in this high-profile, emotionally-charged incident.
Staff support
A small team of OH advisers attended the store on the day of the incident
and remained there throughout the following week. Advisers identified those
involved and an informal debriefing took place.
The atmosphere was highly emotional, heightened by the continued presence of
press and emergency service personnel. They were based in the car park, and
used the coffee shop and other facilities at the invitation of the store
manager.
The OH nurses talked with employees and supervisors on the shopfloor over
the following few days to ensure all team members were accounted for, as there
was concern that individuals could absent themselves where trauma intervention
might be required.
In particular, the team was worried about a small number of individuals, all
of whom had been directly involved in the incident. They agreed that their
presence in the early days was important to store personnel, and they were able
to support each other during this difficult time.
Action
Once it had been agreed to trial the trauma care programme, a group debrief
was arranged. It was well-publicised to ensure all individuals knew about it
and felt able to attend.
The session started with a short presentation by occupational psychologist,
Noreen Tehrani, on the psychological impact of trauma and how this differed
from usual stress reactions. All participants were asked to complete a
post-incident questionnaire, to assess levels of avoidance; arousal;
re-experiencing; anxiety and depression. Evaluation of the questionnaire
highlighted the same sub-group of individuals about which the OH advisers had
been concerned.
For the OH manager coordinating the post-incident care, this was reassuring
and validated the usefulness of such a tool in these circumstances. Specific
interventions, such as relaxation exercises and trauma counselling, were made
available for those individuals identified as requiring further support.
Follow-up care
All participants were asked to complete a follow-up questionnaire after
three months, to assess symptom levels. Line managers were asked to evaluate
the performance of individuals, and absence records were audited to assess
attendance prior to and following the incident.
The OH manager had the opportunity to use the post-incident questionnaire
again following a second incident. A group of first aiders had unsuccessfully
tried to resuscitate a young woman who had collapsed while shopping. A group
debrief was carried out and the questionnaire used again. Follow-up after two
months was positive in terms of continuing levels of symptoms and general
feeling about the trauma care process.
Covering violence
Sainsbury’s operates a violence at work policy, in common with many
organisations who have employees regularly exposed to verbal and physical abuse
from members of the public. The OH department had to develop an apt and
measurable trauma care programme that was flexible enough to encompass
work-related incidents, personal trauma and catastrophes, such as the train
crash.
The company employs some 140 000 individuals across its 450 stores. The
earliest model of the occupational health service was set up in 1945. It
examined workers returning from the Second World War in order to help resettle
them into the meat and dairy processing factory and small retail outlets that
comprised the company at that time.
Each of the current occupational health advisers is responsible for 20
stores. Recent initiatives include setting up occupational health services in
the distribution division and Homebase.
A growing trend of violence in the stores led two retail occupational health
managers to review how the existing violence at work policy was operating.
Store staff are vulnerable to drunken and drug-induced abuse and attacks
from members of the public, and incidents of robbery and assault. Research
showed more than 400 reported assaults on workers in one year alone. Risk
reduction measures are in place, including CCTV, alarms, security, training and
a retail security team who investigate incidents from a damage and stock loss
perspective, as well as helping debrief those involved.
Working model
The result of OH intervention at Ladbroke Grove, with the inception of the
new trauma care programme remains encouraging. Time lost through sickness or
other absence associated with the incident was kept to a minimum, and positive
feedback was gained from store management and colleagues. The model appears to
provide an effective tool for measuring key symptoms following a traumatic
incident at work. It provides evidence for OH records as well as demonstrating
an appropriate response by the organisation in identifying and providing the
care required in such circumstances.
Olivia Walpole RGN/DOHN is Sainsbury’s occupational health manager for
head office, London and the South.
Further reading
Violence at Work: A Guide for Employers,10/96. IND(G)69L (Rev) 2/97 C750 HSE
Books
Preventing Violence to Retail Staff, HS(G)133 (1995) HSE Books ISBN 0 7176
0891 3
Preventing Violence to Staff, HSE Books ISBN 0 1188 5467 4
Tehrani N (1998) Does Debriefing Harm Victims of Trauma. Counselling
Psychology Review 13/3 p6-12
Tehrani N, Westlake R (1994) Debriefing Individuals Affected by Violence.
Counselling Psychology Quarterly 7/3 p251-259
Sainsbury’s new trauma care programme
The new model of trauma care programme is based on the following criteria:
Immediate Checklist for use by store personnel following a critical
incident. This would form the basis of a debriefing session.
Three to seven days Post-incident questionnaire to assess current
psychological state and whether specialist intervention is required. These may
be administered by suitably trained key personnel in store, but would be
evaluated by the OH team.
Two to three months Follow-up questionnaire at suitable interval to
assess whether recovery is taking place. These findings may be combined with
evaluation of attendance and performance.
An expert team of OHAs will undertake further training in debriefing skills,
run group debriefing where appropriate and undertake evaluation of the
questionnaires.
Model benefits
– Ability to obtain an objective measurement of an individual’s
psychological state following a traumatic incident.
– An assessment tool that all OHAs –
with the appropriate training and back-up – can use confidently and hence, with
confidence.
– A clear indicator of need for further or specialised help.
– A confident indicator of where further help is not required.
– Evidence of the organisations commitment to the psychological well-being
of those exposed to traumatic incidents, whether work-related or personal.
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– An opportunity, through group debriefing, to facilitate peer support and
ensure common understanding of the incident.
– Clear understanding from store and organisation, of the process that
should be undertaken following a critical incident.
