Prevention is better than a cure

in the workplace could be seen as an epidemic. However, some public sector
employers are showing it can be avoided if the right policies are put in place.
Jo Rick, principal research fellow, Institute for Employment Studies, applauds
their creativity and flexibility in tackling the problem

public sector, with constant modernisation initiatives and a powerful impetus
for sweeping change in every area, appears to be the perfect breeding ground
for stress. A cycle of new demands and pressure leads to more stress, absence,
and then further demands to do better still. Organisations could be forgiven
for pressing the panic button.

hold on. What is this ‘disease’ that could spread so quickly? The fact is that
‘stress’ is used too often as a catch-all phrase. A GP will write ‘stress’ on a
sick note because their duty is to decide whether or not a person is fit for
work. However, the key to being able to intervene effectively is understanding
the specific nature of the problem.

as a cause of absence is different from physical illnesses. If an employee
sends in a sick note, for example, for a broken leg, the employer immediately
has some idea of the likely length of absence, the limitations on that employee
during the illness and whether there will be any need for adjustment to work in
the longer term.

diagnosis of stress says nothing about the specific problem, the possible
causes, the likely length of absence and whether the problem is really
work-related. Technically speaking, stress is not a diagnosis, and is not
listed in medical diagnostic criteria.

more closely and employers will see that stress is not the invisible assassin,
stalking the workplace, but is being used to describe what is actually a range
of specific, identifiable and usually preventable or resolvable situations.
Organisations can deal with it, and there are many examples of good practice in
the UK of how employees are being rehabilitated back into work.1

other good practice in rehabilitation, organisations are starting to recognise
that if they are to tackle stress, they need to start with a much more detailed
and specific assessment of the nature of the problem.

instance, Lancashire Constabulary Central Division has changed its culture to
ensure stress is seen as an issue that needs to be addressed quickly. An
attendance policy is in place to pick up on longer spells of absence, and any
absence relating to stress or anxiety is followed up immediately. Full
assessments are made to pinpoint the real causes of absence and employees are
able to agree their own rehabilitation plan, which might involve temporary
‘recuperative’ duties, change of work location or home working. The range of
stress policies and practices are seen to have been a real success in reducing
levels of sickness absence.

Sandwell Healthcare Trust, there is a robust absence reporting procedure in
place, with regular contact with the absent employee. Rehabilitation plans are
tailored to the needs of the individual employee, often involving the use of
temporary placements. The trust operates a case management system, with roles
clearly defined for the line manager, divisional HR managers and occupational
health in each plan. Training is available for managers in managing change and
advice on how to maintain contact with an absent employee – a difficult task
for many managers when stress is the problem.

rehabilitation practice is based around the following principles:

Maintaining contact with the employee on a personal rather than a purely
work-related basis

Attempting to diagnose the specific problems behind the stress involved

Providing immediate support from the start of the absence

Encouraging stress awareness among line managers

Being creative and flexible about options for a return-to-work

Developing an agreed rehabilitation plan with the employee

Creating a written policy or set of guidelines for employee rehabilitation.

is much talk of flexibility in the workplace in order to improve motivation and
productivity. It may actually be that creativity and flexibility in approaches
to preventing stress and rehabilitating employees can bring even bigger rewards.

organisations are trying something new. For example, offering coaching for
managers in dealing with an employee once they are off work with stress, and
the creation of closer working relationships between employers, occupational
health and GPs to determine more specific causes.

more specific diagnoses become, the more quickly this ominous, entirely vague
epidemic can be exposed and organisations will be able to get a handle on the
specific underlying issues.


Best Practice in Rehabilitating Employees Following Absence Due to Work-Related
Stress, Thompson, Neathey, Rick, HSE 2003, ISBN 0 7176 2715 2, £20.00, is also
available as a free download from the Health & Safety Executive stress web

more information, contact Jo Rick,,
at the Institute for Employment Studies (IES),

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