High
levels of stress in public sector organisations – the NHS, police and local
government – has been the biggest single factor in staff turnover. But all
these organisations have now taken giant strides to identify and eliminate
stress as far as possible. Paul Tyrell
reports
Last
September, the Audit Commission published a report, Recruitment and Retention,
which found that stress was the biggest single factor causing resignations from
the public sector. Those who had left were polled on what had prompted them to
leave, with the following results:
–
80 per cent blamed bureaucracy and paperwork, saying they had been given too
many targets and their work was increasingly driven by what could be measured
instead of what mattered to service users
–
70-plus per cent blamed a lack of resources, excessive workload and long hours;
and many were stressed out by the sheer pace of change, coupled with a sense of
being undervalued by government, managers and the public
–
All of those 70-plus per cent rated these problems higher than low pay or lack
of career progression, although
–
36 per cent said pay was an important reason why they left, and
–
24 per cent said better pay would have encouraged them to stay.
What
with high exposure, low rewards and, in many cases, everyday tasks that are in
themselves stressful, traumatic or dangerous, is it any wonder the public
sector is caught in a vicious circle of stress? We asked the professionals
responsible for developing anti-stress strategies for the public sector how
they are coping.
The
National Health Service
All
NHS employers must have a policy in place on work-related stress supported by
written risk assessments of work-related ‘stressors’. They have been helped in
this since 2000 by a best-practice model called ‘Improving Working Lives’
(IWL), where all NHS organisations were required to achieve accreditation by
April this year. Reducing stress wasn’t the only goal of IWL, but it has
undoubtedly been a spin-off for many people.
In
many parts of the NHS, this has given rise to team-based self-rostering;
annualised hours; carer and childcare support; and career breaks. The
Department of Health (DoH) says it is "changing the long-hours
culture". It claims "access to occupational health services is now
the norm rather than the exception it was just a few years ago". And it
adds that "we are giving staff the freedom to manage their own work-life
balance, to be in control. And being in control is a major contributor to
reducing stress levels".
The
DoH seems to be on the right track. A recent survey of staff, including nurses,
junior doctors and consultants, found their leading stressors included an
erosion of autonomy, a lack of control over their work and a lack of work-life
balance, as well as the usual suspects such as poor management support, low
resources and overburdening administration.
So
are these issues really being tackled? Elaine Way, president of the UK
Association of Healthcare Human Resource Management (AHHRM), and chief
executive of Foyle Health & Social Services Trust in Londonderry, Northern
Ireland, feels progress is being made in a few areas at least.
"Difficulties
in recruiting to certain key posts can impose stress on team working and AHHRM
welcomes the very significant progress made in recruiting new staff,
particularly nursing staff, over the past year," she says. "The
European Working Time Regulations will also improve the situation, especially
for doctors."
Way
hails the closer ties made with trade unions – AHHRM is supporting a Unison
initiative called Zero Tolerance Zone, designed to raise public awareness of
the violence faced regularly by NHS staff. This is an obvious and major cause
of stress, and to raise staff awareness of the need to report such incidents.
Way
also praises local initiatives such as stress-busting sessions, training
managers to identify and manage stress, and access to confidential counselling.
"My
top tip to other HR managers would be to try to identify stress at the earliest
possible opportunity, and by this I mean stress likely to affect the
individual’s ability to be effective," she says. "One method we are
considering is allowing employees to have a day out to release pressure before
the situation reaches breaking point."
So
in a nutshell, prevention is better than cure.
–
Find out more about Improving Working Lives at www.doh.gov.uk/iwl/index.htm
The
police
"We’re
just at the start of recognising we have a problem with stress, and that we
need to do something about it," says chief superintendent Mike McAndrew, a
spokesman for the Police Superintendents Association of England and Wales
(PSAEW).
"A
lot of cops may not want to talk to their local HR managers, who are employed
by the organisation, because they feel they are admitting weakness when the job
requires them to be tough on a daily basis. So part of the process needs to be
external," he said. "We need to have a safety net, and to make
officers recognise that it isn’t abnormal to suffer stress when you are doing a
difficult job."
McAndrew
is part of a Home Office steering group that includes the PSAEW and the Police
Federation of England and Wales. In August, the group proposed the introduction
of regular psychological testing for police officers to monitor how they cope
with the mental strain of their jobs.
The
initiative forms part of a £15m Strategy for a Healthy Police Service, approved
last October by then-Home Office minister John Denham, which aims to reduce
levels of sickness, absenteeism and early retirement among officers. Government
figures show the number of days lost in the force due to sick leave in 2000-01
was more than 1.5 million.
Under
the new proposals, all officers should eventually be monitored for signs of
stress, but resources are likely to be concentrated initially on those most at
risk – members of firearms squads, undercover agents or teams investigating
paedophiles, for example. Regular tests, designed to act as an early warning
system, would probably involve officers filling in health questionnaires. If
necessary, they could get further help and talk face-to-face with occupational
psychologists.
Most
police forces in the UK are only beginning to develop anti-stress initiatives,
but in Northern Ireland, they have been operating them for about 10 years.
"This
force, more than any other, has undergone operations that are particularly
stressful," says Ray Phillips, honorary secretary for the Superintendents’
Association of Northern Ireland (SANI). "So we’ve built a system for
people involved in traumatic incidents, such as bombings and shootings, where
our occupational health system will kick in. People will be monitored and, if
necessary, treated in relation to those incidents with counselling and
‘de-stress’ programmes."
Phillips,
who 10 years ago was an inspector dealing with terrorist incidents in South
Down, and trained other officers before joining the SANI, suggests it is vital
to document "a policy that sets out what a traumatic incident is, the
criteria on which you implement that policy, and an occupational health action
plan".
Local
government workers
Steven
Sumner is the national health & safety policy adviser to the Local
Government Employers Organisation (EO). It is his job to give local authorities
a strategic steer on how to deal with stress, as well as helping them meet the
Health and Safety Executive’s (HSE) numerical targets for reducing accidents
and ill-health at work.
According
to EO figures, stress causes 19.3 per cent of all absences. That rises to 34.6
per cent in terms of long-term sickness absence. "Careers such as teaching
and social work tend to have higher reported rates of stress, but we can find
stress anywhere," Sumner says. "We can’t say any job is immune
because it depends on a person’s ability to cope with what is placed upon them."
Sumner
is currently preparing detailed guidance for local authorities on how to
prevent and manage stress, which will be published in the next few months. He
is also involved with the EO’s participation in the HSE’s stress pilot
programme, which aims to create a best-practice model for stress management in
any organisation by this time next year (go to www.hse.gov.uk/stress/stresspilot/index.htm).
Sumner
suggests there are three stages where you can intervene to address stress in
your organisation. Primary intervention is where you look at the work an
employee is doing and change it or the organisation to ensure that person is
not harmed in any way. Secondary intervention builds capacity in the
individual, through stress awareness, stress management training, confidential
counselling and/or help with time management, such as speed reading.
"People
don’t want to be preached to at work, but they can be given the opportunity of
a healthier lifestyle," he points out. "Local authorities are well
placed to do this because they can give staff discounts to leisure facilities.
Some even buy in alternative therapies, and provide employee assistance
programmes for issues arising outside as well as inside work."
Finally,
tertiary intervention puts people back together if they fall apart. This involves
counselling and/or other therapy to help someone recover and rehabilitate.
In
the case of field workers trying to ease the stress of others, Sumner advises
recruiting the right people. "What one person can cope with, another
person cannot. You also need to train them to the right level. They need to be
properly equipped, with training, qualifications and competencies."
–
For more information on what the EO is doing to counter stress, log on to www.lg-employers.gov.uk
"Difficulties
in recruiting to certain key posts can impose stress on team working and AHHRM
welcomes the very significant progress made in recruiting new staff,
particularly nursing staff, over the past year"
Elaine
Way
President of the UK Association of Healthcare Human Resource Management (AHHRM)
and chief executive of Foyle Health & Social Services
"We’ve
built a system for people involved intraumatic incidents, such as bombings and
shootings, where our occupational health system will kick in. People will be
monitored and, if necessary, treated in relation to those incidents with
counselling and ‘de-stress’ programmes"
Ray
Phillips
Honorary secretary for the Superintendents’ Association of Northern Ireland
(SANI)
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"A
lot of cops may not want to talk to their local HR managers, who are employed
by the organisation, because they feel like they’re admitting weakness when the
job requires them to be tough on a daily basis."
Mike
McAndrew
Spokesperson for the Police Superintendents Association of England and Wales
