Best management practice in tackling workplace stress TRUST STRESS MANAGEMENT PROJECT Sue Grimshaw...

Best management practice in tackling workplace stress

TRUST STRESS MANAGEMENT PROJECT

Sue GrimshawActing Head of Occupational Health Dept & Stress Project Lead


Common causes of stress in the workplace

Unreasonable demands for performance Lack of interpersonal communication between

the employer and the employees Lack of interpersonal relationship among the

employees The fear of losing one's job. Long working hours Less time to spend with the family Under utilization of skills Underpaid jobs A promotion that did not materialize –

promises promises promises!


The cost of stress Sickness absence in the NHS is estimated to cost

the service some £1.7billion each year A quarter is likely to be attributable to stress

related sickness. Time lost to sickness absence amounts to 10.3

million working days or The equivalent of having 45,000 whole time

equivalent staff not at work Of these, a quarter are likely to be due to stress

related sickness. Nhs employers


Money Money Money £175,000

£850,000

£109,754


Signs of Symptons of Stress Physical Headaches Indigestion Colds/Flu Skin condition Acne High BP Sleeplessness Nervous ticks Tense Muscles

Emotional signs Anxiety Anger Feeling hopeless Depression Negativity De-motivated Low self-esteem


Signs of Symptons of Stress Behavioural Signs Smoking Alcohol Increased caffeine Irritability and aggression Increased forgetfulness Moodiness and sulking Apathetic Withdrawal Obsessive behaviour Increased mistakes Crying Decreased personal

standards

Changes in Thinking Style

Confused Negative Indecisiveness Poor concentration Blinkered Things out of

proportion Constant criticism Cynicism


What started the project?

• Occupational Health (OH) data demonstrated a doubling of cases of work related stress in 2006/7

• Perceived causes – workload, interpersonal conflict at work and the £21m restructure

• High sickness absence rate at 5.34%

• This demanded a management led approach, not medical “treatments”


Next steps• Trust Board >to consider analysis/findings so far >they took ownership >to support a Stress Management Project

• Timing >Trust emerging from Financial recovery programme >Aiming FT status and focus on Patient Quality >The Blackpool way still needing to embedded


Broader effects


Impact on individual, colleagues and organisation

Individual Unhappy, de-

motivated, disengaged, absence

Colleagues Frustrated, antipathy

to Trust Increased workload

pressure from absent colleagues

Disengagement

Organisation Increased grievances

and management problems

High absence rates Inconsistent patient

care/ service delivery Negative public image Reputation hinders

recruitment Workforce lacking in

skills & competency


Our strategy & targets Existing Data, Board & Workforce Engagement

Reduce sickness 4.3% / Work related Stress cases by 30 %

Adhere to Hse Management Standards who supported the project fully

Make the Trust a great place to work = increased recruitment /retention


Barriers to the project• This is too difficult/ too big• This is not my role• What problem?• Stress makes people work harder• Nothing to do with the Organisation• Targets affected if we take our eye off the

ball• Everyone will say they are stressed if its

highlighted• They should try my job!


Key stakeholders identified for the Stress Project to succeed

• CEO• Chairman• Executive Directors• Non-Executives• Staff Side representatives• The Workforce• All the above agreed to implement all

reasonable recommendations and explain why any were not implemented


Project methodology

• Focus groups – 8 sites

• Robust project management tools

• Reporting methods

• Role of Ceo & Executive Directors

• Working in partnership with HSE


Findings of the Focus groups

Issues causing the stress to the workforce• Communication• Management Style• Learning & Development opportunities• Bullying & Harassment• Sickness & Absence• Recruitment & Retention• Lack of staff engagement• Car Parking• How we care for each other• 70 recommendations


Successes so far (1)

• Staff Survey 2006 response rate was 44%

2007 response rate was 58%



Results indicate a widespread improvement and divisional differences have all but disappeared, staff are reporting improvements as individuals.


Key Results from 2008 Staff Survey relevant to Stress Project

Key Findings Change Since 2007 Survey

Ranking compared with all Acute Trusts 2008

Trust commitment to work-life balance

Increase (better than 07)

Highest (best) 20%

% having well structured appraisals in last 12 months


Highest (best) 20%

Support from immediate managers


Highest (best) 20%


Key Results cont’d …

Key Findings Change since 2007 Survey

Ranking compared with all Acute Trusts in 2008

Perceptions of effective action from employer towards violence and harassment


Highest (best) 20%

% reporting good communication between senior management and staff

New question Highest (best) 20%

Staff Job Satisfaction Increase (better than 07)

Highest (best) 20%

% that would recommend the trust as a place to work

New question Highest (best) 20%



• Sickness & Absence rate now is 4.31%

• By 2009 Work related stress presenting to OH down by 40%

• Long working hours culture leading to stress/ absence from work being actively managed

• Occupational Health moved back onto main site 3-4 years ahead of schedule

• Winners of HPMA Award 2009 (HSE Category – Stress)



• Compliance with NHSLA at Level 2 now aiming for level 3

• Stress Website for staff

• Employment Assistance Programme launched on April 9th 2009

• June 2009 – 87 % staff appraised

• June 2010 – 100% staff appraised

• Stress management training programme Trust-wide – at manager’s request for all staff to access



• Exit Questionnaires 3 versions and they are being used Dedicated staff to assist with completion Will identify trends, issues and successes

• Learning & Development reviewing current training provision and induction/mandatory programmes

• Trust has implemented Leadership & Management Programmes to develop staff & managers


Successes so far (5) Poor performance now being robustly managed across the

Trust

Bullying and harassment cases now being dealt with in agreed timescales (6 weeks)

Multi-storey car park being built – parking for all staff on site within next two years

Grapevine magazine

A resource for other organiations nationally


Phase 2 – Review of Current OH service provision• Focus groups have been run to ask workforce for further ideas e.g. well

being initiatives

> Social events for staff

> Review of catering provision to assist staff with healthy eating options

> Fast track appointments – to employ physiotherapist in the department

> Increased counselling & CBT provision

> Hours Occupational Health extended increased clinic productivity

> Health promotion events

> Improve communication /information for staff accessing Occupational

Health

> Greater telephone access

> Known as Health & Well being centre


Overall impact on the workforce if the Project succeeds

Staff will feel: Valued Supported Involved Happy at work A sense of worth Motivated

Staff will have: Positive working

relationships Career development A pride in where they

work A sense of belonging. A voice that is heard


• Reduction in Sickness & Absence has improved staff ratios for patient care delivery

• Trust converting “Bank Hours” to substantive nursing posts – improved continuity of care

• Staff able to access training skill development resulting in competent safe practitioners

• Staff more aware of stress (? Good or bad)

Making a difference to patient care


How to manage stress Responsibility of the Individual

Understand nature and sources of stress.

Make someone aware of how you are feeling – ideally your line manager but if not, HR or contact your Occupational Health provider

Manage your time effectively and efficiently.

Follow an appropriate lifestyle

Develop a personal strategic management process (have a mission, set achievable goals, allocate resources and periodically assess the situation).

Be systematic in decision-making and problem solving.


What a manager needs to do… Be proactive in dealing with

stress in the workplace

Offer reassurance to the person – “you’re not on your own”.

Seek advice from HR or their line manager if unsure what to do.

Don’t say ‘so are all of us’

Have self awareness around how your management style may impact on others – in times of difficulties, don’t revert to using the stick!

Take immediate action – Make time & Listen Ask what they need Aim to alleviate the situation &

review progress

We can assume that a person can withstand the normal pressures of work but once you are aware of a problem it is reasonable that something is then done

Be aware of the DDA – need to consider reasonable adjustment necessary to support and alleviate stress


Responsibility of the Organisation

Ensure that the workload is in line with the employees’ capabilities and resources.

Jobs that have meaning, stimulation,less monotony & opportunities for employees to use their skills.

Clearly define employees’ roles and responsibilities.

Employees should participate in decisions and actions affecting their jobs.

Improve communications - reduce uncertainty about career development & future employment prospects.

Provide opportunities for social interaction among employees.

Establish work schedules that are compatible with demands & responsibilities outside the job.


How to manage your own Stress

Smiling

Your thoughts/ what are your 10 top qualities Exercise /Breathe

Rest – take time out

Support & Feedback


How to manage your own Stress

Hugging – for you to receive or give

Relaxation – take it easy / Meditation 10 mins per day/Alternative therapies

Balanced diet –obesity can increase stress levels. Reduce toxins smoking & alcohol work against the body

Need Help – Ask!!

Work / Life Balance:- use to do lists


The Ten Commandments to Stress

prevention Plan your day Build a balanced

system Know your energy

curve & concentration

Be realistic you are not superhuman

Learn to delegate

Aim for satisfaction Learn to say ‘No’

assertively ! Look for things in

your work to enjoy Laugh to reduce

stress Make time for you


Thankyou

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Best management practice in tackling workplace stress TRUST STRESS MANAGEMENT PROJECT Sue Grimshaw...

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