01 June 2006
Dr Rosemary Anderson

In the last article, Stress: preparing the way we looked at the importance of preparation to carrying out a successful risk assessment. Once the preparation is complete, you are on the starting block and can look in detail at the assessment process itself. This will need to follow the five steps common to all risk assessments:

• identify the hazards
• decide who might be harmed and how
• evaluate the risk
• record the findings
• review.

Identify the hazards

This stage will involve all employees at all levels becoming familiarised with the stress risk factors and management standards so they are aware of causes of stress and what the organisation can do to improve matters.

Many health and safety practitioners will now be familiar with the Health and Safety Executive's (HSE) stress management standards, which are set out in the box below. The risk factors are: change; control; demands of the job; role; relationships; support; and training. More information on these, which could form the basis of a training programme, is available from the HSE at www.hse.gov.uk/stress.

It is a good idea to combine training about the risk factors and management standards with basic stress management awareness training to help employees understand the concept in general and the psychological component. Staff will need to be aware of the difference between pressure and stress and that different pressures affect people differently. Some will also need to be educated that stress should not be seen as a weakness, because under the right (or wrong) circumstances, stress can happen to anybody. This awareness training need not be carried out face to face; leaflets or e-learning sessions can be just as effective.

As part of the training or communications exercise, staff need to understand why you are carrying out a stress assessment at all. If they are sceptical about motives then they will not return questionnaires, and a good rate of return is essential to gain a representative sample of the organisation.

Managers will need training too. Carrying out a stress risk assessment involves a lot of managerial effort and programmes often fail if managers are not trained in stress awareness. If managers are taught to understand stress, the stress policy, the business case and the risk-assessment process, most will see the need to tackle stress and their role in doing so. They will also be generally more receptive and supportive.

A good training course will also deliver a "double whammy" by showing managers how they can add to or reduce stress for staff themselves and what they can do to improve things. This will help with stage two below. Managerial training could even double as focus groups to determine qualitatively the causes of work-related stress in the organisation.

One government body was lamenting recently that it had carried out a survey over a year ago and none of the managers had done anything about the results. Guess what the answer was when they were asked if they had trained the managers first?

Decide who may be harmed and how

Once employees and managers understand the concept of stress and the risk factors, it is time to move to stage two. This is a heavyweight stage because it is the point where employers need to identify causes of stress in their organisations. Many people mistakenly believe this stage is the whole risk assessment.

Health and safety managers sometimes rush straight to this stage and carry out a stress survey without paying any attention to preparation and the other stages. It is important to be aware that all five stages are needed for a thorough risk assessment.

To complete stage two, the HSE recommends managers use a variety of methods to generate both quantitative and qualitative data. Quantitative stress audits produce a lot of useful data, but you can also gain insight by talking to individuals and running focus groups. Analysis of absence figures, staff satisfaction surveys and exit and return-to-work interviews will also yield useful information.

Stress audits may be tailor-made or "off-the-peg" questionnaires, but either option is often very costly. The HSE has produced its own generic survey, available on its website free of charge at www.hse.gov.uk/stress.

In some cases, a formal survey is inappropriate. In an organisation with less than a dozen employees, for instance, a survey is unlikely to remain confidential. Instead, information can easily be gained by holding focus groups or via team meetings, appraisals or informal chats. In a very small organisation, the health and safety manager can get a very good picture simply by talking to each staff member informally. In larger organisations, a combination of methods is the best approach.

Evaluate the risk

At stage three, managers need to work with the information they acquired in the previous step. If you have used the HSE survey, you will be able to see how your business is faring against the top 20% of organisations and you will be given targets for improvement. If you have used your own audit method, then you need to set your own improvement targets. A key to success at this stage is to provide fast feedback to staff by communicating the information gathered in step two.

As part of its "valuing staff" campaign, one health trust circulated audit results to all employees using A5-sized flyers supported by focus groups with line managers. Feedback was very positive.

Programmes are less successful if solutions to problems are decided by senior management with no input from staff. Possible solutions to stressors need to be discussed by all departments and levels of the organisation. This is best done in small groups. Senior managers often think they have the best answer only to find, after consultation, that they were wrong.

The management standards are very useful at this stage, as they explain what good organisations are doing and provide suggestions of good practice. The HSE publication Real Solutions, Real People is also very helpful for case studies, though most of these come from the public sector.

Record your findings

At the recording stage, managers should develop an action plan. In doing this they should, as before, include senior management and employee representatives at all levels. Writing an action plan enables managers to set goals to work towards, prioritise important issues and demonstrate to everyone that they are serious about addressing employees' concerns. Action plans also provide markers against which progress can be to evaluated and reviewed later.

The HSE advises an action plan should identify:

• what the problem is
• how the problem was identified
• what you are going to do in response
• how you arrived at the solution
• milestones and dates to achieve them by
• a commitment to provide feedback to employees and a date for review.

A healthcare trust which completed the action planning stage particularly successfully first convened local focus groups to help draw up  departmental action plans listing interventions to address issues specific to each department. A steering group then collected these action plans, reviewed them and used them to develop a final overall action plan for the trust. They then communicated this plan to all employees.

Programmes are most successful where managers devote attention to small changes. Little things really do make a big difference.

Monitor and review

This fifth and last stage is often forgotten, but it is a major part of the risk assessment process. If stress management is to be successful, it is important to check it is working and tweak it where necessary. The action plan should be the reference point to ensure all actions have been completed satisfactorily. Again, at this final stage the HSE emphasises the need to update senior managers and employees on progress and provide them with the opportunity for feedback.

According to Colin Mackay and colleagues at the HSE (writing in Work and Stress journal in 2004), "the Management of Health and Safety at Work Regulations involve the hierarchy of control approach, a key feature of which is that collective protective measures must be given priority over individual protective measures". In plain English, this means that the HSE risk assessment approach just outlined involves collective data, identifying and dealing with risks in a population, rather than risks for the individual. But this does not mean that individual concerns should be ignored. Solutions used for the majority may not address sources of stress for individuals, but employers still have a duty of care to take steps to protect the health and wellbeing of these employees too.

It is therefore obviously sensible and good management practice for health and safety representatives to ensure that managers are aware of the need to identify individual concerns and the need to work with staff to find solutions. This can form part of the management training. One suggestion is to hold discussions after an audit has been carried out. Managers can discuss the results of the audit in staff team meetings or specially convened groups. However, managers also need to be sensitive to issues as they arise throughout the working year and not just those thrown up by an audit. This is not difficult for good managers as they will already be doing what is necessary. They will have a good rapport with staff and will be approachable. They will also be more likely to know if employees have difficulties at home and, therefore, when they are more likely to be vulnerable to stress at work. They will also have a clear picture of what the individual likes to do, how they operate at work and the kind of things that could cause them stress. They will be happy to try to find solutions at an early stage.

Chris Rowe, head of psychosocial policy at the HSE, has said that the executive "recognises that much stress is created by managers not managing people properly. The HSE standards aim to prevent this situation happening by describing the sort of things that should be in place in good high-performing organisations."

For poor people-managers, however, this is more of a problem and they need to be encouraged to adopt this type of behaviour. To do this, the basic risk assessment framework is a good approach to use. Using the five steps, managers can be encouraged to try to identify how individual staff may be harmed (step two), talk to staff informally to evaluate the risk, decide on any actions that may be necessary to ease the situation (step three), record any decisions (step four), and review progress after an appropriate interval (step five).

This article draws on the booklet from the HSE and the International Stress Management Association Making the Stress Management Standards Work - How to Apply the Standards in your Workplace, available free from www.hsebooks.com or to download from www.isma.org.uk/stressatwork.pdf.

 

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Stress management standards

 

• Demands: Staff indicate that they are able to cope with the demands of their job.
• Control: Staff say they have a say in the way they do their work.
• Support: Staff indicate they receive adequate support from colleagues and superiors.
• Relationships: Staff believe they are not subjected to unacceptable behaviours at work.
• Role: Staff indicate they understand their role and responsibilities.
• Change: Staff indicate that the organisation engages them frequently when undergoing organisational change.

Source: HSE

 

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Dr Rosemary Anderson is a chartered psychologist and runs her own consultancy ApP specialising in all aspects of personal and organisational stress management. She has worked with the HSE on stress policy for three years.
www.andersonpeakperformance.co.uk

 

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