Psychosocial Risks Workshop Shaun Lundy

Psychosocial Risks at Work Work-related-stress Violence & aggression at work

Psychosocial Risk Workshop Examine the HSE stress management standard and associated guidance. Review Dan’s story, an HSE case study designed to provide a real life example stress at work. Examine the guidance available on violence & aggression at work. Review workplace examples of violence & aggression at work and interventions designed to prevent injury.

HSE Management Standards Approach This presentation is adapted from the HSE presentation available at:

Contents of this presentation An organisational approach to work-related stress covering: Getting started. A comprehensive risk assessment Embedding the approach

An Organisational Approach Getting started Gaining senior management commitment Understanding the organisational drivers The setting up of steering groups Comprehensive risk assessment The Management Standards Approach Embedding the approach Review of existing policies & procedures based on interventions Continuous improvement

The Management Standards Approach HSG218 (2007)

Management Standard 1.Identify the stress risk factors: Understand the management standard. 2.Decide who might be harmed and how: Gather data. 3.Evaluate risk: Explore problems and develop solutions. 4.Record your findings: Develop and implement action plans. 5.Monitor & Review: Monitor and review action plans and assess effectiveness.

Getting started The business case:  Employee commitment to work  Staff performance and productivity  Attendance levels  Staff recruitment and retention  Customer satisfaction  Organisational image and reputation  Potential litigation

Getting started The legal case: The Management Standards are guidance, however, employers may already have duties: Under the Management of Health and Safety at Work Regulations 1999 (UK): To assess the risk of stress-related ill health arising from work activities. Under the Health and Safety at Work etc Act 1974 (UK): To take measures to control that risk.

Getting started Moral case: There is evidence that prolonged periods of excessive pressure have an adverse effect on health Research provides strong links between stress and physical effects such as heart disease, back pain, headaches, gastrointestinal disturbances or various minor illnesses; and psychological effects such as anxiety and depression Poor coping strategies can also lead to other behaviours that are harmful to health, such as skipping meals, drinking too much caffeine or alcohol, or smoking.

Getting started Gaining senior management commitment Setting up a steering group (or other forum) Agreeing terms of reference for the Steering group Assigning roles and responsibilities

Setting up a steering group Who should be part of the steering group:  Senior management  Employee group representative  Trade unions representative  Health & safety manager  Human resources  Occupational Health  Line management

Steering group – key roles Project Champion:  Represents the project at Board level  Updates the Board on progress  Ensures the project is adequately resourced Day-to-day Champion:  Takes the role of project manager  Organises and facilitates meetings  Documents decisions to provide an audit trail  Keeps the project on schedule and on budget

Steering group – key activities  Project management  Planning  Resources  Marketing / communications  Monitoring progress  Approval of action plans  Generation and approval of management reports

Steering group –Communications Methods of communication:  Briefing groups  Intranet  Newsletters  Notice boards   Individual memos and letters  Newspapers

Categories of Stressors  Demands: workload, work patterns, and the work environment  Control: How much say the person has in the way they do their work  Support: encouragement, sponsorship and resources provided by the organisation, line management and colleagues  Relationships: promoting positive working to avoid conflict and dealing with unacceptable behaviour  Role: Whether people understand their role within the organisation and whether the organisation ensures that they do not have conflicting roles  Change: How organisational change (large or small) is managed and communicated in the organisation.

HSE Healthy Workplace Solutions ranking exercise n=900 HealthLocal Governm’t Central Governm’t EducationFinance Demand Control Support 36=353 Role =5554 Relation’p =54=33=5 Change 11121

Gathering Data Sickness absence data Employee turnover Exit interview Productivity data Performance appraisals Informal talks with employees Focus groups Surveys Return to work interviews

Gathering Data What are we looking for in the data? Areas of good performance Existing knowledge of problems Correlations between data sources ‘Hot spots’ Map the issues in the data to the Management Standards

HSE Analysis Tool Functions (Nov 2008) 12 user defined categories (demographics) Filters display number of respondents and % Totals sheet gives responses for each question Two data sets available for benchmarking Import facilities allow data to be imported from other sources and previous versions of the analysis tool MSQonline application allows questionnaires to be distributed and collated electronically

Evaluate the risk and take action Team briefings Cascade briefings Existing working groups Other staff forums? HSE recommends the use of ‘Focus Groups’ as a means of engaging with staff.

Focus Group Issues Who is going to facilitate the focus groups? How many focus groups are needed? Who should attend a focus group? Who will manage staff attendance? Who will organise locations? Who will be responsible for collating action plans? Who will communicate the agreed actions to all staff? Guidance on ‘How to organise and run focus groups’ is on the Management Standards web pages (see: )

Action Planning The output from focus groups needs to be captured in a prioritised action plan. Things to consider: Time frame, quick wins can demonstrate you are taking action, other interventions will deliver in the medium to long term Level of the intervention, is it aimed at a team (micro), a department or directorate (macro) or the whole organisation (strategic)? Responsibility, named individuals to take responsibility for each action and to report progress It is important employees are kept informed of progress at regular intervals. This activity needs to be part of your communications plan.

Example Interventions  New targeted policies  Review of existing policies  Raising awareness of existing policies  Line Manager training  Job design / task analysis  Risk assessment of jobs and people  Communication initiatives  Mentoring

Example of Policy DEMANDS: The standard is that:  Employees indicate that they are able to cope with the demands of their jobs; and  Systems are in place locally to respond to any individual concerns. States to be achieved are:  The organisation provides employees with adequate and achievable demands in relation to the agreed hours of work;  People’s skills and abilities are matched to the job demands;  Jobs are designed to be within the capabilities of employees; and  Employees’ concerns about their work environment are addressed.

Embedding The Approach This is about making the management of stress part of everyday H&S management. How can this be achieved? Reviewing existing policies & procedures based on interventions Evaluating effectiveness of interventions on organisational performance Continuous improvement

Embedding The Approach Gaining senior management commitment can be challenging and time consuming Need to prepare senior management for possible bad news! Focus groups can be time consuming if not planned in advance Payback period on resource investment is months rather than years

Summary Elements of the Management Standards approach can be integrated with existing initiatives Existing data can be used within the approach, there is no requirement to run a new staff survey Focus groups, or other staff consultation, are a key component of the approach Employer, senior and line management need to buy into the approach and the delivery of the interventions The Management Standards themselves need to be embedded into every day custom and practice

West Dorset General Hospitals NHS Trust Complaint regarding work related stress Investigation identified concerns were valid Trust unwilling to take action to address issue Improvement Notice issued requiring risk assessment of work-related stress HSE provided support to comply with Notice

Action taken by Trust Surveyed staff to seek their views on: Forms and degrees of stress; Contributory factors; Changes that could cut stress. Identified concerns with: Inadequate information; Inadequate support; Lack of involvement in change; Job demands; Inappropriate behaviour.

Action taken by Trust Set up a steering committee Shared results of survey with staff Consulted staff on specific issues Produced a SMART action plan

Action taken by Trust Utilised more permanent staff and less agency staff; Training for managers on stress risk assessments; Took action on long standing bullying issues - better implementation of bullying and harassment policies and procedures; Allowed locally owned rota scheduling; Devolved more budget to ward/unit level to increase control at local level

Outcomes Trust Chief Executive and HR Director vocal in support of the benefits of the work carried out Safety and Union representatives applaud the changes, particularly in attitudes New enthusiasm amongst staff and reps for health and safety – volunteers for dept health and safety leads and committees

Work-related Stress Case Study Dan’s Story studies/

HSE (2007) RR553, Management competencies for preventing and reducing stress at work HSE (2001) INDG281 - Work related stress: a short guide CIPD (2008) Absence Management Report HSE & CIPD (2008) Managing stress at work: A refined framework for line managers Useful reports

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Violence & Aggression in the Workplace

HSE Definition: “Any incident in which a person is abused, threatened or assaulted in circumstances relating to their work” Can include: Physical violence – assault, wounding, robbery Verbal & mental abuse Discrimination, harassment, bullying What is violence?

Factors influencing Violence at work Occupational group is the factor which is most strongly associated with the risk of assaults at work (Budd, 1999). However, exposure to violence at work not only depends on a person’s occupation but also upon the circumstances and situations under which a person performs their job. Working alone, for example, increases the vulnerability of workers (Chappell & Di Martino, 2000.)

Employees whose job requires contact with the public can be at risk: Caring professions – social services, hospitals, doctors’ surgeries Education Cash transactions – banks, retail premises Delivery/collection Licensed premises – clubs, pubs Risk factors

 Poor morale  Poor image for an organisation  Extra costs to employers:  Absenteeism  Recruitment  Higher insurance premiums  Compensation payments  Costs to employees:  Pain, distress, anxiety, stress, disability, death Effects of violence

Do a risk assessment Start by talking to your staff Review any history Look at absence data related to work- related stress Find out if you have a problem

Risk Assessment Process

Licensed and retail businesses risk factors Large amounts of money or exchanging money. Staff having face-to-face contact with customers. Opening in the evening or late at night. Dealing with customer complaints or disputes. Dealing with angry customers in disputes/complaints, eg over goods, services and refunds, allegations of short changing or cash mistakes or non-authorisation of card purchases can trigger customer embarrassment and violence

Additional risk factors Lone workers or small numbers of staff. You sell or guard high-value goods. Items may include medications, expensive merchandise or alcohol/tobacco. You sell age-restricted goods. Refusing to serve customers who are underage or are without ID, or refusing to sell alcohol after licensing hours or to those who are intoxicated, can also trigger violence. Your staff are under pressure. Exceptional workloads, inadequate stocks or staff shortages may slow employee performance and lead to delays, queues and customer impatience and hostility. Your customers have a history of violence or are likely to be under the influence of drink or drugs.

Additional Risk Factors Your premises are in a high-crime area. Businesses with previous experience of robbery, assaults or threats are more at risk of repeat incidents. Your business is quite isolated or you do not have many customers. Your premises have easy access/escape routes. Your business's layout/lighting is poor. For example, tills are located near doors or there is poor visibility from outside the shop to inside. You do not have any (obvious) security measures, which may suggest to potential assailants or criminals there is low risk of detection and minimum protection.

Control Measures Work Environment CCTV, Premises design and layout, visibility, Lighting, security device, security personnel and crowd control. Working Practices Cash handling and transit procedures, staffing levels, dealing with customers and opening hours Training Legal options Partnership working

Debriefing Time off work Legal help Other employees may need guidance and training on how to react post-incident Looking after victims of violence

Case Study One store was responsible for one third of shop based crime in the West End area of Westminster, London, in This amounted to 900 citizens' arrests being carried out by internal security staff between January and October. A joint visit was carried out by an environmental health enforcement officer from Westminster City Council, and a police crime prevention officer (CPO). The company had very few procedures in place to protect the health and safety of their staff in terms of work-related violence, in spite of clear evidence that the risk of violence was a significant issue for staff working in the premises.

Following the inspection A full security audit was commissioned and carried out by a specialist contractor. The final report made a number of important recommendations which built upon the advice presented to the company by the CPO on previous visits. This included the need to: improve security lines of sight, reposition CCTV, modify the arrangements for the display of goods for sale, provide additional training for staff, change the way cash is moved around the store and provide better security in the cash office

Outcome In 2004, this store had accounted for 36% of all shoplifting arrests in this police district. In 2005, following the implementation of the above recommendations, this had fallen to 13%. A reduction in crime of this order has had a significant effect, not only in terms of actual incidents of violence involving staff, but also their perception of risk and fear of crime.

Further Information HSE Guidance (INDG 423) Violence and Aggression HSE Research Report (2009) RR698: A literature review of effective management of the risk of violence in licensed and retail premises arising from crime and disorder