management of stress policy - north east ambulance service · of a stress management group, a sub...

Ref: CO-POL-97 Version: 1 Status: Ratified

Management of Stress Policy

Document Profile Box Document Reference: CO-POL-97 Version: 1 Ratified by: Assurance Committee Date ratified: 29/7/10 Name of originator/author: Head of Risk & Claims Name of responsible committee/individual: Director of Finance Date issued: October 2010 Review date: 12 months from issue Target audience: Trust Wide Document owner: Director of Finance Authorised signatory:


Contents

Section Page

1 Introduction 2

2 Purpose 3

2.1 The Legal Case: The Law Requires Employers to Tackle Stress 4

2.2 The Business Case: Tackling Stress Brings Business Benefits 5

2.3 The Moral/Ethical Case: Tackling Stress Prevents Ill Health 6

3 Definitions 7

4 Duties 7

4.1 Role of Employee 7

4.2 Role of Line Manager 8

4.3 Role of Occupational Health Department 8

4.3.1 Information Available for Staff 9

4.3.2 Availability of Counselling Services 9

4.4 Role of Human Resources 10

4.5 Role of the Safety Representatives 11

4.6 Role of any Committees/Groups with responsibilities for Stress Management 11

4.6.1 Trust Board 11

4.6.2 Project Steering Group 11

4.6.3 Working Group 12

5 Risk Assessment Process 12

5.1 MSWRS Step 1: Identify Hazards 13

5.2 MSWRS Step 2: Decide who may be Harmed and How 14

5.3 MSWRS Step 3: Evaluate the Risk and Take Action 14

5.4 MSWRS Step 4: Record your Findings 15

5.5 MSWRS Step 5: Monitor and Review 15

6 Standards/Key Performance Indicators and Process for Monitoring Effectiveness

16

7 Dissemination, Implementation and Access to this Document 16

8 Review, Updating and Archiving of this Document 17

9 References 18

10 Associated Documentation 19


Appendices

Appendix A Overview: The Management Standards and the 5 Steps to Risk Assessment 20

Appendix B Risk Assessment Tools 21

Appendix C Organisational Risk Matrix 26

Appendix D Terms of Reference for the Stress Management Steering Group 27

Appendix E Checklist for the Review and Approval of Procedural Document 32

Appendix F Flowchart for the Creation and Implementation of Procedural Documents 34

Appendix G Version Control Sheet 36


Document Summary

North East Ambulance Service NHS Trust places a high value on Health and Safety and recognises that its duty of care extends to well being and mental health as well as to physical health at work.

This policy therefore exists to safeguard the health, safety and welfare of people at work by ensuring that suitable and sufficient risk assessments are carried out in respect of workplace and organisational exposures which may give rise to workplace stress.

The Trust is committed to implementing a stress management policy for all employees throughout the organisation. This will include improving the organisational environment through effective and sensitive management and the support and training of managers and supervisory staff in good management practices.

Further measures will include the allocation of adequate and appropriate resources to enable managers to implement the Trust’s stress management strategy based upon what might be reasonably practicable. There will also be the provision of a confidential counselling service for staff who may be affected by stress caused by work (or other external factors).

Due acknowledgement is given to the Health & Safety Executive’s Stress Management Standards which identify six key potential stressors at work. The Trust will work to proactively manage these and reduce work related stress. The Trust will implement the Stress Management Standards through the formation of a Stress Management Group, a sub group of the Strategic Health & Safety Committee.

A suitable training package will be delivered to appropriately identified staff. This will acquaint managers with knowledge about stress; will overview the management standards themselves and explain the basis of how to carry out a stress risk assessment.

North East Ambulance Service NHS Trust An Organisation-wide Policy for the Management of Stress


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1 Introduction

Work-related stress is a major cause of occupational ill health. That means sickness absence, high staff turnover and poor performance in an organisation. Managing stress effectively could help organisations, their employees and their representatives proactively and reactively manage the issue of stress sensibly, and minimise the impact of work-related stress within the NHS.

North East Ambulance Service NHS Trust (NEAS) recognises that many of its employees will, on a regular basis, be potentially exposed to both individual and successive distressing situations and will work in a situational environment that would not normally be encountered by other health care workers.

Dealing with the emotional distress of a work-related situation adds pressure to the individual and

it is well recognised that stress reduces employee well-being, effectiveness, performance and the work-home relationship. Therefore it is important that NEAS takes reasonable steps to identify and effectively address potential stressors in all the various working environments within the organisation.

In line with the Health & Safety Executive’s Stress Management Standards and working within

the Health & Safety at Work Act 1974, NEAS is committed to ensuring, as far as is reasonably practicable, the physical and mental well being of all employees within the Trust.

In recognising that all employees are likely to experience stress-related symptoms at some point

during their working lives, which may be associated with work related, domestic or other factors, this policy exists to:

Demonstrate the Trusts commitment to mediate organisational causes of stress and/or

provide effective support to minimise any adverse affects in the short and long term. Create a climate of mutual trust which encourages staff to recognise and report symptoms

of stress in themselves and colleagues in order that workplace stressors can be addressed at an organisational level and that appropriate help and support may be given. Establish how the potential risk of stress to the organisation is assessed and managed.

Provide both managers and staff with information on recognising and alleviating the

symptoms and causes of stress. Offer information on how individual cases will be handled.



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2 Purpose

The Trust will take all reasonable care to ensure that employee health is not placed at risk through excessive or sustained levels of stress arising from

The way work is organised

The way in which people deal with others

From the day to day demands placed upon employees.

The Trust will identify workplace stressors and conduct risk assessments to reduce/eliminate stress or control the risks from stress in accordance with recognised risk assessment practice. These risk assessments will be based on the Health & Safety Executive’s Management Standards for Work Related Stress (MSWRS) (2007c) (Appendix A) and will be reviewed regularly.

The MSWRS are a pragmatic methodological approach to proactive management of work related stressors that are freely available from the internet via the HSE website http://www.hse.gov.uk/stress/index.htm.

The MSWRS are corporate tools which enable organisations to address stress issues without substantial external assistance. The whole MSWRS approach is completely supported via downloads from the HSE website, and full references and links to the corresponding documents are provided within this policy. It is important that the Trust undertake the MSWRS approach in the correct order and according to the structure quoted on the website.

The Trust will consult with Trade Union Safety Representatives on all proposed action relating to the prevention of workplace stress.

The Trust is committed to implementing a stress management policy for all employees throughout the organisation. This includes:

Improving the organisational environment through effective and sensitive management

Support and training for all managers and supervisory staff in good management

practices A confidential counselling service for staff affected by stress caused by either work or

external factors

Adequate and appropriate resources based on what is reasonably practicable to enable managers to implement the Trust’s agreed stress management strategy

http://www.hse.gov.uk/stress/index.htm



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The HSE MSWRS identify six key potential stressors at work that, if properly managed proactively, can help to reduce work-related stress. When following the MSWRS approach, the Trust will consider all of the areas below when implementing their policy.

Demands Includes issues like workload, work patterns and the work environment.

Control How much say the person has in the way they do their work.

Support Includes the encouragement, sponsorship and resources provided by the organisation, line management and colleagues.

Relationships Includes 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.

By using the HSE MSWRS organisations can assess their current position regarding work related stressors and their ongoing performance in proactively managing work-related stress. The MSWRS indicator and analysis tools graphically present goals that employers should be working towards through an ongoing process of risk assessment and continuous improvement.

2.1 The Legal Case: The Law Requires Employers to Tackle Stress

Although there is no specific law controlling stress at work, health and safety law requires that employers: Ensure, so far as is reasonably practicable, the health, safety and welfare at work of all

their employees; (Health and Safety at Work etc Act 1974 5) To assess the risk of stress-related ill health arising from work activities.

(Management of Health and Safety at Work Regulations 1999 6) Assess the health and safety risks to which their employees are exposed at work.

(Management of Health and Safety at Work Regulations 1999 6) Do not discriminate against employees on account of a disability as

defined under the Disability Discrimination Act 7.

Where physical features and/or existing working arrangements place the disabled person concerned at a substantial disadvantage, reasonable adjustments are required to either the workplace or to the way in which work is carried out. Ill health arising from, or exacerbated by, stress at work may constitute a disability under the Act.



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2.2 The Business Case: Tackling Stress Brings Business Benefits

To meet Government Standards

The Revitalising Health and Safety initiative was announced by the Deputy Prime Minister on 30 March 1999 to inject new impetus and relaunch the health and safety agenda, 25 years after the Health and Safety at Work Act 1974. Aims of Revitalising Health and Safety

To inject new impetus into the health and safety agenda To identify new approaches to reduce further rates of accidents and ill health caused by

work, especially approaches relevant to small firms To ensure that our approach to health and safety regulation remains relevant for the

changing world of work over the next 25 years To gain maximum benefit from links between occupational health and safety and other

Government programmes. The Government’s approach has been to focus on ideas capable of adding value to the current system without threatening its overall balance. For example, while appropriate enforcement and deterrence is crucial, this must not be at the expense of promoting voluntary compliance and models of excellence. The Government wishes to build on 25 years of successful partnership between employers, employees, trade unions and consumers on the Health and Safety Commission. This Strategy Statement sets out how the Government and Health and Safety Commission will work together to revitalise health and safety. At its heart are the first ever targets for Great Britain’s health and safety system:

To reduce the number of working days lost per 100,000 workers from work-related injury and ill health by 30% by 2010

To reduce the incidence rate of fatal and major injury accidents by 10% by 2010

To reduce the incidence rate of cases of work-related ill health by 20% by 2010

Legislation There is no specific legislation regarding the management of occupational stress at present. However, the Trust recognises that stress management is a vital element in managing the health, safety and welfare of its employees and aims to try and meet these targets. There are also legal duties which relate to tackling stress in the workplace. This legislation includes: Health and Safety at Work etc Act 1974; Management of Health and Safety at Work Regulations 1999 Workplace (Health, Safety and Welfare) Regulations 1992 Health and Safety (Display Screen Equipment) Regulations 1992 Working Time Regulations 1998 Sex Discrimination Act 1986 Race Relations Act 1976 Disability Discrimination Act 1995



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Employment Rights Act 1996; Protection from Harassment Act 1997; Human Rights Act 1998; Safety Representatives and Safety Committee Regulations 1997; Health and Safety (Consultations with Employees) Regulations 1996.

Improvement of Working Lives Research has shown that; 536,000 Britons suffer from work related stress

5 million people in Britain believe they are exposed to work related stress

80,000 people reported work related heart disease

20% of individuals rate their jobs as very or extremely stressful

Good management of workplace stress would greatly reduce the risk exposure of the Trust and its Employee’s.

To Reduce Costs At over 13 million days a year, work related stress is the biggest occupational cause of working days lost through injury or ill-health. With an average of 29 days lost per case, it costs society about £3.7 billion a year. In addition to these cost savings and benefits detailed, an organisation could benefit from the associated savings/benefits detailed below;

Improved staff moral and commitment to work Improved efficiency and savings via increased staff performance and productivity

Improved staff retention levels due to lower staff turnover and intention to leave

Reduced absence

Improved staff recruitment and ability to attract desirable applicants

Customer/Service User satisfaction

Improved organisational image and reputation

Reduced potential for litigation.

2.3 The Moral/Ethical Case: Tackling Stress Prevents Ill Health

Tackling stress prevents ill health. There is now convincing evidence that prolonged periods of stress, including work-related stress, 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 Psychological effects such as anxiety and depression.



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Stress can also lead to other behaviours that are harmful to health, such as skipping meals, drinking too much caffeine or alcohol, or smoking.

3 Definitions

Definitions of terms used within the context of this document.

Stress

The Health & Safety Executive define stress as

“The adverse reaction people have to excessive pressure or other types of demand placed on them”

This makes an important distinction between pressure, which can be a positive state if managed correctly, and stress which can be detrimental to health.

Pressures can arise from an individual’s personal life as well as from their work. People also vary in their ability to cope with different types of pressure. Some will recognise that their health is affected and will seek help; others will not acknowledge that they are stressed although it may be apparent to their manager and work colleagues.

Stress can be a product of working and caring for people. It is an occupational hazard that can be controlled and managed like any other. By identifying risk factors and introducing appropriate measures, stress and ill health in the workplace can be drastically reduced.

4 Duties

4.1 Role of Employee

Employees have duties and responsibilities under the Health and Safety at Work Act 1974;

Employees have a duty to take care of their own health and safety at work Be aware of the MSWRS and the Trusts Organisation-wide Policy for the

Management of Stress and how these assist the Trust to proactively manage workplace stressors Raise issues of concern and/or highlight any problems that they may be

experiencing with their Safety Representative, Line Manager or Occupational Health. Co-operate and fully engage with Safety Representative, Health and

Safety, Occupational Health etc in the pursuance of any measures to reduce workplace stress. Accept opportunities to access counselling services as indicated or

recommended.



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4.2 Role of Line Manager

Line managers should;

Conduct and implement recommendations of risks assessments within their jurisdiction Ensure good communication between management and staff, particularly

where there are organisational and procedural changes Ensure staff are fully trained to discharge their duties

Ensure staff are provided with meaningful developmental opportunities

Monitor workloads to ensure that people are not overloaded

Monitor working hours and overtime to ensure that staff are not

overworking, and monitor holidays to ensure that staff are taking their full entitlement Attend training as requested in good management practice and health and safety

Ensure that bullying and harassment are not tolerated within their jurisdiction

Be vigilant and offer additional support to a member of staff who is experiencing stress

outside work e.g. bereavement or separation Co-ordinate and assist in compilation of action plans for implementation, following

definition of interventions by staff focus groups Manage implementation of the action plan and specific interventions.

4.3 Role of Occupational Health Department

The Occupational Health Manager, assisted by the Head of Risk and Claims will be responsible for the day to day implementation of this policy. The Head of Risk and Claims, assisted by the Occupational Health Manager will ensure that a suitable steering group is formed whose principle function will be to champion the stress agenda and manage the process.

The Occupational Health Manager, assisted by the Head of Risk and Claims will ensure that adequate and appropriate resources are allocated.

The occupational health department should;

Provide specialist advice and facilitate or deliver awareness training on stress Offer Information, Instruction and Training to support managers in

undertaking stress risk assessments



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Support individuals who have been off sick with stress and advise them and their management on a planned return to work Refer to the designate Trust counselling service and/or specialist agencies as required

In conjunction with the Strategic Health and Safety Committee, monitor and review the

effectiveness of measures to reduce stress Inform the employer and the Strategic Health and Safety Committee of any changes and

developments in the field of stress at work

4.3.1 Information Available for Staff

The following information and resources are available to employees via management or the Trusts intranet/internet;

This policy which will be available to all staff via the Trust intranet and the Trust web site A health information leaflet entitled “Workplace Stress” available on the Trust Intranet and

in the occupational health department. The HSE website is available to employees via, www.hse.gov.uk

Results of trust wide risk assessments using the HSE Stress Indicator Questionnaire Tool

and through local risk assessments.

4.3.2 Availability of Counselling Services

The NEAS NHS Trust has made a commitment to the psychological health and well-being of its members of staff by providing a comprehensive Counselling Service that is readily accessible to all. The Counselling Service is provided by a single company under a Service Level Agreement (SLA) with the Occupational Health Department.

No other Counselling Service can be utilised under the terms of the SLA. Counsellors with recognised qualifications, who are not directly connected with the NEAS NHS

Trust and therefore regarded as independent, provide this service. Members of staff may discuss any matter confidentially with a Counsellor. The Counselling Service offers:

Confidentiality: Reports will not be forwarded to the Trust without the express permission of the individual member of staff. If a report is required to be forwarded to the Trust it will only be sent to the Occupational Health department Three consultations: A consultation is available to the member of staff within 48 hours of referral. A total of three consultations can be arranged free of charge by the Counselling Service for the member of staff. Further consultations may be organised at the discretion of the Occupational Health Manager.

Only appropriately qualified, professional Counsellors will be available through this programme.

All counsellors within the service are fully qualified practitioners who adhere to the Codes of Ethics of the British Association of Counsellors, their professional body.

This is supplied by: Paradigm Campbell Associates

http://www.hse.gov.uk/



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4.4 Role of Human Resources

The Director of Human Resources, assisted by the Head of Human Resources has lead responsibility for the development, strategic review, organisation and implementation of this policy.

The Human Resources department should;

Give guidance to managers on the stress policy Show commitment to, assist and support the implementation of the

MSWRS throughout the organisation Assist in monitoring the effectiveness of measures to address stress by

collating sickness absence statistics Advise managers and individuals on training requirements

Provide continuing support to managers and individuals in a changing

environment and encourage referral to occupational workplace counsellors where appropriate Provide accountability, feedback and information to senior management and the trust

board regarding implementation of the trust’s stress policy. The Human Resources Team, supported by the Risk and Claims Team will:

Provide guidance on the Trusts management of stress policy Provide specialist advice, information and awareness training of stress

Provide continuing support to managers and individuals in a changing environment and

encourage referral to occupational workplace counsellors where appropriate. Provide training and support to line managers in conducting stress risk assessments,

ensuring those assessments are actioned and reviewed appropriately. Monitor and review the effectiveness of measures in place to reduce stress including collating sickness absence statistics



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4.5 Role of Safety Representatives

The Trusts appointed Safety Representatives;

Must be consulted on any changes to work practices or work design that could precipitate stress Must be able to consult with members on the issue of stress, including conducting any

workplace surveys Must be involved in the risk assessment process

Should be allowed access to collective and anonymous data from human resources

Should be provided with paid time away from normal duties to attend any Trade Union

training relating to workplace stress Should conduct joint inspections of the workplace to ensure that environmental stressors

are properly controlled. Should be at the forefront and have a pivotal role in the implementation of the MSWRS.

They should have an input into the project steering group and be intimately involved in the practical management of the project at every step.

4.6 Role of Committees/Groups with Responsibilities for Stress Management

4.6.1Trust Board

The Chief Executive has overall accountability for the Health, safety and welfare of employees, patients, and visitors to Trust premises and members of the public with whom we come into contact during the course of their work. Together with the rest of the Trust Board, the Chief Executive takes the safety and well-being of all staff members very seriously and seeks to reduce the risk of them being injured during the course of their work.

4.62 Project Steering Group

The Trusts Strategic Health and Safety Committee will be the appointed project steering group for the management of workplace stress;

The Strategic Health and Safety Committee will perform a pivotal role in ensuring that this policy is implemented



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The Strategic Health and Safety Committee will oversee monitoring of the efficacy of the

policy and other measures to reduce stress and promote workplace health and safety.

4.6.3 Working Group

This group will maintain both the organisation’s and the employees' sense of involvement in the project and will oversee the implementation of the stress management standards.

The Trust will implement the Health & Safety Executive’s Stress Management Standards through the formation of a Stress Management Group, a sub group of the Strategic Health & Safety Committee.

This will consist of the following members: Executive Lead Staff Side Representatives Senior Managers (or nominated deputies) from key areas within the Trust Health & Safety Advisor Occupational Health Manager Head of Risk and Claims

Other members may be co-opted as required from areas such as:

Human Resources Information Technology Communications

5 Risk Assessment Process

In line with HSE Stress Management Standards and working within the Health and Safety at Work Act 1974 NEAS is committed to ensuring, as far as is reasonably practicable, the physical and mental wellbeing of all employees within the Trust. The Management of Health and Safety at Work Regulations 1999 provides detailed requirements of employers to make a suitable and sufficient assessment of the risks to the health and safety of employees to which they are exposed whilst they are at work. This includes the risk of work-related stress.

5.2 Undertaking a risk assessment for work-related stress is more complicated than for physical

hazards, but it involves the same basic principles. It is the line manager’s responsibility with the support of the risk and safety team to undertake stress risk assessments in the workplace.

5.3 Stress risk assessments take into account the following: Demands- workload, work patterns & work environment Control- how much influence employees have over their work Support- encouragement and development of the staff



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Relationships- the way people interact at work, promotion of positive working and dealing with unacceptable behaviour Role- ensuring employees understand their role & ensuring employees do not have conflicting roles Change- how change is communicated and managed with the Trust

5.4 Workplace stressors will be identified by the following means: The ongoing annual staff focus group programme incorporating representatives of all major staff groups within the Trust and this will be led by the Head of Human Resources, assisted by the Head of Risk and Claims and Occupational Health manager. Data collected as part of the annual NEAS staff survey/ questionnaire will be analysed by the Human Resources Department Monthly monitoring of sickness absence data of all major staff groups within the Trust by the Human Resources department Data collected by the Human Resources Manager on a quarterly basis on any significant findings around workplace stressors identified through performance appraisals Quarterly data collected by the Human Resources department on staff turnover rates and exit interviews

5.4.1 The Head of Human Resources assisted by the Head of Risk and Claims and Occupational Health Manager will collate and review all the data obtained by the above methods. This data will be summarised into a summary document which will be presented to the HR Strategy and Strategic Health and Safety Committees on an annual basis and will be considered as part of the stress risk assessment review.

5.5 Stress risk assessments will be reviewed routinely on an annual basis and a new review date

documented to ensure they remain valid. However if there is a significant alteration to working practices, a failure of a control measure or an adverse incident involving workplace stress a re-assessment will be carried out immediately.

5.6 A Risk Action/Treatment plan will be developed for all identified significant stressors via the risk assessment process. Each action will be assessed as to its importance and its priority. An individual will be named and given responsibility for ensuring the action is carried out by the appropriate due date. Where possible an assessment will be made of the resources required to undertake the action. The assessment of the resources required should contain an analysis of staff resources as well as revenue and capital financial resources.

5.7 Where an action plan has been implemented, Designated Managers must ensure that the

Register is updated on progress / completion on a monthly basis. Periodic review of action plans will be undertaken to audit completion dates but it is the Designated Manager’s responsibility to notify completion.

5.1 MSWRS Step 1: Identifying the Hazards



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The starting point is the content of the MSWRS six Management Standards themselves. It is important to become familiar with these and how they apply in, and translate to, the local context of the workplace. There will be organisational ‘hot-spots’ but these can only be identified by undertaking a systematic risk assessment. Each of the six factors does not always operate singly – often they combine or interact.

Find out what’s causing stress in the workplace

5.2 MSWRS Step 2: Decide Who may be Harmed and How

The Trust will utilise various information and statistics gathered throughout the normal daily operation to assist with identifying who may be harmed and how, examples are:

High levels of sickness absence may indicate a potential problem area. Checking the reasons given for absence may help identify the cause. Being open and honest about stress helps to reduce the perceived stigma

and improve the reliability of the reasons staff give for absence. Low productivity can be an indicator of problems. Talking to employees

should help you explore the reasons behind this. High employee turnover could be an indication of high stress levels.

Investigate why people are leaving - conducting exit interviews is one way of doing this. Performance appraisal could offer an opportunity to have a one-to-one

discussion about work and to explore whether people in your team are experiencing excessive pressure. Team meetings and focus groups can help you assess current

performance. They allow the Trust to explore issues in considerable depth and are particularly useful if you want to find out what specific groups of people think about their work.

The HSE Management Standards includes an indicator tool (2007b).The questionnaire associated with this tool will be distributed to all employees an annual basis. It is made up of 35 items that ask about “working conditions” that are known to be potentials for work-related stress. These working conditions correspond to the six stressors of the Management Standards. The employee answers according to how they feel about these aspects of their work.

All the responses gathered will then be entered into HSE’s Analysis Tool (2004d). The Analysis Tool computes an average figure for each of the six Management Standards for the organisations workforce, or a particular part of the workforce.

5.3 MSWRS Step 3: Evaluate the Risk and take Action



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The MSWRS approach directs organisations to both evaluate the risk and take action. The Trust will:

Consult with employees to discuss problems Work in partnership with employees to take action

Ensure issues affecting individuals are addressed

Feed back results to employees

Record the findings.

The Trust will evaluate the risk by using the organisational risk matrix. This will ensure that the stress risk assessments can easily feed the directorate/corporate risk register and therefore be assessed and analysed in conjunction with the other risks, both clinical and non-clinical, highlighted within the Trust. Post risk assessment the Trust will try and determine what risk reduction measures could be put in place, and communicate these measures effectively throughout the Trust.

5.4 MSWRS Step 4: Record your Findings

The MSWRS approach will identify areas of concern from the indicator tool results, and other relevant information and an action plan to address the issues identified as potential stressors by staff groups should be compiled. The Trust will take steps to develop some solutions and accurately record any findings.

The Trust will produce and disseminate action plans. The action plan will:

Assist the Trust in setting goals to work towards Assist prioritisation

Demonstrate that the Trust is serious about addressing employees’ concerns

Provide something to evaluate and review against.

An action plan is a key part of the Trusts risk assessment and will include the following:

What the problem is How the problem was identified

What the trust are going to do in response

How organisations arrived at this solution

Who is responsible for delivery of the plan/target

Some key milestones and dates for them to be reached

A commitment to provide feedback to employees on progress

A date for reviewing against the plan.



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The action plans will be agreed with employees, senior management and employee representatives. The final plans will be shared with employees.

5.5 MSWRS Step 5: Monitor and Review

The Trust will ensure that the action plans created following risk assessment are being adhered too, and that actions are being completed.

Effectiveness of the management of stress will be demonstrated by collecting data on employee turnover, sickness absence and productivity, and measuring any progress against emerging trends or changes in this data.

The Trust will also evaluate the effectiveness of any risk reduction measures implemented. This evaluation will take place after a few days for a simple intervention (e.g. an adjustment to the physical environment), or after a few months if piloting a complicated long-term solution (such as a new staffing rota system).

The Trust will utilise follow up surveys to measure progress against the related action plans and MSWRS policy. This will be in addition to any arrangements that have been established to talk about stress on a regular basis.

It is important to remember that the MSWRS are about making steady improvements in the way the trust proactively manages workplace stressors. It is critical that organisations are committed to continuously working with employees to identify and address the problems in the workplace that could lead to stress-related ill health.

6 Standards/Key Performance Indicators and Process for Monitoring

The effectiveness of this policy will be monitored through the Stress Management Group by examining the following: This Policy will be monitored for its effectiveness by the Head of Human Resources, assisted by

the Head of Risk and Claims through the following:

Responsibilities of staff will be monitored on an annual basis through attendance at meetings, development of reports and by line managers via the performance development review (PDR) process, Information available to staff on the work-related stress will be reviewed on a annual basis

by the Head of Human Resources and the Head of Risk and Claims, this will include a review of information on both the Trusts internal and external web pages An annual review of the completed work-related stress risk assessments, including the

process for identifying workplace stressors will be undertaken by the Risk and Claims Manager and the Occupational Health Manager. This will monitor the process for identifying workplace stressors and also the requirement to undertake a risk assessment. This review will be submitted to the Executive Team and the Strategic Health and Safety Committee on an annual basis. The advice available to staff in the event that they are called as a witness will be

monitored on an ongoing basis through the number of requests submitted to the Claims Co-ordinator. The arrangements for counselling staff affected by staff will be monitored by the staff

support network and the occupational health service on a quarterly basis. Data relating to usage of the available support mechanisms for staff will be submitted on a bi-monthly to the Executive Team and quarterly to the Strategic Health and Safety Committee by the Human Resources Department.



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Where risks, failings or deviations are identified through the monitoring of this policy an action plan will be created with clear timescales and communicated to relevant Leads. This action plan will be performance managed by Head of Human Resources and reported by exception to the Executive Team.

7 Dissemination, Implementation and Access to this Document

To facilitate the implementation of the management standards approach, a training programme will:

Acquaint managers with knowledge about stress

Overview the management standards themselves and

Explain the basis of how to carry out a stress risk assessment.

A simple training needs analysis has been undertaken and has identified the following as requiring this training:

Non-Executive Directors

Executive Directors

Senior Managers

Team Leaders All other Trust Employees

Once Every three years

Every two years

Every two years

Every two years

Train package will be stand alone (2 hours) but may also form part of a wider management training package.

The training programme will be delivered to these core staff. Subsequent to this, its delivery frequency will be adjusted according to staff turnover.

This document has been disseminated to all staff via the Trust intranet and is available on the Trust web site.

8 Review, Updating and Archiving of this Document

Review and Monitoring To monitor and review the Stress Risk Assessment process in conjunction with the HSE standards. Other sources of information may be used to provide an overall picture of work related stress within the Trust such as;

Staff survey results Exit interviews Employee turn over data



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Sickness absence data Bullying and Harassment data Grievance data Informal talks with employees Staff focus groups

Updating

This policy will be updated on an annual basis by the policy owner or earlier if required for the following;

Changes in legislation Changes in Trust policy or procedure Concerns in relation to the effectiveness of the policy

Archiving Records must be kept for specified minimum periods of time as defined in the NEAS Records Retention and Disposal Schedule (QSSD 1301), and specified periods defined when a review should be made of the records to determine whether records should be selected for preservation, retained or disposed. 9 References

Health & Safety Executive (HSE). (2004a). Action plan template. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2004b). Demands: Are You Doing Enough? Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2004c). How To Organise And Run Focus Groups. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2004d). HSE Management Standards Analysis Tool. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2004e). Securing Management Commitment. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2004f). Working Together to Reduce Stress at Work: A Guide for Employees. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2005). Tackling stress: The Management Standards approach. Available at www.hse.gov.uk.

Health & Safety Executive (HSE). (2007a). An example of a stress policy. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2007b). HSE Management Standards Indicator Tool. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2007c). Management Standards for Work-related Stress. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2007d). Overview: The Management Standards and the 5 Steps to Risk Assessment. Available at: www.hse.gov.uk.

http://www.hse.gov.uk/stress/standards/pdfs/actionplan.pdf


http://www.hse.gov.uk/stress/standards/pdfs/suggestions.pdf


http://www.hse.gov.uk/stress/standards/pdfs/focusgroups.pdf


http://www.hse.gov.uk/stress/standards/pdfs/analysistool.xls


http://www.hse.gov.uk/stress/standards/pdfs/securing.pdf


http://www.hse.gov.uk/pubns/misc686.pdf

http://www.hse.gov.uk/pubns/misc686.pdf


http://www.hse.gov.uk/pubns/indg406.pdf

http://www.hse.gov.uk/pubns/indg406.pdf


http://www.hse.gov.uk/stress/standards/pdfs/examplepolicy.pdf


http://www.hse.gov.uk/stress/standards/pdfs/indicatortool.pdf


http://www.hse.gov.uk/stress/standards/index.htm


http://www.hse.gov.uk/stress/standards/sitemap.htm

http://www.hse.gov.uk/stress/standards/sitemap.htm




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Health & Safety Executive (HSE). (2007e). Steering Groups. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2007f). Step 1 - Identify the Hazards. Available at: www.hse.gov.uk.

Health & Safety Executive (HSE). (2007g). Work-related Stress. Available at: www.hse.gov.uk.

Health and Safety at Work etc. Act 1974 (c. 37). London: Stationery Office.

The Management of Health and Safety at Work Regulations 1999 London: Stationery Office.

10 Associated Documentation

This Policy/procedure should be read in accordance with the following Trust policies, procedures and guidance.

Dignity at Work Policy Whistle-blowing Policy Equality and Diversity Policy Sickness Absence Management Policy Improving Working Lives through Employee Friendly Policies and Procedures & Flexible

Working Practices

http://www.hse.gov.uk/stress/standards/pdfs/steeringgroups.pdf


http://www.hse.gov.uk/stress/standards/step1/index.htm


http://www.hse.gov.uk/stress/


http://www.opsi.gov.uk/RevisedStatutes/Acts/ukpga/1974/cukpga_19740037_en_1

http://www.opsi.gov.uk/si/si1999/19993242.htm



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Appendix A - Overview: The Management Standards and the 5 Steps to Risk Assessment (HSE 2007d)

http://www.hse.gov.uk/index.htm

http://www.hse.gov.uk/index.htm



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Appendix B - Risk Assessment Tools

A1 Guidance for Managers: Risk Assessment of stress at work This guidance note provides advice for managers on how to conduct a risk assessment of stress at work in 5 clear stages using the risk management action plan at the end of this section. The HSE has an on-line step by step guide stress risk assessment. Much of the guidance in this policy amounts to good management practice. However the advantage of adopting a risk based system for assessing stress in the workplace is that it is a proactive approach aimed at preventing stress before it occurs. The risk assessment should be a collaborative process within teams and should involve senior managers. A risk assessment should be undertaken for each group of staff e.g. HQ staff, operational staff and support staff. In some circumstances it may be necessary for individuals. A2 The 5 steps to risk assessment are: Identify the hazards Decide who might be harmed and how Evaluate the risk and take action Record your findings Review and monitor your assessment over time

A3 Identify the Hazards The key work related factors with potential to cause stress in an organisation are: Demands of the job Job Role Control of work environment Relationships within the workplace Change Support & Organisational Culture

The HSE has issued guidance on management standards employers should achieve in order to minimise work related stress in each of these areas of work stressors.

A4 Decide who might be harmed and how Some members of the team will be more vulnerable to developing work related stress than others. In particular those who: Have a history of significant or physical health problems Have been absent work due to work-related stress or difficulties with coping in the past Have personal difficulties which may be unrelated to work Are inexperienced in their role Are of a personality type which tends towards over work.

You may be aware of some of these factors in some of your staff, but if in doubt ask sensitively and in confidence regarding the risks of work-related stress. Many people cope very well if they know their manager is supportive.



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A5 Evaluate The Risk And Take Action a. Gathering Data

It is a matter of personal choice how a manger gathers data about their team. Team discussion/focus groups Analysis of appraisal reports Analysis of sickness absence data Analysis of staff turnover Stress Questionnaires such as the HSE indicator tool

b. Linking problems to solutions The table below gives practical guidance on how tackle any problems identified. HAZARD HSE MANAGEMENT STANDARD

A. Demands of the Job Employees Indicate they can cope with the Demands of their Jobs

Too little time for task Inadequate staffing

Prioritise tasks Cut out unnecessary work Try to give warning of urgent or important jobs to enable individuals to plan their work.

Boring or repetitive work Too little to do

Job enrichment/ job rotation Change the way jobs are done by moving people between jobs, giving individuals more responsibility, increasing the scope of the job, increasing the variety of tasks, giving a group of workers greater responsibility for effective performance of the group

Inadequate resources for task

Analyse requirements for any project/task: Equipment/ tools Staffing Funds

Supporting students Make staff aware of referral pathways to student services for help with students with complex problems.-counselling, study skills etc Provide adequate information and training for personal tutors.

Managing staff

Ensure all staff in management roles have adequate training and support from senior colleagues in managing complex staff matters. Ensure managers know about central services (Educational development, HR, finance, staff development, occupational health, counselling, safety) available to support their work. Have formal written procedures to help new managers.

Employees experiencing excessive

workloads

Employees working under excessive pressure

Review workload and demands regularly and as an integral part of the appraisal and performance management process. Support staff in planning their work. Try to establish what aspects of their job they find challenging. Redistribute work or set different work priorities if not coping.

The physical working environment poor temperature control noise lack of facilities for rest/breaks poor lighting poor ventilation

Make sure workplace hazards are properly controlled. Undertake risk assessments of work space and significant tasks

The psychological working environment threat of aggression or violence verbal abuse

Assess risks, implement controls including appropriate training



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B. Control

Employees Indicate they have a Say in How their Work

Not being able to balance the demands of work and life outside work

Encourage a healthy work-life balance. Ensure staff take all their allocated holiday allowance and distribute it sensibly across the year.

Rigid work patterns Fixed deadlines occurring in different parts

of the academic year shift work lone work Lack of control over work

Try to provide some scope for varying working conditions and flexible work schedules (e.g. flexible working hours, working from home), and the scope for people to influence the way their jobs are done. This will increase their interest and sense of ownership. Avoiding scheduling extra projects at busy times of the year.

Conflicting work demands e.g. research and teaching

Set realistic deadlines for tasks. Take into account that everyone is different, and try to allocate work so that everyone is working in the way that helps them work best and using their talents. Be clear about tasks required

Too much training for the job Too little training for the job Skills not recognised –promotion prospects

not recognised Over promotion

Make sure individuals are matched to jobs. Analyse skills alongside the task. Provide training for those who need more e.g. when introducing new technology Increase the scope of jobs for those who are over-trained. Consider mentoring to help less experience staff or those underperforming

Other difficulties faced by area/team Details:

Discuss stress with the team to create a better understanding of the difficulties faced and the possible solutions available. This type of approach can lead to providing a longer-term solution and one that is shared and supported by the whole team.

C. Role

Employees Indicate they Understand their Role and Responsibilities

Lack of clarity about job role

Make sure everyone has a clearly defined job description/ role profile. Revise this when circumstances change eg promotion or reorganisation of team

Confusion about how everyone fits in i.e.

ambiguity about others’ roles

Make sure that everyone has clearly defined objectives and responsibilities linked to business objectives, and training on how everyone fits in. Visual diagrams can help people’s understanding of this.

Conflicting demands

If reporting to more than one person ensure there are no conflicting demands on the individual Ensure all staff have an annual appraisal with clearly defined objectives with realistic timelines. Ensure staff can raise any concerns about conflicting demands on their time.



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F. Support and Organisational Culture

Employees Indicate they Receive Adequate Support and Information from Colleagues and Managers

Lack of support from managers and co-workers.

Support and encourage staff, even when things go wrong. Consider having regular one to one meetings with staff and give regular constructive feedback on performance. Consider introducing a mentoring scheme

Employees unaware of support available to them

Ensure staff are aware of support services available to them -the Staff Counsellor, Occupational Health Service, Chaplaincy ,HR and Trade Unions Ensure staff know how to access resources needed to undertake task.

Lack of communication and consultation

Introduce clear objectives, good communication and close employee involvement, particularly during periods of change. Hold regular team meetings.

Failure to celebrate success Acknowledge and reward successes in your staff.

A culture that considers stress a sign of weakness

Be approachable – create an atmosphere where people feel it is OK to talk to you about any problems they are having. Have an open door policy

Be understanding towards people who admit to being under too much pressure.

An expectation that people will regularly work excessively long hours or take work home with them.

Avoid encouraging people to work excessively long hours. Lead by example. Schedule work in a way that allows recovery time after unavoidable busy periods

E. Relationships

Employees Indicate they are not Subjected to Unacceptable Behaviours

Poor relationships with others Student / Client complaints

Provide training in interpersonal skills. Engage in team-building activities, both informal through social events and formal such as an away day. Provide clear information for clients/students. Consider student support needs. The student counselling service provides information and training for staff in personal tutoring.

Combative or confrontational communication styles

Encourage constructive and positive communications between staff. Managers should discuss and address combative and/or confrontational communication styles with members of staff who display these behaviours. Consider training in managing conflict

Bullying, racial or sexual harassment Set up effective systems to prevent bullying and harassment. Ensure staff are aware of City's policies on equal opportunities and harassment and know how to get support. Practise by example and make it clear that these behaviours are not acceptable in your team.



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D. Change Employees Indicate that the Organisation Engages Frequently with them when Undergoing Organisational Change

Poor communication -uncertainty about

what is happening Fears about job security Not enough time allowed to implement

change Inexperience/fear of new technology Lack of skills for new tasks Not enough resource allocated for change

process Dysfunctional teams

Consult with staff likely to be involved in a change management

programme – if staff feel included and acknowledged in the process they are more likely to cooperate with a change.

Provide timely information so they have time to understand the reasons for change

Provide effective support for staff throughout the process. Getting together as a team can help people feel less isolated with their

concerns Ensure effective two way communication throughout process –

knowing exactly what is going to happen when can help people feel less anxious about a change. Consider developing a timetable of the change process

Allow adequate time for the process – time planning for the change and for people to talk through their concerns about the change will pay off at a later stage

Allocate adequate resources – this includes financial resources, space, time and the emotional energy needed to effect the change

Consider training needs – do people have the tools to effect change? Does the skill mix of the team need to be reviewed?

Consider environmental factors – a poor work environment can be very stressful.

Consider changes in group dynamics – an apparently small change e.g. a different positioning of desks can have a major impact on communication and work relationships

A6 Record your findings If your risk assessment has identified areas of concern and you have taken steps to develop some solutions, it is important that you:

Record these and how you identified them; Agree realistic timescales with staff Share your plans with senior management Communicate the outcome to your staff; Decide how you are going to review the results.

The best method of achieving this is to write and disseminate an action plan.

An action plan is a key part of your risk assessment and should at least include the following:

What the problem is; How the problem was identified; What you are going to do in response; How you arrived at this solution; Some key milestones and dates for them to be reached; A commitment to provide feedback to employees on progress; A date for reviewing against the plan

A7 Review your assessment and revise where necessary Follow up changes you make to ensure that they’re having the effect you intended. You might consider a follow survey using the indicator tool to measure progress since last assessment. Review what you’ve done when you make major changes in your workplace (e.g. organisational change, new equipment, work systems or processes) or if there is a change in management or personnel to make sure that stress has not increased. Review the assessment if anyone declares work related stress



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Review assessment at least once a year

North East Ambulance Service NHS Trust An Organisation-wide Policy for the Management of Stress Ref: CO-POL-97 Version: 1 Status: Ratified

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Appendix C - Organisational Risk Matrix

1 2 3 4 5 Domains Negligible Minor Moderate Major Catastrophic Impact on the safety of patients, staff or public (physical/psychological harm)

Minimal injury requiring no/minimal intervention or treatment. No time off work

Minor injury or illness, requiring minor intervention Requiring time off work for >3 days Increase in length of hospital stay by 1-3 days

Moderate injury requiring professional intervention Requiring time off work for 4-14 days Increase in length of hospital stay by 4-15 days RIDDOR/agency reportable incident An event which impacts on a small number of patients

Major injury leading to long-term incapacity/disability Requiring time off work for >14 days Increase in length of hospital stay by >15 days Mismanagement of patient care with long-term effects

Incident leading to death Multiple permanent injuries or irreversible health effects An event which impacts on a large number of patients

Quality/ Complaints /audit

Peripheral element of treatment or service suboptimal Informal complaint/inquiry

Overall treatment or service suboptimal Formal complaint (stage 1) Local resolution Single failure to meet internal standards Minor implications for patient safety if unresolved Reduced performance rating if unresolved

Treatment or service has significantly reduced effectiveness Formal complaint (stage 2) Local resolution (with potential to go to independent review) Repeated failure to meet internal standards Major patient safety implications if findings are not acted on

Non-compliance with national standards with significant risk to patients if unresolved Multiple complaints/ independent review Low performance rating Critical report

Totally unacceptable level or quality of treatment/service Gross failure of patient safety if findings not acted on Inquest/ombudsman inquiry Gross failure to meet national standards

Human resources/ organisational development/staffing/ competence

Short-term low staffing level that temporarily reduces service quality (< 1 day)

Low staffing level that reduces the service quality

Late delivery of key objective/ service due to lack of staff Unsafe staffing level or competence (>1 day) Low staff morale Poor staff attendance for mandatory/key training

Uncertain delivery of key objective/service due to lack of staff Unsafe staffing level or competence (>5 days) Loss of key staff Very low staff morale No staff attending mandatory/ key training

Non-delivery of key objective/service due to lack of staff Ongoing unsafe staffing levels or competence Loss of several key staff No staff attending mandatory training /key training on an ongoing basis

Statutory duty/ inspections

No or minimal impact or breech of guidance/ statutory duty

Breech of statutory legislation Reduced performance rating if unresolved

Single breech in statutory duty Challenging external recommendations/ improvement notice

Enforcement action Multiple breeches in statutory duty Improvement notices Low performance rating Critical report

Multiple breeches in statutory duty Prosecution Complete systems change required Zero performance rating Severely critical report

Adverse publicity/ reputation

Rumours

Potential for public concern

Local media coverage – short-term reduction in public confidence Elements of public expectation not being met

Local media coverage – long-term reduction in public confidence

National media coverage with <3 days service well below reasonable public expectation

National media coverage with >3 days service well below reasonable public expectation. MP concerned (questions in the House) Total loss of public confidence

Business objectives/ projects

Insignificant cost increase/ schedule slippage

<5 per cent over project budget Schedule slippage

5–10 per cent over project budget Schedule slippage

Non-compliance with national 10–25 per cent over project budget Schedule slippage Key objectives not met

Incident leading >25 per cent over project budget Schedule slippage Key objectives not met

Finance including claims

Small loss Risk of claim remote

Loss of 0.1–0.25 per cent of budget Claim less than £10,000

Loss of 0.25–0.5 per cent of budget Claim(s) between £10,000 and £100,000

Uncertain delivery of key objective/Loss of 0.5–1.0 per cent of budget Claim(s) between £100,000 and £1 million Purchasers failing to pay on time

Non-delivery of key objective/ Loss of >1 per cent of budget Failure to meet specification/ slippage Loss of contract / payment by results Claim(s) >£1 million

Service/ business interruption Environmental impact

Loss/interruption of >1 hour Minimal or no impact on the environment

Loss/interruption of >8 hours Minor impact on environment

Loss/interruption of >1 day Moderate impact on environment

Loss/interruption of >1 week Major impact on environment

Permanent loss of service or facility Catastrophic impact on environment

Risk Matrix - Likelihood score Likelihood score 1 2 3 4 5

Descriptor Rare Unlikely Possible Likely Almost certain Frequency How often might it/does it happen

This will probably never happen/recur

Do not expect it to happen/recur but it is possible it may do so

Might happen or recur occasionally

Will probably happen/recur but it is not a persisting issue

Will undoubtedly happen/recur,possibly frequently

Appendix D - Terms of reference for the Stress Management Steering Group


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Terms of Reference

Title:

Stress Management Steering Group

Date approved and approving body:

September 2008 Assurance Committee

Date reviewed: Next review date:

September 2008 September 2009

Purpose:

The Stress Management Steering Group is a sub group of the Strategic Health & Safety Committee. The Stress Management Steering Group will implement the Health & Safety Executive’s Management Standards and oversee the implementation of the stress management standards.

Membership: Core Members :- Executive Director (Chair) Head of Human Resources Head of Risk and Claims Health and Safety Advisor Occupational Health Manager Staff Side Representative

Additional NEAS staff to be invited as required from areas such as IT, Senior Managers and key areas from the Trust

Deputies: In the event that the Head of Risk and Claims, Head of Human Resources or Occupational Health Manager are unable to attend, they should nominate a suitable Deputy. Any nominated deputy will be acting on behalf of the above detailed post-holder and must be fully briefed prior to the meeting to enable them to act and make decisions on their behalf.

Chair: Executive Director Vice Chair: Head of Human Resources Quorum: The meeting shall be considered quorate in the presence of the Chair

or Vice-Chair Person and at least one third of the group members should be in attendance.

Secretary: The Risk Administrator shall be the Secretary to the Committee and provide appropriate support to the Chairman and Committee members.

Frequency of Meetings: The Group shall meet quarterly and extra-ordinary meetings can be called at the behest of the Chair or Vice-Chair. Every effort will be made to give adequate notice of these meetings. Extra-ordinary meetings shall be held as necessary and as determined by timescale and milestones. The Chair of the Group shall draw attention to any issues that require disclosure or Executive Action.


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Rules as to Meetings & Proceedings:

The Group Secretary will be responsible for the items listed;

Arrangement of suitable venues for Group Meetings Preparation of agendas and minutes Distribution of agendas, minutes, relevant supporting

information and documents prior to the meetings Maintenance of Action List Recording of the Group meeting minutes Publication of minutes

The Group Secretary will ensure the distribution of the agenda, relevant supporting information and documentation to all members of the Group at least five days in advance of the meeting. The Chair or Vice-Chair person will approve the minutes of the meeting within 10 working days. The approved minutes will be circulated to every member of the Group who should ensure they are accessible for staff at all levels within the Trust. The approved minutes will be posted on the Trusts internal intranet site. The approved minutes must also be placed on the Health and Safety notice boards of all Trust premises, shared and singularly occupied. Any other Trust forum or individual can place items on the agenda of a meeting of the Group, provided that such matters are within the Terms of Reference of the Group. All queries as to the interpretation of the Constitution and Terms of Reference shall be referred to the Chair or Vice-Chair Person. Any variation or amendments to the Constitution and Terms of Reference may only be made by agreement of the Group and only following the submission of a proposal to a previous meeting or discussion. All variations and/or amendments agreed by the Group will be subject to the approval of the Strategic Health and Safety Committee. The principles which this group will follow include:

Safeguarding the Trusts vision and values and ensure the organisations obligations to key stakeholders are met and are patient-led.

Effective and appropriate communication and consultation at all levels Existing and new services directly-provided to be efficiently resourced and managed to ensure good quality, safe and respectful services for patients that represent value for money and address inequalities.

The basis of evaluation and decision making to be consistent, unified and open and aligned to the Trust’s strategic directions, relevant policy and supporting strategies.

Attendance at meetings: In the event that a member cannot attend the meeting, they should

nominate a suitable deputy to attend.


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Members of the Group must attend 75% of meetings within a 12 month period. Attendance at meetings of the Group will be open to others where the Committee feels such attendance is relevant or necessary for the effective consideration of topics on the agenda. Additional members with specific expertise may be co-opted onto the Group as required. Co-opted members will not act as voting members of the Group Group members will cease to be members if they:

Resign from the Group Fail to attend 3 consecutive meetings without providing

apologies to the Chairperson. Resignation from employment with the Trust Breaching confidentiality

Authority/Tolerances:

The Group is authorised to:

Investigate any activity within its Terms of Reference Seek any information it requires from any employee and

all employees are directed to co-operate with any request made by the Group.

Obtain outside independent professional advice Secure the attendance/participation of outsiders with

relevant experience and expertise Establish time-limited task-groups to undertake specific

pieces of work Commission visits, inspections, research, surveys or other

activities, as necessary for it to obtain knowledge and information required

Develop necessary policy and strategy documents relative to its remit

The Group is authorised to seek clarification and further investigation of any Stress in the Workplace matter and to request any relevant information from any employee.

To agree the annual objectives of the Group and all related policies/protocols prior to ratification by the Strategic Health and Safety Committee. Approve Terms of Reference for any nominated sub-groups/working groups.

To develop, agree and promote co-operation between all levels across the Trust in instigating, developing and monitoring arrangements so as to ensure the health, safety and welfare of all employees, visitors, contractors and users of the services provided. To establish and maintain a communication model to ensure all necessary workplace stress related information is effectively and timely communicated to the relevant people.

Duties – decision making:


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To Initiate and promote the measures aimed at maintaining and improving health and safety at work. In particular promote risk assessments as a method of identifying potential stressors thus improving safety performance and reducing the related risk.

Duties – advisory: The Group will advise the appropriate Committee as appropriate on those issues delegated to it by the Strategic Health and Safety Committee. The Group is authorised to recommend amendments to these Terms of Reference, for formal ratification by the Strategic Health and Safety Committee. The Committee will advise the Strategic Health and Safety Committee of any requirement to obtain external or other independent professional advice and secure attendance of external persons/companies with relevant experience and expertise if required. Prioritise outstanding Workplace Stress related issues with a view to advising the appropriate Committee as and when required. To receive and challenge, as appropriate, reports on all aspects of Workplace Stress and recommend action as appropriate. Ensure the minutes of the meetings are distributed to each member of the Group and brought to the attention of all Trust staff. Copies must also be placed on the Health and Safety notice boards of all Trust premises, shared and signally occupied. Present reports on their proceedings as may be required, subject to the requirements of confidentiality, data protection, freedom of information act and the protection of sensitive business information. To highlight any significant risks to the appropriate Committee and advise on the action being taken to mitigate same.

Duties – monitoring: Consider new legislation which falls within the terms of reference

and its impact on the Trust. The Group is authorised to initiate and monitor any action necessary or desirable for compliance with legislation in relation to Workplace Stress. Monitor Workplace Stress management plans. Consider and review related workplace stress reports and/or information provided by the enforcing authority inspectors and to receive other safety audits, assessments and reports so that recommendations for corrective actions can be made.

Review and monitor related workplace stress statistic trends; so that reports and recommendations can be made to the Strategic Health and Safety Committee. To review the degree of compliance with accepted best practice in the management of Workplace Stress.


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To review and identify areas of non-compliance or areas at risk of non-compliance and recommend action to address Contribute, monitor and review the development of all relevant Health and Safety policies and procedures within the Trust which relate to workplace stress.

Duties – Standing Agenda Items • Every meeting:

• Annually:

Apologies for Absence Minutes of Previous Meeting Register of Decisions Review of Matters Discussed (at this meeting) Contribution to the Cost Improvement Programme? Decisions made? Has other internal/external stakeholder involvement (budgetary/training etc) been considered? “Any Other Business

Review Committee Objectives Review All Associated Policies And Procedures Implications for NHSLA Standards Implications for HCC Standards Contribution To The Cost Improvement Programme Report And Review Of Effectiveness

Subgroups: The Group reserves the right to establish time limited working groups.

The findings of these meetings will be referred to the Group for ratification or progress and necessary actions. The membership of each working group will be agreed by the Group and may not necessarily reflect the quorum identified in this document.

Accountability: The Group shall be accountable to the Strategic Health and Safety Committee.

The Group is authorised by the Strategic Health and Safety to investigate any activity within its Terms of Reference.

Reporting responsibilities:

Assurance Committee via the Strategic Health and Safety Committee The Group via the Strategic Health and Safety Committee shall contribute to the formal annual Health and Safety report for presentation to the Trust Board. The minutes of the Group will be reported to the Strategic Health and Safety Committee and/or the appropriate Committees

Self Assessment: On an annual basis the Group will assess the workplace stress related incidents encountered by the Trust to assess whether these have reduced as a result of the controls and or recommendations made by the Group. These outcomes will form part of the annual report of effectiveness.


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Appendix F - Flowchart for the Creation and Implementation of Procedural Documents

Read “An Organisation-wide Policy for the development and management of

procedural Documents” Develop

Undertake Prioritisation – Is the Document Required?

Ensure Proposed Document Does Not Duplicate National Standard

Ensure it Does Not Duplicate Work Elsewhere in the Trust

Agree the Requirement for the Document with Relevant Committee if Necessary

Use Trusts Template

Rationale and Priority Evidence Base Development Plan

Identify • Who will do the work • Who should be involved • How will it be done

Identify all Relevant Stakeholders Including Service Users

Ensure Relevant Expertise is Utilised

Consult With Service Users and Stakeholders

Identify who will be Responsible for Each Task, i.e. Dissemination, Implementation

Content

Identify Clear and Focused Objectives

Target Population e.g. Service Users or Staff Groups for Whom the

Document is Intended

Intended Outcome – What Should it Achieve?

Keep Statements Simple and Unambiguous

Plan to Develop and Necessary Support Information, Leaflets etc…

How Will the Trust Measure Compliance? Set Measurable Standards and Design

Methods for Monitoring Compliance and Effectiveness

Identify what Type and Source e.g. Research, Expert Opinion, Clinical

Consensus and Patient Views

Is it Based on a National Document? If ‘Yes’, is local Information Required?

Include References Cited in Full in Agreed Organisational Format

Continue to Consultation and Approval on Next Page


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Appendix F - Flowchart for the Creation and Implementation of Procedural Documents

Re-approve Procedural Document at the Appropriate Committee/Group

Consult with all Relevant Stakeholders Including Service Users

All Procedural Documents with HR Implications Must be Taken to the JCC

Complete Document Review Processes, Including Equality Impact Assessment

Screening Tool and Checklist for the Review and Approval

Approve Document as Outlined in this Policy, and then Complete the Checklist for Review

and Approval of Procedural Documents

Log Document on the Organisations Register/Library of Procedural Documents

Consultation and Approval Responsibility Dissemination, Implementation and Access

Identify • Who will do this • How will it be done • Period of Implementation

Link with Induction Training, Continuous Professional Development and all other

Groups Requiring Access

How and Where will Staff Access the Document?

Plan to Remove Old Copies from Circulation

Ensure Staff are Aware the Document is Logged on the Organisations Register/Library

of Procedural Documents

Monitoring, Compliance and Review

Implement the Monitoring Arrangements Contained Within the Procedural Document

Consider Findings from Monitoring Arrangements at an Appropriate Committee

Implement Changes to Improve Compliance and Effectiveness with the

Procedural Document

Review Document in Accordance with Planned Review Date

Is There New Evidence of Best Practice to be Incorporated into the Document?

Who will be Responsible for Co-ordinating the Ongoing Development, Implementation and

Review of the Document?

Archive Old Versions of the Document



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Appendix G - Version Control Sheet

Version Date Author Status Comment


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