TRUST STRESS MANAGEMENT PROJECT

1. TRUST STRESS MANAGEMENT PROJECT Sue Grimshaw Acting Head of Occupational Health Dept & Stress Project Lead

2. Common causes of stress in the workplace • Unreasonable demands for performance • Lack of interpersonal communication between the employer and the employees • Lack of interpersonal relationship among the employees • The fear of losing one's job. • Long working hours • Less time to spend with the family • Under utilization of skills • Underpaid jobs • A promotion that did not materialize – promises promises promises!

3. The cost of stress • Sickness absence in the NHS is estimated to cost the service some £1.7billion each year • A quarter is likely to be attributable to stress related sickness. • Time lost to sickness absence amounts to 10.3 million working days or • The equivalent of having 45,000 whole time equivalent staff not at work • Of these, a quarter are likely to be due to stress related sickness. Nhs employers

4. Money Money Money • £175,000 • £850,000 • £109,754

5. Physical Headaches Indigestion Colds/Flu Skin condition Acne High BP Sleeplessness Nervous ticks Tense Muscles Emotional signs Anxiety Anger Feeling hopeless Depression Negativity De-motivated Low self-esteem Signs of Symptons of Stress

6. Behavioural Signs Smoking Alcohol Increased caffeine Irritability and aggression Increased forgetfulness Moodiness and sulking Apathetic Withdrawal Obsessive behaviour Increased mistakes Crying Decreased personal standards Changes in Thinking Style Confused Negative Indecisiveness Poor concentration Blinkered Things out of proportion Constant criticism Cynicism Signs of Symptons of Stress

7. What started the project? • Occupational Health (OH) data demonstrated a doubling of cases of work related stress in 2006/7 • Perceived causes – workload, interpersonal conflict at work and the £21m restructure • High sickness absence rate at 5.34% • This demanded a management led approach, not medical “treatments”

8. Next steps • Trust Board >to consider analysis/findings so far >they took ownership >to support a Stress Management Project • Timing >Trust emerging from Financial recovery programme >Aiming FT status and focus on Patient Quality >The Blackpool way still needing to embedded

9. Broader effects

10. Individual Unhappy, de-motivated, disengaged, absence Colleagues Frustrated, antipathy to Trust Increased workload pressure from absent colleagues Disengagement Organisation Increased grievances and management problems High absence rates Inconsistent patient care/ service delivery Negative public image Reputation hinders recruitment Workforce lacking in skills & competency Impact on individual, colleagues and organisation

11. Our strategy & targets • Existing Data, Board & Workforce Engagement • Reduce sickness 4.3% / Work related Stress cases by 30 % • Adhere to Hse Management Standards who supported the project fully • Make the Trust a great place to work = increased recruitment /retention

12. Barriers to the project • This is too difficult/ too big • This is not my role • What problem? • Stress makes people work harder • Nothing to do with the Organisation • Targets affected if we take our eye off the ball • Everyone will say they are stressed if its highlighted • They should try my job!

13. Key stakeholders identified for the Stress Project to succeed • CEO • Chairman • Executive Directors • Non-Executives • Staff Side representatives • The Workforce • All the above agreed to implement all reasonable recommendations and explain why any were not implemented

14. Project methodology • Focus groups – 8 sites • Robust project management tools • Reporting methods • Role of Ceo & Executive Directors • Working in partnership with HSE

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

16. Successes so far (1) • Staff Survey • 2006 response rate was 44% • 2007 response rate was 58% • 2008 response rate was 61% • 2009 response rate was 65% • Results indicate a widespread improvement and divisional differences have all but disappeared, staff are reporting improvements as individuals.

17. Key Results from 2008 Staff Survey relevant to Stress Project

18. Key Results cont’d …

19. Successes so far (2) • Sickness & Absence rate now is 4.31% • By 2009 Work related stress presenting to OH down by 40% • Long working hours culture leading to  stress/ absence from work being actively managed • Occupational Health moved back onto main site 3-4 years ahead of schedule • Winners of HPMA Award 2009 (HSE Category – Stress)

20. Successes so far (3) • Compliance with NHSLA at Level 2 now aiming for level 3 • Stress Website for staff • Employment Assistance Programme launched on April 9th 2009 • June 2009 – 87 % staff appraised • June 2010 – 100% staff appraised • Stress management training programme Trust-wide – at manager’s request for all staff to access

21. Successes so far (4) • Exit Questionnaires • 3 versions and they are being used • Dedicated staff to assist with completion • Will identify trends, issues and successes • Learning & Development reviewing current training provision and induction/mandatory programmes • Trust has implemented Leadership & Management Programmes to develop staff & managers

22. Successes so far (5) • Poor performance now being robustly managed across the Trust • Bullying and harassment cases now being dealt with in agreed timescales (6 weeks) • Multi-storey car park being built – parking for all staff on site within next two years • Grapevine magazine • A resource for other organiations nationally

23. Phase 2 – Review of Current OH service provision • Focus groups have been run to ask workforce for further ideas e.g. well being initiatives > Social events for staff > Review of catering provision to assist staff with healthy eating options > Fast track appointments – to employ physiotherapist in the department > Increased counselling & CBT provision > Hours Occupational Health extended increased clinic productivity > Health promotion events > Improve communication /information for staff accessing Occupational Health > Greater telephone access > Known as Health & Well being centre

24. Staff will feel: Valued Supported Involved Happy at work A sense of worth Motivated Staff will have: Positive working relationships Career development A pride in where they work A sense of belonging. A voice that is heard Overall impact on the workforce if the Project succeeds

25. Making a difference to patient care • Reduction in Sickness & Absence has improved staff ratios for patient care delivery • Trust converting “Bank Hours” to substantive nursing posts – improved continuity of care • Staff able to access training skill development resulting in competent safe practitioners • Staff more aware of stress (? Good or bad)

26. How to manage stress Responsibility of the Individual • Understand nature and sources of stress. • Make someone aware of how you are feeling – ideally your line manager but if not, HR or contact your Occupational Health provider • Manage your time effectively and efficiently. • Follow an appropriate lifestyle • Develop a personal strategic management process (have a mission, set achievable goals, allocate resources and periodically assess the situation). • Be systematic in decision-making and problem solving.

27. Be proactive in dealing with stress in the workplace Offer reassurance to the person – “you’re not on your own”. Seek advice from HR or their line manager if unsure what to do. Don’t say ‘so are all of us’ Have self awareness around how your management style may impact on others – in times of difficulties, don’t revert to using the stick! Take immediate action – Make time & Listen Ask what they need Aim to alleviate the situation & review progress We can assume that a person can withstand the normal pressures of work but once you are aware of a problem it is reasonable that something is then done Be aware of the DDA – need to consider reasonable adjustment necessary to support and alleviate stress What a manager needs to do…

28. Ensure that the workload is in line with the employees’ capabilities and resources. Jobs that have meaning, stimulation,less monotony & opportunities for employees to use their skills. Clearly define employees’ roles and responsibilities. Employees should participate in decisions and actions affecting their jobs. Improve communications - reduce uncertainty about career development & future employment prospects. Provide opportunities for social interaction among employees. Establish work schedules that are compatible with demands & responsibilities outside the job. Responsibility of the Organisation

29. How to manage your own Stress Smiling Your thoughts/ what are your 10 top qualities Exercise /Breathe Rest – take time out Support & Feedback

30. Hugging – for you to receive or give Relaxation – take it easy / Meditation 10 mins per day/Alternative therapies Balanced diet –obesity can increase stress levels. Reduce toxins smoking & alcohol work against the body Need Help – Ask!! Work / Life Balance:- use to do lists How to manage your own Stress

31. The Ten Commandments to Stress prevention Plan your day Build a balanced system Know your energy curve & concentration Be realistic you are not superhuman Learn to delegate Aim for satisfaction Learn to say ‘No’ assertively ! Look for things in your work to enjoy Laugh to reduce stress Make time for you

32. Thankyou • Any Questions