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An IHS Guide

Produced by: Janet Perkin

August 2006

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What is Stress?
In Japan there is a cause of death called Karoshi, it claims 10,000 lives a year, it is regarded
as sudden death from over work. Stress related absence is said to have increased by 500%
since the mid 1950s in the UK alone. It is the second-biggest cause of work-related illness
in Britain, and costs employers about 400 million per year. The wider cost to society has
been calculated at around 4 billion a year.
Stress can mean different things to different people and is often a generic term for a set of
symptoms which can be related to life, work and environmental situations.
Much of the research carried out in relation to stress has shown that there is a link between
poor work organisation and subsequent ill health of employees.
The Health and Safety Executive (HSE) define stress as:
the adverse reaction people have to excessive pressure or other types of demand placed on
This definition makes an important distinction between pressure, which can be a positive
state and improve performance if managed correctly, and stress, which can be detrimental to
It is important to recognise that stress is not necessarily a bad thing. Within certain limits an
individuals performance improves with increased levels of stress. When stress becomes
excessive performance drops off.
Research carried out by the HSE has shown that up to 5 million people in the UK feel very or
extremely stressed by their work and approximately half a million people believe they are
experiencing stress to such an extent that they are being made ill by it.
It should also be remembered that in some cases stress can be a sign of medical problems and
employees should always be advised to seek medical advice.

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What are the effects of stress on employees?

There are various effects associated with stress. Each employee is individual and the
reactions are likely to be different, both physically and mentally. Some of the common
symptoms, which are often indicators that a person is suffering from stress, are as follows:

Lack of concentration
Unable to relax
Cannot think clearly
Distressed and irritable
Lack of self esteem
Does not enjoy work
Depressed and negative about everything
Tired and sleepy
Reduction in effectiveness of immune system
Heart disease
Psychiatric illness

These are just some of the symptoms which may occur. Each individual is different and the
type, severity and number of symptoms will vary accordingly.
Individuals are no longer able to keep going with their job. It tends to occur amongst highly
motivated individuals. It is seen to be linked with trying to achie ve individual and
organisational objectives and becoming frustrated in not being able to achieve the desired
outcomes. This frustration causes a spiral of increasing stress that leaves the individual
exhausted. Burnout often manifests itself as poor performance, poor decision-making,
negative attitudes and exhaustion.
Stress may also result from home pressures, money, family etc. Managers must deal with
these situations sympathetically.
What are the effects of stress on the employer?
If employees are suffering from stress while they are at work, the costs to the business and
the performance will be affected. Work stress can result in:

An increase in time off work due to ill health

An increase in accidents at work, due to tiredness, which in turn leads to lost time,
stoppages and near misses. These may lead to an increase in civil claims, and
increased compensation and insurance premiums.
An increase in staff turnover, which in turn adds to costs of recruitment and training.
An increase in customer complaints, if staff are customer facing and are tired and
A decrease in overall performance and productivity

It is estimated that 30-40% of all sickness absence from work is attributed to some form of
mental or emotional disturbance (whether work related or not!)

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People do not work effectively under stress and may induce stress into colleagues.
Reducing stress is cost effective and will lead to lower sickness rates, improved performance
and less staff turnover.
Estimates from Self- Reported Work-Related Illness (SW101/02) Survey 2001/2 indicate that
depression or anxiety account for an estimated thirteen and a half million reported lost
working days per year.
What is the law which relates to stress at work?
There is no specific law relating to stress at work, and it not mentioned specifically in any
health and safety legislation. It is recognised by the HSE as a serious work hazard and
extensive guidance and standards have been issued by them, advising on how to deal with it.
The HSE have set up a specific website specifically for stress related advice and information
The HSE argue that having a positive, satisfied and psychologically healthy workforce will
produce economic benefits, through improved attendance, motivation and commitment. The
law requires employers to tackle work related stress. Under the Health and Safety At Work
etc Act 1974 employers have a general duty to ensure, so far as reasonably practicable, the
health of their employees at work. This includes taking steps to make sure that they do not
suffer stress-related illness as a result of their work.
Employers must take account of the risk of stress-related ill health when meeting their
obligation under the Management of Health and Safety Work Regulations 1999. The main
provision of these Regulations, as far as stress is concerned is a duty to assess; a duty to apply
the principle of prevention; a duty to ensure employees capability to provide training; duties
towards young people.
New landmark rulings were made by the Court of Appeal in the case of Sutherland V Hatton
and others 2002. The court set out a number of practical propositions for the future claims
concerning workplace stress:

Employers are entitled to take what they are told by employees at face value unless
they have good reason to think otherwise. They do not have a duty to make searching
enquiries about employees mental health

An employer will not be in breach of duty in allowing a willing employee to continue

in a stressful job if the only alternative is to dismiss or demote them. The employee
must decide whether to risk a breakdown in their health by staying in the job

Indications of impending harm to health at work must be clear enough to show an

employer that action should be taken, in order for a duty on an employer to take
action to arise

The employer is in breach of duty only if he fails to take steps which are reasonable,
bearing in mind the size of the risk, gravity of harm, the cost of preventing it and any
justification for taking the risk

No type of work may be regarded as intrinsically dangerous to mental health

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Employers who offer a confidential counselling advice service, with access to

treatment, are unlikely to be found in breach of duty

Employees must show that illness has been caused by a breach of duty, not merely
occupational stress

Compensation will be reduced to take account of pre-existing conditions or the chance

that the claimant would have fallen ill in any event

Are employers responsible for controlling stress at work?

Yes, employers have a duty to ensure health, safety and welfare of their employees. Every
employer should be concerned about stress not only because of the legal responsibilities, but
also because of the moral and common-law responsibilities on employers to have a duty of
care to their employees.
All employers are increasingly at risk from being sued by their employees for stress and
many cases have succeeded in the civil courts.
It is the responsibility of the employer to show that he has discharged his duty of care to his
Civil claims for stress are increasingly successful and stress management is becoming a
prerequisite for insurance cover under Employers Liability insurance.
How to determine if there is a problem with stress in the workplace?
There are five major categories of work related stress:

Factors intrinsic to the job

Role in the organisation
Relationships at work
Career development
Organisational Structure and climate

Factors Intrinsic to the Job

Working conditions e.g. changes in noise, lighting, speed of work, physical exertion
and repetition
Shift work impacts on blood temperature, metabolic rate, blood sugar levels, mental
efficiency, motivation, sleep patterns and social life
Long hours It has been suggested that beyond 40 hours a week, time spent working
is increasingly unproductive and can create ill health
Risk and danger the individual may be in a constant state of arousal the associated
adrenaline rush, respiration changes and muscle tension may all be threatening to long
term health. Note that appropriate training and equipment may support the individual
to cope with the situation
New technology the need to adapt to new ways of working may exert pressure
Work overload quantitative overload refers simply to having too much to do.
Qualitative workload refers to work that is too difficult for the individual

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Work under-load not being sufficiently challenged by work e.g. repetitive, boring
and un-stimulating

Role in the Organisation

Role ambiguity not having a clear idea about ones work objectives, responsibilities
or others
Role conflict job demands may be conflicting, the individual may have to perform
things they dont want to do or things they dont believe are part of the job. The
individual may find themselves torn between different groups within the organisation.
The ability to cope may vary with personality
Role incompatibility the person and the job may not fit
Responsibility responsibility in organisations usually relate to people and things,
this in itself can cause stress

Relationships at Work - possible stressors include:

Relationships with superiors

Relationships with subordinates
Relationships with colleagues

Career Development - stress may be linked to:

Opportunities for promotion and reward and perceived in equality

Job security
Performance review

Organisational Structure and Climate - Issues may include:

Lack of participation
Not identifying with the organisation
Organisational structure of change/review

Unemployment Stress may arise from:

Loss of identity
Loss of social contact
Loss of security
Loss of income
Loss of time structure

How to establish if there is a problem of stress in the workplace

Consulting with employees is essential and this can be done via trade union representatives,
employee representatives or at staff meetings. Remember to include everyone, it is not only
management who can suffer from stress.

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Questionnaires can be a good starting point, and should be anonymous so as not to intimidate
people. Check records for levels of absenteeism do certain departments or teams have a
higher level of absenteeism than others.
Employers should involve employees at every stage of the fact finding, they are the ones who
know what is going on and can provide a true picture of the situation within the workplace.
In effect this fact finding is like carrying out a risk assessment. Regulation 3 of the
Management of Health and Safety Regulatio ns 1999 requires employers to assess risks to
health and safety from hazards at work. The five steps to risk assessment are as follows:1.

Identify the hazards

Decide who might be harmed and how
Evaluate the risk by: Identifying what is being done; deciding whether it is enough;
deciding what more needs to be done
Record the significant findings of the assessment
Review the assessment at appropriate intervals


Step 1 - Identify the Hazards Determining if there is a Problem

Informal talks with staff

Performance appraisal
Focus groups
Managing and monitoring attendance including return to work interviews
Sickness/absence data
Productivity data

The HSE draw attention to seven broad categories of risk factors for work-related stress.

Culture of the organisation and how it approaches work related stress


Demands such as work load and exposure to physical hazards


Control how much say a person has in the way they do their work


Relationships covering issues such as bullying and harassment


Change how organisational change is managed and communicated in the organisation


Role whether the person understands their role in the organisation and whether their
organisation ensures that the person does not have conflicting roles.


Support and training - factors unique to the individual

Step 2 - Decide Who Might Be Harmed

Work-related stress can affect any member of your team, those exposed to the risk factors
identified by the HSE may be affected.
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At particular times in their lives people may be more vulnerable to work-related stress e.g.
major life event.
The ability to cope with stress varies from individual to individual.
Step 3 - Evaluate the Risk
For each of the hazards identified in step 1, three questions need to be asked:
1. What actions are you already taking?
2. Is it enough?
3. What more do you need to do?
Regulation 4 of the Management of Health and Safety at Work Regulations 1999 states in
controlling risks, the principles below must be applied in the following order:

Avoid risks (e.g. make the work environment safer so staff are not anxious about the
risk of violence)


Evaluate risks which cannot be avoided


Combat risks at source (e.g. organise work appropriately and clarify roles)


Adapt the work to the individual


Develop a coherent protection policy covering issues such as organisation of work,

working conditions and relationships


Give collective protective measures priority over individual protective measures (e.g.
by tackling risk at source rather than just providing information and training to
individuals, or access to employee assistance programmes)


Give appropriate instruction to employees

Step 4 - Record the Significant Findings of the Assessment

The Management of Health and Safety at Work Regulations require employers to undertake a
suitable and sufficient risk assessment.
Regulation 3(6) requires that if an employer employs five or more employees they must
record the significant findings of the risk assessment and any group of employees identified
as being especially at risk.
Step 5 - Review the Assessment at Regular Intervals
Regulation 3(3) of The Management of Health and Safety at Work Regulations state that the
risk assessment must be reviewed whenever there is reason to believe that it is no longer
valid. The HSE suggest at first review the assessment every six months. If after a year this
period is seen to be too frequent (i.e. no significant changes) move to an annual review
Assessments should be revised if there are forthcoming changes that could affect employees.
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Changes in staff or individual employees circumstances ma y affect the risk assessment.

What solutions can be put in place to control stress?
The following table shows the risk factor and possible solutions associated with each risk. It
should be used as a guide as to the possible solutions which could be implemented in the
workplace, but remember each situation is different and a suitable solution should be agreed
by all concerned.
Risk Factor

Areas included
Working patterns
Physical environment


Input by employees on the

way they work


Level of support provided

by managers and


Promoting positive
working to avoid conflict
Address unacceptable


Understanding of
individual roles with the
Conflicting roles within the


Managing and
organisational change

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Possible Solutions
Regular meetings
Discuss anticipated workload and
Develop personal work plans
Adjust working patterns
Ensure people are appropriately trained
for the task
Implement systems where employees
have a say
Discussion forums
Discuss employees skills and the way they
are used
Regular one to ones
Team meetings to discuss pressures
Ask how employees would like to have
access to managerial support
Develop training, including refresher
Provide a written policy for dealing with
unacceptable behaviour and communicate
Agree and implement procedures to
prevent or quickly deal with conflict
Encourage good communication
Hold team meetings so that employees
can clarify their roles
Display targets and objectives
Agree specific performance standards and
review periodically
Introduce personal work plans
Develop suitable inductions
Ensure staff are aware of why change is
Define and explain key steps of change
Ensure staff are aware of the impact of the
change on their jobs

All of the following set out to improve the overall situation in the workplace by
implementing the actions revealed as necessary by the risk assessment process. This may
include for example:

Stress Management Training

Stress Awareness Training
Complementary Training
Self Help Staff Booklets
A Stress Management Policy

Whereas the following deal with the treatment and rehabilitation of individuals who have
already suffered ill health as a result of stress.

Support schemes for employees who want to discuss their problems confidentially
with someone outside the organisation.
Personal counselling for staff either using an in house team or by referral to external

Other strategies which could be implemented include:Positive Organisational Responses to Stress

Job design e.g. make the job interesting, ensure it does not make unreasonable
demands: are long hours and taking work home considered the norm

Involvement and communication people may gain a greater understanding of the

organisation and the rationale for actions, ambiguity may be reduced and sources of
stress identified and acceptable strategies deve loped. This can be used as part of a
strategy to cope with change

Awareness programs provide people with information on the existence,

manifestation and management of stress

Health programs boost the individuals capacity to cope with stress

Organisational design the physical structuring of the organisation

Personal development boost the individuals feelings of competence but also as a

means of relaxation

Personnel policies flexible working, crche facilities

Procedural frameworks provide guidance to staff on how to deal with situations and
so reduce stress related to uncertainty

Improving the physical environment ensure that factors such as heat, light and
ventilation are appropriate

Improving the psychosocial environment e.g. bullying and harassment

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Conflict Management

Planning plan workloads; provide clarity in relatio n to roles and responsibilities.

Ensure that the workload is appropriate and that employees have the necessary
capability and capacity. Remember under- load as well as overload can cause stress

Culture design create a supportive culture, encourage participation, communication,

support and mutual respect, recognise and deal with issues

Training and recruitment ensure that there is an appropriate fit between individuals
and the job

Provision of support services e.g. counselling

Other Considerations
Managers must be aware and communicate that:

stress related problems are not a sign of weakness

pressure of excess workloads can trigger illness
stress and illness can be related

Managers should encourage:

group problem solving to discuss perceived causes of stress

develops supporting culture and improve coping techniques

Strategies for senior mangers include:

Ensuring they are accessible to staff to discuss problems and anxieties.

Taking lead in changing the view that being under stress is a reflection of personal
Revising effective induction and introduction programmes for new staff.
Encouraging staff to talk about their feelings and effects of stress.
Encouraging, commending and recognising supportive behaviour of others.
Developing co-operative rather than adverse management styles.
Engendering team spirit.

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What other techniques are available for alleviating the symptoms of anxiety and
reducing tension?
1. Relaxation:

deep muscle relaxation

breathing exercise

2. Exercise:

reduces tension and enhances mood

will also increase resilience to stress

3. Medication (can be useful in short term)

4. Interpersonal Skills:


5. Support Groups:

enhancement of professional skills

in house training

6. Lifestyle:

Maintain balance between work and non work related interests e.g. diet, holidays,
hobbies etc.

7. Professional help and counselling

Stress is not good for the work culture and employers must tackle it positively, assessing its
risks and adopting organisational strategies.
A more open and informed attitude to problems of stress will also help people emerge from
the isolation of their own anxieties.
It is important to talk

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Stress Monitoring Programme

Personal Record Form
Date: .................................................................................................. Time: ........................
Work Activities giving rise to excessive pressure in employees opinion and why

Other General Work Load (comments by Manager)

Factors in work load identified by Manager which may cause stress at a high level
for a prolonged period of time:

Measures agreed to help reduce stress levels and exposure times:

Review Date (no later than 4 weeks): ...................................Time: .........................

Signed Manager: ......................................... Employee: ..........................................

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Stress Monitoring Programme

Review Form
Date: .................................................................................................. Time: ........................
Effectiveness of measures agreed to reduce stress levels as discussed at meeting on

Further/continuing measures required?

If yes please detail:


If yes:



Review Date (no later than 4 weeks): ...................................Time: .........................

Signed Manager: ......................................... Employee: ..........................................

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PART 2.0 - Toolbox Talk


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Stress - What is it?

The Health and Safety Executive (HSE)
define stress as:
the adverse reaction people have to
excessive pressure or other types of
demand placed on them

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What are the effects of stress?

Symptoms include:

Lack of concentration
Unable to relax
Distressed and irritable
Lack of self esteem
Depressed and negative

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How can this affect you?

Increase risk of accidents
Increase in time off work due to ill
Increase in customer complaints
Decrease in overall performance and

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What are an employers duties?

Must take account of stress related illness, by
carrying out a risk assessment
1. Identify the hazards
2. Decide who might be harmed and how
3. Evaluate the risk by identifying what is being done,
deciding whether it is enough and what more needs to be
4. Record significant findings
5. Review the assessment at appropriate intervals

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Stress Risk Assessment

Divide into 2s and discuss what jobs or
activities could be considered stressful in
your workplace.
Discuss what you think can be done to
reduce possible effects of stress associated
with those activities

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What can be done?

Management to discuss anticipated workload and
concerns with employees
Adjust working patterns
Regular team meetings and individual discussions
Company to provide appropriate training
Encourage good communication in all directions
Ask managers to display targets and objectives
If you dont understand anything ASK!

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Some things to consider: Talk about the problems being

Be open-minded as to what could change
Be flexible
Encourage management to create a
supportive company culture

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Some things to consider

(continued): Stress is not a weakness it is a symptom
of something which needs to be improved
Manage your work patterns sensibly
Generate some fun in the workplace!!

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Workplace stress can be a real issue, we

want to make sure that you dont suffer
with it.
Remember; Talk to your manager if you
are concerned that you may be suffering
from the symptoms of stress, dont suffer
in silence

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