Professor Sayeed Khan

Transcription

1 Inside government: Reducing Sickness Absence: Improving Health and Productivity in the Workplace. March 2016 Striving to Reduce (unnecessary) Absence Tackling Stress Related Illness Professor Sayeed Khan MBBS, BMedSci, DGM, CMIOSH, FRCGP, FFOM, FRCP, FRSA, DM Chief Medical Adviser, EEF - the manufacturers' organisation Chief Occupational Physician, EEF OHS Member, Industrial Injuries Advisory Council Clinical co-lead RCGP NEP in Health and Work Site occupational physician for 2 factories Honorary Professor in Occupational Health, Univ of Nottingham

2 Stressed?

3 Thank you for the invitation Recognising the EXTENT to which stress and common mental health problems are the cause of long term sickness absence Outlining common early stress MARKERS and how to identify these and take ACTION at the earliest possible stage Working to tackle the root ORGANISATIONAL CAUSES of stress Developing health and wellbeing STRATEGIES that align with both organisational and employee interests

4 Stress extent Sick notes: Late 80s suffering from life Early 90s LBP Late 90s TATT / Stress Early 00s S/A/D Late 00s work-related stress

5 Stress extent [employers chose top 3 causes of long-term sickness absence ]

6 Stress extent % of employees taking no sickness absence Presenteeism? Unwell Untreated Unskilled Unsure Unmotivated

7 Stress markers Early markers no significant problems yet Come in early Work late Feel the need to work at weekends Take home paperwork, don t get the chance to do it, then feel guilty Don't take all your holiday entitlement No lunch break Saturday morning headaches Sunday night insomnia

8 Stress markers Later markers problems developing -ve behaviours Unusual response to a situation (irritable, unduly quiet) Blaming others Taking it out on someone else Procrastination Over-reacting ( catastrophization )

9 Stress markers Last markers significant problems

10 Stress markers Dealing with the main stressors Friends Finance Family Personality Health Work

11 Stress markers 3-round Delphi study involving academics, occupational physicians, psychiatrists and psychologists. Consensus was reached for 11 workplace stressors and 7 personal factors Wong MGP Poole CJM Agius R. Attribution of mental illness to work: a Delphi study. Occup Med (Lond) 2015;65: Personal factors 1. previous mental illness; 2. personality traits (neuroticism); 3. adverse life events 4. social circumstances; 5. resilience; 6. a family history of mental illness 7. potential secondary gain. Workplace stressors: 1. high job strain; 2. effort reward imbalance; 3. major trauma; 4. interpersonal conflict; 5. inadequate support; 6. role ambiguity; 7. person job mismatch; 8. organizational injustice; 9. organizational culture; 10.work scheduling 11.threats to job security.

12 Stress - action Recognise it! Rapid intervention (HASAWA, duties of employers) nervous breakdown, wait Occupational health input (liaise with GP) CBT (privately) / CPE (at work) Counsellors Employee Assistance Programmes MEDIATION Improve Rehabilitation. Avoid waiting for people to get better by staring at the wall ( treatment by fit note) Do get people to come in for a cup of tea Don t just look at work-related issues Identify other areas

13 Stress organisational causes

14 Stress organisational causes

15 Stress organisational causes

16 Stress organisational causes

17 Stress organisational causes

18 Stress organisational causes

19 Stress organisational causes Medicalisation of poor performers

20 Stress organisational causes Stress: HSE tool

21 Stress organisational causes 360 degree feedback probably better

22 Stress organisational causes Standard Hierarchy of control approach Eliminate Stress questionnaire

23 Stress organisational causes

24 Stress organisational causes HSE management standards on stress Demands. Control. Support. Relationships. Role. Change.

25 Stress organisational causes EEF Work Organisation Assessment Questionnaire Relationship with management. Being Valued. Physical Environment. Workload Issues. Relationship with colleagues

26 Stress organisational causes Category Correlation with job satisfaction Correlation with personal health Relationship with management. Being valued. Physical environment Workload Issues Relationship with colleagues 1 st 2 nd 3 rd 4 th 5 th 3 rd 4 th 2 nd 1 st 5 th

27 Stress organisational causes Standard Hierarchy of control approach Eliminate Substitute The Manager as stressor soft skills training Improve control measures PPE Stress questionnaire Stress Awareness Workshops/training for managers and for employees Wellbeing of employees Coping strategies in specific situations (complaints handlers) has its place in select situations (CBT in rehabilitation)

28 Stress strategies IDEAS - religious belief / or faith in anything / rituals (walk the dog) PLACES - house / childhood retreats - places you felt safe / shed THINGS - cars / personal photos / diaries/hobbies PEOPLE - long standing or special friends / family / partner ORGANISATIONS - church / club / professional body TECHNOLOGY - social media / TV / games console

29 Stress strategies number of talks at today s conference

30 Stress strategies Rank Employee attraction 1 Private medical insurance 2 Income protection insurance 3 Exercise advice or programmes 4 Wellbeing health checks 5 Online counselling % Employee retention 67 Income protection insurance 64 Private medical insurance % Reducing absence 68 Online counselling 48 Wellbeing health checks 25 Online counselling 31 Weight loss advice or programmes 24 Wellbeing health checks 24 Health promotion events 31 Health promotion events 30 Exercise advice or programmes % Improving health 71 Smoking cessation advice or programmes 68 Weight loss advice or programmes 66 Health promotion events 57 Exercise advice or programmes 56 Wellbeing health checks %

31 Stress strategies 37% with a potentially serious untreated health condition Urgent actions required to address issues Educate workforce in identifying & reporting issues Targeted programmes, follow-on actions Weight reduction, x,y,z locations needs education & counselling MSK, x location, ergonomic review Mental Health common themes, bullying, stress Requires management understanding / training More formal questionnaire assessment HR communication & counselling services

32 Stress productivity ST 100 Best Co 1. Leadership 2. My manager 3. Personal growth 4. Wellbeing 5. My team 6. Community giving 7. My company 8. Fair deal Workplace stressors: 1. effort reward imbalance; 2. interpersonal conflict; 3. inadequate support; 4. organizational injustice; 5. organizational culture; 6. work scheduling 7. threats to job security.

33 Thank you for listening Have you picked up at least one useful tip?