Managing Stress and Enhancing Wellbeing Policy

SH HR 08 Managing Stress and Enhancing Wellbeing Policy Version: 1 Summary: Keywords (minimum of 5): (To assist policy search engine) Target Audience: This document provides guidance to managers and staff on proactively and effectively managing stress and enhancing well-being, as part of day-to-day good working practices as well as when stress has been identified as an issue. Health & Safety; Stressors; Stress; Pressure; Risk Assessment; Well Being; Welfare; Stress Factors; Stress Management; Occupational Health; Employee Assistance Programme; EAP; HSE Management Standards; Guidelines for Managers; Guidelines for Staff. All Southern Health NHS Foundation Trust staff Next Review Date: October 2018 Approved by: Joint Consultative and Negotiating Committee Strategic Workforce Committee Date of meeting: 14 th June 2012 27 th June 2012 Ratified by: Trust Board Date of meeting: 25 September 2012 Date issued: Author: Sponsor: Liz Skeats - Sandra Grant Director of Workforce & Development 1

Version Control Change Record Date Author Version Page Reason for Change 16/4/15 1 Extend review date to July 2015 29/6/15 1 Extend review date to September 2015 24/9/15 1 Extend review date to December 2015 11/11/15 1 Review date extended to February 2016 27/1/16 1 Review date extended to March 2016 09/3/16 1 Review date extended to May 2016 13/5/2016 1 Review date extended to September 2016 28/9/16 Review date extended to Dec 2016 21/11/16 Review date extended to Feb 2017 20/2/17 Review date extended to Mar 2017 26/3/17 Review date extended to May 2017 12/5/17 Review date extended to August 2017 4/8/17 Review date extended to December 2017 9/11/17 Review date extended to Mar 2018 15/1/18 1 4 Section 1.4 updated details directing staff to other trust policies 2/2/2018 Review date extended to October 2018 Reviewers/contributors Name Position Version Reviewed & Date Human Resources Team, Staff Side and Joint Consultative and Negotiating Committee, 2

CONTENTS Page 1. Introduction. 4 2. Scope.. 4 3. Definitions.. 4 4. Roles and responsibilities 4 5. Policy 6 6. Monitoring compliance... 9 7. Policy review.. 10 8. Associated documents. 11 9. Supporting references. 11 Appendices A1 Indicators of Stress 12 A2 Guidelines for Managers.. 14 A3 Guidelines for Staff 16 A4 Equality Impact Assessment 18 3

1. Introduction 1.1. Southern Health NHS Foundation Trust (the Trust ) is committed to creating a working environment that promotes the health and well-being of its staff. To this end, the Trust believes that their staff is the most important asset and that their wellbeing is essential to effective work performance and the provision of high quality services. 1.2. The Trust specifically recognises that there will be times when an individual may experience excessive stress or negative pressures at work or in their personal life, which may affect their health, performance and ability to provide an efficient and effective service. 1.3. The Trust is specifically committed to minimising avoidable work related-stress and promoting staff well-being, as far as is reasonably practicable and having policies and procedures in place to support all staff. 1.4 The Trust also recognises the need to support staff involved in a Critical Incident, complaint or claim. (For further details please refer to Policy for Managing Incidents and Serious Incidents, Complaints, Concerns and Compliments Policy and Procedure and the Claims Management Policy). 2. Scope 2.1. This policy and its associated procedures will apply to all staff directly employed by the Trust other when specific conditions may apply e.g. to Medical and Dental staff. This also includes trainees, secondees and staff on honorary contracts or on joint contracts with the Trust and another employer. 3. Definition 3.1. The Health and Safety Executive defines stress as the adverse reaction people have to excessive pressure or other types of demand placed on them. This definition gives a clear distinction between pressure, which can be a positive state if managed correctly, and stress, which can be detrimental to health. 4. Roles and Responsibilities 4.1. Trust 4.1.1. The Trust has a legal duty of care to staff to ensure health at work, as set out in the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999. The Trust will ensure that its policies and practices reflect this duty and review the operation of these documents at regular intervals. 4

4.1.2. The Trust has a legal obligation under the Health and Safety legislation to manage the risks to the health and safety of staff. This means undertaking risk assessments as well as managing activities to reduce the incidences of stress in the workplace. 4.2. Managers 4.2.1. Managers must ensure that they take steps to reduce risks to staff health and wellbeing by: ensuring that the right people are recruited to the right jobs and that a good match is obtained between individuals recruited and job descriptions/specifications; keeping staff in the team up to date with developments at work and how these might affect their job and workload; ensuring that staff know who to approach with problems concerning their role and how to pursue issues; making sure jobs are designed fairly and that work is allocated appropriately between teams; ensuring that work stations are regularly risk assessed to ensure that they are appropriate and fit for purpose; undertaking risk assessments, evaluating risks identified, and ensure these are recorded and regularly monitored and reviewed; and providing support to staff. 4.2.2. Further guidelines for managers are shown at Appendix Two. 4.3. Staff 4.3.1. Staff must take responsibility for managing their own health and wellbeing, by adopting good health behaviours (for example in relation to diet, alcohol consumption and smoking) and informing the Trust if they believe work or the work environment poses a risk to their health. Any health-related information disclosed by a member of staff during discussions with managers, the HR department or the OH service is treated in confidence. 4.3.2. Further guidelines for staff are shown at Appendix Three. 4.4. Human Resources 4.4.1. The Director of Workforce & Development has delegated responsibility from the Board to ensure this Policy and associated procedure is properly implemented and monitored. 4.4.2. The Human Resources Team has a responsibility to ensure that the policy is followed, fairly and consistently. Their duties will involve: developing organisation-wide policies and procedures to protect the wellbeing of staff; assisting Line Managers in supporting individuals; and 5

liaising as appropriate with Occupational Health and other medical professionals, with the object of helping staff to maintain good health and wellbeing. 4.5. Occupational Health (OH) 4.5.1. OH will provide a service designed to help staff stay in work, or to return to work. This will include: providing advice and support to Trust staff in relation to preventing negative mental health at work and promoting positive mental health; preparing medical assessments of individuals' fitness for work following referrals from line managers and the Human Resources Team; alerting managers to situations where staff appear to be suffering from the effects of harmful stress at work and advise them accordingly; identifying support to staff with stress-related work problems including work related stress and working with individuals to help them to establish a work life balance; informing staff about the Employee Assistance Programme and prompt a referral if necessary; and supporting staff who have been off sick with stress and advise them and their managers on a planned return to work and rehabilitation plan where appropriate. 4.5.2. Human Resources, Occupational Health and the Employee Assistance Programme are able to provide guidance and assistance, which may include a referral to other services where necessary. 4.6. Trade Unions 4.6.1. Trade Unions shall endeavour to: preserve and promote positive mental health and to identify ways to reduce work-related stress within their areas; understand how to recognise the potential impact on mental health when decisions are made; make themselves accessible to their members and treat their problems in confidence and with respect; refer members for assistance through the appropriate organisational support mechanisms; and be available for advice and support. 5. Policy 5.1. What Is Stress? 5.1.1. Stress is an adverse reaction(s) experienced to too much (or too little) pressure. 6

5.1.2. Stress is what an individual may experience due to the pressures and demands placed upon them. All work has its pressures and individuals differ in their ability to be able to cope with different types of pressure. 5.1.3. Stress can also arise from the pressure people experience in their home and personal lives, e.g. bereavement, relationship or family problems, financial difficulties. These factors can make people more vulnerable to stress at work. 5.1.4. Staff and managers should be vigilant in recognising stress not only in themselves, but their colleagues and the staff they manage. 5.1.5. Examples of indicators of stress are illustrated at Appendix One. 5.2. Causes of Work-Related Stress 5.2.1. The HSE identifies the following potential causes of workplace stress in accordance with the HSE Management Standards: Demands examples are workload and/or exposure to physical hazards or difficult situations which have a negative impact on emotional wellbeing; Control - how much say the individual has in the way they carry out their work; Support from peers, colleagues and managers; Relationships with colleagues, and issues such as bullying and harassment; Role whether the individual understands their role in the organisation and if they have conflicting roles or role demands; Change how organisational change is managed and communicated in the organisation. 5.3. Prevention Of Work-Related Stress and Enhancement Of Wellbeing At Work 5.3.1. The Trust has been proactive in striving to create a work environment which enhances staff well-being and engagement, thereby taking a preventative approach towards work-related stress. To this end, the Trust has implemented a range of measures including organisational support, systems, processes, policies and procedures to reduce the adverse impact of stress and facilitate effective stress management and the enhancement of staff well-being. 5.4. Employee Assistance Programme (EAP) 5.4.1. Counselling, advice and support are available through the Employee Assistance Programme (EAP). This support gives individuals the opportunity to discuss and explore their problems in complete confidence with an independent experienced, sympathetic professional initially over the phone. 5.4.2. This approach provides short-term solution-focused counselling to assist staff in identifying the problem and developing a practical plan of action for resolving it, and can be effective in treating a wide range of occupational and domestic stress related issues. 5.4.3. The EAP is provided by Workplace Options; telephone number 0800243458; email assistance@workplaceoptions.com. 7

5.5. Procedure Principles 5.5.1. For a more detailed outline of the Managing Stress and Enhancing Wellbeing Procedure please refer to the separate procedure document. 5.5.2. In summary: If an individual believes they are suffering the negative effects of stress, rather than endlessly worrying about it, they are encouraged firstly to talk to their Line Manager. Alternatively an individual can contact the Human Resources Team or Occupational Health to discuss their concerns. A stress risk assessment should be carried out by the Line Manager for the individual using the HSE Management Standards/HSE stress indication tool questionnaire. Further details on completing the questionnaire and how to analyse the results are contained on the HSE website. Any work related stressors that are identified need to be managed effectively and reduced; assistance and support should also be given to allow the individual to deal with any external sources of stress, whether these are short or longer term. An individual may wish to discuss the possibility of changing their working conditions or making changes to reduce stress whilst recognising their own, their colleagues' and the Trust s needs. Regular review meetings between the Line Manager and the individual must be held to ensure appropriate support is being provided and agreed actions being taken. The regularity of the meetings should be agreed between the Line Manager and the individual as different situations will require a greater regularity of meetings than others. In all cases, if the Trust is aware that an individual is suffering from stress, appropriate steps will be taken to try to manage the situation this may include reviewing workloads, providing assistance, training or transferring to other duties. This will be done in discussion with the individual and may be on a temporary or permanent basis, as appropriate. 5.6. Training Requirements 5.6.1. Line Managers and staff should regularly discuss individual training needs to ensure that they have the necessary skills to adapt to ever-changing job demands. An analysis of training needs will be particularly important prior to, and during, periods of organisational change. 5.6.2. Managers and staff are encouraged to participate in communication/feedback exercises, including stress audits and staff surveys. All staff are expected to be aware of the importance of effective communication and to use the media most appropriate to the message, for example team meetings, one-to-one meetings, electronic communications and organisation-wide methods. The Trust will ensure that structures exist to give staff regular feedback on their performance, and for them to raise concerns. 8

6. Monitoring Compliance 6.1. Human Resources (HR) will monitor and analyse data on a quarterly basis. HR will use the data to monitor the implementation of the policy and management of cases. In addition, the data will be collated and analysed for information regarding stress risk assessments, at the organisational level, to highlight any trends and areas which require further action and interventions by the Trust. 6.2. Data can be obtained from the: Annual NHS Staff Opinion Survey Sickness absence data 6.3. Subsequently, the data will be used to inform and improve policies, as well as provide recommendations for improving working practices. HR will provide relevant reports, based on this data, to the Strategic Workforce Committee (SWC), Executive Board and the Joint Consultative and Negotiating Committee (JCNC). 6.4 The following table outlines the Trust s arrangements for monitoring compliance with this policy and its associated procedure. - Monitoring Compliance Element to be monitored Lead Tool Frequen cy Reporting arrangements Duties: (roles and responsibilities) are being delivered in-line with the Trust expectations. Head of HR - ICS Workforce report on levels of sickness absence, identifying reasons for absence. Twice yearly SWC and JCNC. Monitoring data from the EAP and OHU provider related to stress related referrals. Twice yearly SWC and JCNC. Process for how staff can access information on the management of work-related stress Head of HR - ICS Management and monitoring of the EAP and OUH provider. Review of number of contacts. Staff survey outcome, measuring staff awareness of EAP provider. Monthly Annual 6 monthly to SWC and JCNC. Annual update with the staff survey action plan; SWC and Board. 9

Process for how workplace stressors are identified Head of HR - ICS Management and monitoring reports from the EAP and OHU provider. Twice yearly SWC and JCNC. Analysis of staff survey using key factors associated with mental health & wellbeing Detailed report on sickness absence to JCNC twice a year. Annual Twice yearly Annual update with the staff survey action plan; SWC and Board JCNC Analyse data on a quarterly basis to the Strategic Workforce Committee (SWC), Executive Board and the Joint Consultative and Negotiating Committee (JCNC). Deputy Director of HR & Heads of HR Workforce report on levels of sickness absence, identifying reasons for absence. Monitoring data from the EAP and OHU provider related to stress related referrals. Twice yearly Twice yearly SWC and JCNC. SWC and JCNC. Process for how the organisation carries out risk assessments for the prevention and management of work-related stress HR Best Practice Lead Senior HRM Regular review programme of the Trust policies to integrate process. In-line with the HR policy review program me. Any changes to policies will be ratified through the relevant governance structures. 7. Policy Review 7.1. The policy and procedures contained within these documents will be in place for three years following approval of a review and amendments. An earlier review can take place should exceptional circumstances arise resulting from this policy; in whole or in part, being insufficient for the purpose and/or if there are legislative changes. 10

8. Associated Documents Special Leave policy Flexible Working policy Managing Sickness Absence Policy and Procedure Bullying and Harassment Policy and Procedure Equal Opportunities policy Maternity, Paternity and Adoption policy Grievance Policy and Procedure Code of Conduct for NHS Managers Disciplinary Policy and Procedure Organisational Change Policy and Procedure Performance and Development Review Policy Recruitment and Selection Policy Speak Up (Whistleblowing) Policy and Procedure Critical Incident Policy Managing High Professional Standards in the NHS 9. Supporting References www.hse.gov.uk/stress/standards/index.htm Health & Safety Executive s website containing information on work related stress and HSE Management Standards www.isma.org.uk The International Stress Management Association UK is the UK's leading association for stress management professionals. www.samaritans.org.uk The Samaritans is an organisation which aims to benefit society by improving people s emotional health in order to create a greater sense of wellbeing. www.mind.org.uk Mind is a mental health charity which provides support and advice to individuals. 11

APPENDIX ONE INDICATORS OF STRESS These are some of the symptoms that are indicators of too much pressure that can come from the individual, work, home, any combination of, or maybe even all three. Psychological Signs Inability to concentrate or make simple decisions Memory lapses Becoming rather vague Easily distracted Less intuitive & creative Worrying Negative thinking Depression & anxiety Emotional Signs Tearful Irritable Mood swings Extra sensitive to criticism Defensive Feeling out of control Lack of motivation Angry Frustrated Physical Signs Lack of confidence Lack of self-esteem Aches/pains & muscle tension/grinding teeth Frequent colds/infections Allergies/rashes/skin irritations Constipation/diarrhoea/IBS Weight loss or gain Indigestion/heartburn/ulcers Hyperventilating/lump in the throat/pins & needles Dizziness/palpitations Panic attacks/nausea 12

Physical tiredness Menstrual changes/loss of libido/sexual problems Heart problems/high blood pressure Behavioural Signs No time for relaxation or pleasurable activities Prone to accidents, forgetfulness Increased reliance on alcohol, smoking, caffeine, recreational or illegal drugs Becoming a workaholic Poor time management and/or poor standards of work Absenteeism Self-neglect/change in appearance Social withdrawal Relationship problems Insomnia or waking tired Reckless Aggressive/anger outbursts Nervous Uncharacteristically lying Information taken from www.isma.org.uk 13

APPENDIX TWO - GUIDELINES FOR MANAGERS What Do Line Managers Need To Do To Prevent And Reduce Stress? Good people management practices can help to reduce the incidence of work related stress. The following areas are particularly relevant: Recruitment and Selection Jobs should be well designed with a clear job description and realistic workload. Recruiting the wrong person into a job can lead to a very stressful situation for the whole team. If a job is known to involve exposure to stressful situations, then this needs to be clear to job applicants and taken into account during recruitment. Staff Induction Starting a new job can be exciting, but also stressful, and a good induction programme in the workplace can help a new team member to settle in more quickly and reduce stress within the team. Workload Management All staff should have manageable workloads. Team work and work re-allocation should be considered, particularly where peaks and troughs of work demand occur. Systems should be in place for re-prioritising work at times of high demand or high staff absence. If workload increases above a manageable level, senior managers should be made aware of this. Supervision and Appraisal All staff should receive regular line management supervision, and an appraisal at least once a year. In addition, staff must be offered opportunity to raise issues with their Line Manager as and when they arise. Management Style Managers need to be aware of their own personal style, and whether they are perceived as approachable and supportive by staff. Some staff are very self motivated and require minimal supervision. Others require more support and guidance. Training and Development All staff should have a personal development plan detailing the training and development they need to perform their role effectively. Lack of training can be a cause of poor performance and stress. 14

Change Management and Communication Managers should ensure effective two-way communication with staff, to include proper consultation processes and listening to feedback. Communication should include one to one meetings and team meetings. Staff should be involved in decisions which affect them. Prolonged uncertainty for staff can be very stressful and good leadership is required at these times. Conflict Between Staff Where there is conflict within the team, this needs to be actively addressed by the manager. Support and advice is available from the Human Resources team, and external mediation is a possible option. Bullying and harassment can be a major stressor, and will not be tolerated. Please refer to the Bullying and Harassment Policy and Procedure for further details. Absence Management and Return to Work Returning to work after a period of absence can be stressful and extra support from the Line Manager and colleagues may be required to integrate the individual back into the team. Support for Staff Managers are expected to support their staff in dealing with stress and to actively manage and minimise any stressors within the workplace. It is recognised that individuals respond differently to pressures, and that different strategies will be needed for different individuals. The Employee Assistance Programme (EAP) is available to all staff with either work or nonwork related issues. The Trust s flexible working policies can help to support staff through stressful situations at home. The Occupational Health service can help with work related issues. Critical Incidents Support should be provided to any staff involved in such incidents. Please refer to the Critical Incident Policy for further details. 15

APPENDIX THREE - GUIDELINES FOR STAFF Personal Stress Management Guide For Staff There is a difference between stress and pressure. Individuals may experience pressures on a daily basis, and need it to motivate us and enable us to perform at our best. It s when too much pressure is experienced without the opportunity to recover that stress may be experienced. Stress affects people in different ways at different times, and is often the result of a combination of factors in personal and working lives. Work-related stress can be tackled by working with the Line Manager to identify any issues at source and agree realistic and workable ways to manage them. Every individual has a responsibility to look after their own physical and mental wellbeing, and to take action to prevent stressful situations developing wherever possible. Prevention Includes: Maintaining an open and constructive dialogue with the Line Manager about any issues which may affect work, including any relevant personal issues. Treating all colleagues with respect, and being willing to engage in processes to resolve conflict if it occurs. Taking a positive approach to organisational change. Ensuring own personal effectiveness including good time management, assertive communication with others, and maintaining a support network. Raising any issues of concern to the Line Manager (if possible) in the first instance. If not resolved, raising issues with other colleagues or Trade Union Representatives as appropriate. From an individual s perspective, awareness of the signs/symptoms of stress and being willing to seek, receive or offer support as appropriate. Individuals react differently to life s challenges, and what one person may find stressful, another person may not. Examples of indicators of stress are shown at Appendix One, Self-Help: An individual can take action to improve their own resilience and personal effectiveness: Use of support network. Talk things over with someone that can be trusted and be prepared to ask for support - don t try to be strong all the time. Develop good time management skills and set realistic achievable goals don t try to be a perfectionist. Practice effective communication be assertive, be specific, give and receive constructive feedback. Take allocated breaks away from desk / work place. 16

When To Seek Support: If an individual feels that their behaviour and/or symptoms are affecting their work, or if they feel they are not coping, overwhelmed or unable to face work, then support must be sought. 17

APPENDIX FOUR - Southern Health NHS Foundation Trust: Equality Impact Analysis Screening Tool Equality Impact Assessment (or Equality Analysis ) is a process of systematically analysing a new or existing policy/practice or service to identify what impact or likely impact it will have on protected groups. It involves using equality information, and the results of engagement with protected groups and others, to understand the actual effect or the potential effect of your functions, policies or decisions. The form is a written record that demonstrates that you have shown due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations with respect to the characteristics protected by equality law. For guidance and support in completing this form please contact a member of the Equality and Diversity team. Name of policy/service/project/plan: Managing Stress and Enhancing Wellbeing Policy and Procedure Policy Number: SH HR 08 Department: Human Resources Lead officer for assessment: Liz Skeats: Head of HR (ICS) Amanda Goodwin: Lead Manager for Workforce Resourcing & Planning Jon Monahan: HR Manager Ricky Somal: E&D Lead Date Assessment Carried Out: July 2012 1. Identify the aims of the policy and how it is implemented. Key questions Briefly describe purpose of the policy including How the policy is delivered and by whom Intended outcomes Answers / Notes Southern Health NHS Foundation Trust (the Trust ) is committed to creating a working environment that promotes the health and well-being of its staff. To this end, the Trust believes that their staff is the most important asset and that their well-being is essential to effective work performance and the provision of high quality services. A fair, consistent, equitable and sensitive guidance is provided for employees and managers to proactively identify potential risks of, or actual, work-related stressors and eliminate or minimise its adverse impact, as far as is reasonably practicable. Subsequently, to provide opportunities to enhance employee well-being. 2. Consideration of available data, research and information Monitoring data and other information involves using equality information, and the results of engagement with protected groups and others, to understand the actual effect or the 18

potential effect of your functions, policies or decisions. It can help you to identify practical steps to tackle any negative effects or discrimination, to advance equality and to foster good relations. Please consider the availability of the following as potential sources: Demographic data and other statistics, including census findings Recent research findings (local and national) Results from consultation or engagement you have undertaken Service user monitoring data Information from relevant groups or agencies, for example trade unions and voluntary/community organisations Analysis of records of enquiries about your service, or complaints or compliments about them Recommendations of external inspections or audit reports Key questions 2.1 What is the equalities profile of the team delivering the service/policy? Data, research and information that you can refer to The Equality and Diversity team will report on Workforce data on an annual basis. 2.2 What equalities training have staff received? All Trust staff have a requirement to undertake Equality and Diversity training as part of Organisational Induction (Respect and Values) and E- Assessment 2.3 What is the equalities profile of service users? The Trust Equality and Diversity team report on Trust patient equality data profiling on an annual basis 2.4 What other data do you have in terms of service users or staff? (e.g results of customer satisfaction surveys, consultation findings). Are there any gaps? As part of one of the world s largest employers, the health and wellbeing of our workforce together with that of all other NHS Trusts, is crucial to the delivery of the improvements in patient care envisaged in the NHS The Trust is preparing to implement the Equality Delivery System (EDS) which will allow a robust examination of Trust performance on Equality, Diversity and 19

Constitution. Southern Health has embraced the findings of the Boorman review which identified that organisations that prioritised staff health and wellbeing performed better, with improved patient satisfaction, stronger quality scores, better outcomes, higher levels of staff retention and lower rates of sickness absence. Human Resources will use workforce data to monitor the effectiveness and implementation of the policy and interventions and management of further risks from work-related stressors The Trust will gather data to evidence its compliance with the EDS: monitoring data can be reported against workforce data ; using Electronic Staff Records (ESR) system. Human Rights. This will be based on 4 key objectives that include: 1. Better health outcomes for all 2. Improved patient access and experience 3. Empowered, engaged and included staff 4. Inclusive leadership 2.5 What internal engagement or consultation has been undertaken as part of this EIA and with whom? What were the results? Service users/carers/staff 2.6 What external engagement or consultation has been undertaken as part of this EIA and with whom? What were the results? General Public/Commissioners/Local Authority/Voluntary Organisations In the table below, please describe how the proposals will have a positive impact on service users or staff. Please also record any potential negative impact on equality of opportunity for the target: In the case of negative impact, please indicate any measures planned to mitigate against this. 20

Age Positive impact (including examples of what the policy/service has done to promote equality) The Trust has adopted the EDS and will monitor sickness absence occurring as a result from stress by protected groups Ageing, work related stress and health: Age Concern explored the relationship age and reported work related stress. This document can be obtained from the Trust Equality and Diversity Lead Negative Impact HSE Statistics show that: The majority of cases of work-related mental-ill-health occur in those aged 35-44 and 45-54 years More cases amongst women in the 25-34 years age group, and more cases amongst men in the 35-44 years age group. Smith A et al. The scale of occupational stress: A further analysis of the impact of demographic factors and type of job, HSE Contract Research Report No. 311/2000, 2000 Action Plan to address negative impact Actions to overcome problem/barrier Applied to all protected characteristics: The Trust will analyse workforce data by protected characteristics to identify any trends or themes National Research articles and reviews can be obtained from the Trust E&D Lead Resources required ESR Trust Risk Assessment Action Plan HSE Management Standards Responsibility E&D Lead/Human Resources Target date EDS Annual Workforce Data Reports (March 2012-16) Policy review Appendix 2 of the A stress related injury The Trust will Risk Trust Policy review 21

Disability Gender Reassignment Marriage and Civil Partnership Procedure highlights that stress-related illness, in certain circumstances, may be covered under the Equality Act. Subsequently, the Trust has an obligation to make reasonable adjustments, where practicable. The Trust has adopted the EDS and will monitor sickness absence occurring as a result from stress by protected groups The Trust has adopted the EDS and will monitor sickness absence occurring as a result from stress by protected groups may constitute a disability for the purposes of the Disability Discrimination Act if it is an impairment that has a substantial and long-term adverse effect on the employee s ability to carry out day-to-day activities The social transition from one gender to the other in itself is a vast undertaking, dealing with the social and personal rejection that can follow, taking powerful hormones to change the body and feelings, undergoing major and minor surgery and more The impact of pressures within personal life cannot be ignored and may have an impact on work performance respond positively to requests of reasonable adjustments The Trust will raise awareness of gender reassignment through Respect and Values training at Organisational Induction, Diversity Champions Network and other methods communication This policy and procedure helps staff to identify the effects of stress and allow the Trust to Assessment Action Plan HSE Management Standards Respect and Values at organisation al induction Risk Assessment Action Plan HSE Management Standards Risk Assessment Action Plan HSE Management Managers/Occupational Health E&D Lead/LEaD Trust Managers/Occupational Health Trust Managers/Occupational Health Organisational Induction Policy Review 22

Pregnancy and Maternity Race Religion or Belief The Trust has adopted the EDS and will monitor sickness absence occurring as a result from stress by protected groups The Trust has adopted the EDS and will monitor sickness absence occurring as a result from stress by protected groups The Trust responds positively to requests of information in alternative formats The Trust has adopted the EDS and will monitor sickness absence occurring as a result from stress by protected groups The impact of pressures within personal life cannot be ignored and may have an impact on work performance HSE report stress is 29.1% more prevalent amongst black and minority ethnic workers than white workers Smith A et al, The scale of occupational stress: A further analysis of the impact of demographic factors and type of job, 2000 No negative impacts have been identified at this stage of screening how ever through the EDS the Trust will monitor any negative support staff with appropriate and supportive action This policy and procedure helps staff to identify the effects of stress and allow the Trust to support staff with appropriate and supportive action This policy and procedure helps staff to identify the effects of stress and allow the Trust to support staff with appropriate and supportive action Access to communication: interpreting and translation service EDS Workforce Data Monitoring Standards Risk Assessment Action Plan HSE Management Standards Risk Assessment Action Plan HSE Management Standards ESR Trust Managers/Occupational Health Trust Managers/Occupational Health Human Resources/E&D Lead Policy Review Policy Review Policy review 23

Sex The Trust has adopted the EDS and will monitor sickness absence occurring as a result from stress by protected groups impacts HSE and Age Concern have highlighted gender differences in work related stress: through the EDS the Trust will monitor any negative impacts EDS Workforce Data Monitoring ESR Human Resources/E&D Lead Policy review Sexual Orientation The Trust has adopted the EDS and will monitor sickness absence occurring as a result from stress by protected groups No negative impacts have been identified at this stage of screening how ever through the EDS the Trust will monitor any negative impacts EDS Workforce Data Monitoring ESR Human Resources/E&D Lead Policy review 24