Beyond Breaking Point?

Key ResultsRachael

McIlroy

Beyond Breaking Point?

Online survey of 2,008 members Followed up with telephone interviews

of 22 respondents – cross-section of age, ethnicity, employer, area of practice

HSE Management Standards Key part of research uses HSE Management

Standards for work related stress Define the characteristics, or culture, of an

organisation where risks from work related stress are being effectively managed and controlled

Cover six key areas of work design that, if not properly managed, are associated with poor health and well-being, lower productivity and increased sickness absence.

HSE Management Standards – 6 areas of work design

Demands – workload, work patterns, work environment

Control – how much say you have in how you work Support – encouragement, support and resources

provided by org, line manager and colleagues Role – whether you understand role in the org and

whether org ensures no conflict in roles Relationships – positive working to avoid conflict

and minimising unacceptable behaviour

HSE Management Standards – question examples Demands I have to work very intensively Different groups demand things that are hard

to combine I have unrealistic time pressures

Control I have a choice in deciding what I do I have a choice in deciding how I do my work

HSE Management StandardsManagerial support I am given supportive feedback

Peer support If work gets difficult, colleagues will help me

Role I am clear about goals, objectives for my dept I am clear what is expected of me

Change Staff are always consulted about change

HSE Management Standards1=low wellbeing 5= high wellbeing

HSE Management Standards

Demands – urgent action needed

Long working hours, unrealistic time pressures and unachievable deadlines

Control – urgent action needed

Little control over the way they work and what they do at work

HSE Management Standards

Managerial support – good but room for improvement

Fairly good relationships with line managers, but problems lie with senior managers

Peer support – clear need for improvement

Support from colleagues is essential when dealing with heavy workloads

HSE Management Standards

Role – good but room for improvement

More confidence about own role than how it fits into wider org objectives

Change – urgent action needed

Very negative score on engagement in workplace change

Main reasons for high levels of stress

Workload Staff shortages Not enough time to do job Rest breaks Poor management Working long hours

Presenteeism – over previous 12 months have you gone to work despite feeling should take sick leave?

Presenteeism – other results NHS Staff Survey England

69% of all staff and 73% nurses had attended work in previous 3 months despite not feeling well enough

NHS Staff Survey Wales

70% of all staff attended work in previous 3 months despite not feeling well enough

Presenteeism - pressures Sickness absence policies Link between sickness absence and

reorganisation Worries about impact on

colleagues/patients Staff shortages and workload Feelings of guilt – internal or external Workplace culture

Personal experience of bullying and violence

Verbal or physical violence Patients/service users 56% Relatives of patients/service users 48% Other members of public 15% Colleagues 21% Manager/team leader 15%

Workplace bullying Manager 23% Colleague 21%

Occupational Health

I have access to OH services at work 86%

I feel confident that OH services would be helpful if I contact them 54%

I can access OH services without a referral 61%

Occupational health services

Access is better in the NHS, social enterprises, universities than GP practices, independent sector and voluntary sector

But confidence in services is low across all sectors

Key Recommendations

Kim Sunley

Senior Employment Relations Adviser

Safe Staffing Levels

RCN actively campaigning on this issue through ‘This in Nursing’ and the work of Safe Staffing Alliance

RCN Guidance Toolkit for activists

Shift Working and Fatigue Development of a ‘Shift in the Right Direction’

– Employer’s duty to risk assess and introduce safe shift patterns

– Importance of rest breaks between and during shifts

CNO announcement of review of 12 hour shifts Continued input into negotiations on Working

Time Directive

Workplace Stress Risk Assessments Legal duty to ensure that work does

not make employees ill Continuous process ‘not a one off’

linked with organisational change and staff survey

HSE need to be active on this and also re-visit benchmarking

Presenteeism and sickness absence Presenteeism must be recognised as a health and

wellbeing issue Implementation of national partnership guidelines on

sickness absence Effective management practices

– Appraisals– Supportive approach– Prompt access to treatment – Equalities Act – Annex Z AfC

Other key recommendations

Engagement and consultation Violence and bullying and harassment Occupational Health Provision Raising concerns

Next Steps

Workshop presentation UKSRC to further shape

recommendations Campaign – ‘This is Nursing’ and other

workstreams/projects NHS Staff Council Toolkit for Activists