This is an excerpt from the TUC book "Hazards at Work: Organising for safe and healthy workplaces", the best-selling guide to health and safety at work.
Buy a copy of the book (if you are a safety representative on a TUC training course, please speak to your tutor about getting a discounted copy).
The HSE says: “Work-related stress is the adverse reaction people have to excessive pressures or other types of demand placed on them at work. There is a clear distinction between pressure which can be a motivating factor, and stress, which can occur when this pressure becomes excessive.” The European Agency for Safety and Health at Work explains that “stress can be said to be experienced when the demands from the work environment exceed the employee’s ability to cope with (or control) them”. The TUC endorses both these definitions and safety reps can use the HSE version as a working definition.
There are no accurate official statistics for stress. The HSE statistics for 2017/18 contain estimates from the self-reported, work-related illness (SWI) questionnaire of the Labour Force Survey (LFS) and this shows:
Numerous surveys by trade unions, professional organisations and academic researchers have repeatedly confirmed that work-related stress is endemic in the public sector, is damaging the lives and physical and mental health of vast numbers of workers and is an increasing epidemic. Spending and job cuts in the public sector and job insecurity throughout the economy (including increases in temporary and zero-hours contracts), plus increasing hours of work and workloads, excessive monitoring, accountability, performance management, target-setting, badly managed change and bullying by management are all identified as causal factors. In jobs that involve working with clients, pupils and the public, violence and aggression are also big stressors. In the public sector – education, health care and the administration of welfare benefits especially– dealing with the effects of austerity on pupils, patients and clients is adding more stress to workers. Maintaining a reasonable healthy work/ life balance is becoming more difficult for most, and impossible for many. Destitution and in-work poverty are increasing along with the consequent use of food banks. Many workers are driven to despair and suicidal thought and actions.
In the TUC 2018 safety reps’ survey, stress was the number one hazard cited by 69 per cent of safety reps, similar to the 70 per cent in 2016. Stress was identified by 74 per cent of safety reps in the public sector compared to 64 per cent in the private sector. Stress was cited as the top hazard by safety reps in 13 out of the 14 sectors, and second in the 14th. Stress is the first concern of safety reps in the voluntary sector, cited by 100 per cent; 90 per cent in central government; 85 per cent in health services; 84 per cent in education; 80 per cent in local government; 68 per cent in other services; 67 per cent in energy and water; 66 per cent in manufacturing; 60 percent in transport and communications; 56 per cent in construction; and 50 per cent in agriculture and fishing. It is the second hazard cited by 52 per cent of safety reps in distribution and hotels.
Overwork is a key stress risk factor and 36 per cent of reps listed it as a top five concern, compared with 40 per cent in 2016. Overwork is more prevalent in the public sector, with 43 per cent of reps identifying it, compared to 27 percent in the private sector. Overwork is the first or second hazard in all those sectors where stress is the most prevalent. Long hours also contribute to stress and this has risen to 29 per cent of reps citing it, compared to 30 per cent in 2016, being cited by 33 per cent of safety reps in the public sector compared to 26 per cent in private sector. Bullying or harassment are also stress risk factors and they have become markedly more common in local and central government, the two worst sectors – cited by 80 per cent and 71 per cent of safety reps respectively. It features in the top five most common hazards in 11 industrial sectors compared with only two sectors in 2008. It is slightly more common in the public sector, with almost half of safety reps citing it in the top five, 49, compared with 44 per cent in the private sector, up from 40 and 33 per cent respectively in 2016.
The key findings of the latest Acas Workplace Stress and Anxiety Survey Report published in June 2019, back up trade union, TUC and HSE findings:
Stress is a natural reaction to excessive demand or pressure. When we feel pressured, hormonal and chemical defence mechanisms are triggered in the body. Often called the ‘fight or flight’ reaction, it evolved to equip us for life-threatening situations eg escaping from wild animals. Mobilised for physical action, we begin to perspire, blood vessels to the skin constrict, blood vessels to the muscles expand, and the stress hormones adrenalin and cortisol are released. Immediate physiological changes occur. If we cannot ‘release’ that tension, including dry mouth and throat, butterflies in the stomach, moist palms, sweating, pounding heart, increased blood pressure and muscle cramps, plus the hormonal/chemical mechanisms, by some physical action, then there can be serious long-term effects on both physical and mental health.
If pressure is prolonged, too frequent or out of control, physical health problems may develop, such as loss of appetite, comfort eating, weight gain or loss, indigestion or heartburn, constipation or diarrhoea, irritable bowel syndrome, sleeplessness, bouts of sweating, headaches, back pain, nausea, breathlessness, fainting spells, impotence or loss of libido, fatigue, eczema and other skin conditions.
Stress can also cause emotional and mental health problems. Society’s attitudes to mental ill health are still very different from those to physical ill health and the stigma adds to the pressures on stressed individuals. Because of these attitudes, people may try to hide their emotional and mental symptoms and not ask for help until their problems are seriously out of control.
Psychological conditions triggered by prolonged stress include fatigue, anxiety, panic attacks, depression, hostility and aggression, psychosomatic complaints and neuroses.The symptoms can be irritability, indecision, suppressed anger, loss of concentration, inability to complete one task before starting another, feelings of paranoia, feelings of inadequacy, tearfulness at minor problems, lack of interest in people and things outside work, constant tiredness and a feeling that sleep is ineffective. Short-term symptoms can develop into much more serious long-term ill-health conditions. Stress can play a role in problems with:
The coping mechanisms that people use to deal with stress, such as smoking, over consumption of alcohol and comfort eating, can themselves lead to ill-health. Chronic work-related stress can cause very serious long-term health problems and increase the risk of the sufferer dying prematurely from a stroke or heart attack. Large-scale studies found a 50 per cent increase in the risk of heart diseases among those who had reported work-related stress compared with those who hadn’t. Hazards magazine estimates that there are about 20,000 premature deaths from heart disease each year, many of these from stress, overwork, long hours and impossible work demands. In addition, Hazards magazine estimates that around 600 people take their own lives each year, 10 per cent of the total suicides, as a result of intolerable work-related stress, and the suicide rate generally has increased since the beginning of the recession in 2010.
Employers will, of course, deny any links between a suicide and work circumstances, even when workers leave messages stating specifically that this was the case. There is no requirement on employers or anyone to report deaths that may be linked to work or to investigate under the reporting of Injuries, Diseases and Dangerous Occurrences Regulations, RIDDOR. But in France suicides are investigated for any work-related causes, see “Suicide as Corporate Murder” and Hazards Magazine pages on suicides. To add insult to injury, in the UK it is still extremely hard to gain civil compensation for ill health caused by work-related stress. Only a few hundred people succeed each year.
There is some overlap but also confusion about work-related stress and mental ill health. Around one in four people will have some form of mental ill health during their lives. The most common is anxiety and depression. The HSE says the key differences between common mental ill health and stress are the causes and the way they are treated. They may share similar symptoms – work-related stress can cause mental ill health, or aggravate and become entangled with an existing mental ill-health problem. But they can also exist independently: people can experience work-related stress and physical changes such as high blood pressure, without developing anxiety and depression. People can have anxiety and depression without work stress.
Work-related stress results from a complex interaction of factors around the way the workplace and the work is managed, and how workers are treated by managers and employers. The cause may be easy to identify and its effects immediately obvious – a bullying boss, two people having to do the work previously done by 10, impossible workloads and deadlines – but often it is more difficult and can be complicated by the presence of external or personal stress factors. The trade union view is that while these personal and external factors can contribute to stress, our concern is to identify and tackle those stress risk factors that are caused by work that is under the employer’s control and can be prevented. Employers will try to individualise – we all react differently to the same situation due to genetic susceptibilities, temperament and physical makeup, what’s going on in our lives – and may resist undertaking risk assessments to the required “suitable and sufficient” standard, arguing that you cannot do such assessments because of these differences. This is nonsense, as not everyone who smokes will develop lung cancer; not every worker exposed to asbestos or silica will develop mesothelioma or silicosis; not all nurses lifting patients will be injured; and not all computer workers will develop a work related upper limb disorder. These are hazards with a huge potential to cause workers’ harm and it is clearly accepted that they should be eliminated or controlled, and stress should be dealt with as a work hazard. The individual response is not the trade union response and it should be challenged and rebutted whenever it arises. Safety reps need to be able to identify exactly what it is in the way work is organised or managed that creates stressful conditions and has the potential to damage all workers, and then to deal with the causes using trade union organisation and methods. Just as they would deal with any other hazard, with collective prevention the main aim plus support for those particularly badly affected.
Acas has advice on stress, HR managers can access advice on how to prevent stress from their professional body the CIPD. There is even a British Standards Institute (BSI) standard, based on the HSE’s materials. There is no shortage of information and advice, just of action. Both Hugh Robertson, health and safety officer of the TUC up to August 2019, and Martin Temple, now chair of the HSE, have complained that despite agreement that the effects of stress are a major problem and that the solution is to remove or reduce the identified stressors, employers, government and the HSE are still failing to reduce and prevent work-stress. The HSE’s Stress Management Standards (SMS), were published in 2004, over 15 years ago. These give a simple and clear process for prevention, with useful easy-to-use, downloadable tools to carry out risk assessment and benchmarking, and suggestions on approach. A number of employers, mainly larger public sector organisations, have found the standards to be an effective tool, but the incidence of work-related stress is still rising and there has been no big change in employers’ behaviour in preventing, reducing and managing it. There has been an increase in ‘presenteeism’ due to fear of taking sick leave, and the problems caused by stress and the cost of presenteeism are widely acknowledged to be higher than that caused by sickness absence alone. Since 2011 the majority of workplaces where stress is rife – including local and national government, education and health services – have been classified as ‘low risk’ and so banned from being proactively inspected by the HSE or local authorities. So inspectors are unlikely to know what is going on in most stressful workplaces until something goes very wrong.
Martin Temple carried out a Triennial Review of the HSE in 2013, (Making Health and Safety Work for Business: removing unnecessary health and safety burdens) when chair of the Employers Engineering Federation, the EEF. He also identified the problem the TUC and trade unions had complained about: that as the HSE had withdrawn from enforcing and promoting the SMS as part of the legal requirements of health, safety and welfare at work, the field was taken over by non-health and safety government bodies. And also by commercial health and safety organisations, which have subverted the issue of the collective prevention and management of work-related stress factors into an individualised health-promotion, lifestyle issue under the guise of ‘stress management’ programmes such as ‘wellbeing’ and ‘resilience’. Temple issued an explicit warning against this. “Those who promote well-being in the workplace should not allow it to be confused with health and safety requirements,” he noted. “I recommend that HSE should ensure its own guidance sets out clearly what employers must do to control work-related health risks and be prepared to challenge others if they inadvertently misrepresent what the law requires to promote the wider wellbeing agenda.”
He also noted that employers taking no action on the biggest workplace health problems were unruffled, as the HSE made clear that its approach to stress was not enforcement-led. For many employers, stress was not considered to be a prevention issue like chemical exposure or musculoskeletal disorders (MSDs). “When employers talk about tackling stress they see it as being a ‘wellbeing’ initiative, not a health and safety one.”
In “Distressing Failure”, Hugh Robertson, the TUC’s health and safety officer up until 2019, criticised the fall in employers using the HSE SMS and instead dealing with stress by introducing ‘stress management’ programmes, which focus on the effects of stress – not the cause. In each case, the employer claimed that this was a stress-prevention programme, yet at no time was the working environment being changed. The causes of the stress were exactly the same, only the symptoms were being addressed. They introduced ‘employee support programmes’– a few counselling sessions – to help workers made ill by stress to cope and return to work; general training on how to deal with stress (usually through e-learning); ‘awareness-raising’; and information or training to line-managers on how to recognise and support those with a stress-related conditions. These were often linked to ‘wellbeing’ initiatives and ‘resilience’ training. Rarely were they linked to risk assessment, other than indicating that the assessments would be used to identify individuals at risk so that they could be offered support.
The TUC isn’t arguing that supporting people with stress is wrong. Unions do work with employers in introducing measures to help workers who are ill, whether it is work-related or not, but that is nothing to do with their legal duties on health and safety. Mental health awareness, mental health first aid, wellbeing and various other measures to support workers and to provide reasonable adjustments and help are to be welcomed if they are part of a comprehensive prevention programme of tackling work-stress. But they must not be used as a substitute for or confused with prevention.
Hugh Robertson criticises resilience as a solution to work-stress by comparing it to food poisoning. If you became ill with E Coli because of poor food hygiene you wouldn’t expect the guilty party to respond by suggesting that scientific evidence showed it was no longer necessary to worry about food hygiene because the real problem was customers’ lack of ‘resilience’. But that is the resilience approach to workplace stress. The resilience industry is on a mission to make feeble workers ‘man-up’, to shrug off the stresses and strains of work, and to tough things out. This releases employers from removing structural stressors or making workplaces healthier. Consultants promote packages aimed at improving workers’ resilience, and professional bodies like the Chartered Institute ofPersonnel and Development and the Institute for Occupational Safety and Health promote it as well. Of course it is important that trade unions ensure their employers support those who are ill because of stress, but not while also allowing the work causes of that stress-related illness to continue and promoting harmful individual ‘resilience’.
The HSE, with Martin Temple as chair, responded to criticism of lack of action and enforcement of the HSE SMS by relaunching them as part of the top three occupational health issues – lung diseases, musculoskeletal disorders and stress – in, March 2017, with new tools and promotion as part of the ‘Go home healthy’, #WorkRight campaign. In October 2017, the government published its review of mental health and employment in Thriving at Work by Lord Dennis Stevenson, mental health campaigner and Paul Farmer, chief executive officer of MIND. This criticised the HSE and set out a vision that by 2027, “employees in all types of environment will have ‘goodwork’, which contributes positively to their mental health, and our society and our economy.” Achieving this was to be based on having the right tools, raising awareness and building confidence. The review found that although the HSE SMS were a first step, they could potentially encourage employers to take a narrow approach because employees with mental health problems can face particular risks at work, regardless of whether or not their condition was caused by work.
In December 2018, Acas published a Framework for Positive Mental Health at Work, which reflected both the “core” and “enhanced mental health standards” set out in Stevenson/Farmer review, including the importance of “good working conditions”, “effective people management” and “open conversations about mental health” and is built on the “engagement of players”.
The government accepted the recommendations of the Stevenson/Farmer review and, as a result, the HSE by April 2019 incorporated a “more holistic approach” to show how its standards can help employers deliver key parts of the review’s mental health core standards, which are more wide-ranging than the SMS. The HSE also revised its stress management guidance to raise employers’ awareness of their duty to assess and manage work-related mental ill-health and look to “increase the focus on workplace mental health and safety during its inspections” and to consider enforcement action.
The law on health and safety at work is quite clear: the employer must remove or reduce the hazards that make workers ill. Stress is a workplace hazard and employers have a legal duty to reduce the risk to workers “so far as is reasonably practicable”. The HSE is the regulator that is meant to be enforcing that requirement and employers have to use either the Stress Management Standards (SMS), or something at least as effective, or else face prosecution. The TUC calls for more enforcement of health and safety, but whether the HSE enforces or not, the law is the law and employers are under a legal duty to prevent harm to workers’ health
from work-related stress. Trade union organisation on stress is crucial to stop work making us sick. There is no specific law dealing with stress but a number of laws do apply that are referenced in other chapters of this book:
The SMS developed out of a consultation process that resulted in a majority view from both unions and employers for some effective regulations or at least an Approved Code of Practice on stress. The HSE response was the management standards to help employers conduct effective risk assessments for work-related stress and set up appropriate measures to deal with the issues identified.
The SMS cover six key areas of work design that, if not properly managed, are associated with poor health and wellbeing, lower productivity and increased sickness absence – the primary sources of stress at work. They represent a set of conditions that, if present, reflect a high level of health, wellbeing and organisational performance. The standards came into effect in 2004. Stress reactions can be caused by a single factor – as in the case of bullying, for example –but they are often the result of a combination of factors. It is important for safety reps to understand each of the six factors and to be able to identify them in the workplace, as this can influence the degree of stress an individual experiences. Specific factors identified under the six main headings will contribute to the development of stress-related
symptoms in many workers. The six areas are:
The SMS recognise that work-stress is a collective problem with the culture at work and that its resolution lies in identifying the work causes and applying control measures to remove the factors causing the problem, which in turn enables the employer to meet its duties in respect of workers’ health.
The HSE’s SMS toolkit is designed to help employers undertake suitable and sufficient risk assessments. It is neutral, is universally applicable,
adopts a general approach to help employers see the broad areas that need to be addressed, and can be used by anyone after some brief training. See the step-by-step workbook. It emphasises the need for a commitment by senior management to identify, lessen and control risks, and argues for effective partnerships with employees, their representative organisations and safety reps.
The main part of the kit is a questionnaire for employees linked to an analysis tool. This is a spreadsheet that calculates the responses, and indicates the scale of any problems the survey has identified. The results are presented in ‘traffic-light’ format, so that:
Even full compliance with the SMS does not mean that all workers are protected. The standard is based on achieving a position where 80 per cent of workers agree with the standard for each of the six work-stress factors above, and are protected. The HSE recommends that the employer establishes a steering group to monitor and oversee the process, consider the results, recommend appropriate responses to control the problems, and play an active part in tackling the problems. The steering group should include adequate trade union representation. It also recommends that the employer establishes focus groups to facilitate employee participation in the process. This will demonstrate the employer’s commitment to a participative process in managing the risk and give staff an opportunity to express their views and feed in information and reactions to the process to enable it to be refined and developed. The role of union safety reps is emphasised at all stages in the process: during the assessments; in steering and focus groups; and in determining effective controls (see below).
The HSE toolkit gives comprehensive advice on developing a stress policy, which strongly emphasises the role of safety reps in developing stress management initiatives. In Scotland, Work Positive, part of the Health Scotland initiative and the Healthy Working Lives programme, has developed its own toolkit, using the HSE’s as a foundation. This one contains an expanded version of the HSE questionnaire, which includes the HSE’s 35 questions, and then adds an extra 32, plus a ‘write-in’ option for Q68. The Work Positive additional questions cover a range of other conditions-of-service issues or aspects of the employment relationship and collective bargaining issues that can contribute to increasing employee stress.
Line managers play a vital role in the identification and management of stress. They are likely to witness problems caused by stress first hand, and will be in the best position to notice changes in staff behaviour that may indicate a stress-related problem. They are also the first point of contact when an individual feels stressed. It is essential that line managers are equipped with the correct skills and behaviour to be able to manage these situations. The HSE worked with the CIPD and Investors in People to design this tool to allow managers to self-assess whether they currently have the behaviour identified as effective for preventing and reducing stress at work. Its aim is to help managers reflect on their behaviour and management style. Safety reps could also use the questionnaire to assess line manager competence as part of an inspection or monitoring process.
Safety reps need to intervene at the primary level: prevention. They should act to address the causes of stress and so prevent workers developing stress-related symptoms and illness, which in turn may lead to absence and, in the worst cases, nervous breakdown, mental illness and even suicide.
Safety reps must beware of and resist ‘wellbeing’ programmes and other individual, lifestyle health promotion plans that only treat symptoms but do not prevent the causes of work-related stress, when they are used instead of employers complying with legal duties under health and safety law. These include: resilience training and mindfulness plus also healthy eating; exercise; smoking cessation; drugs and alcohol counselling; and massages. Of course all or some of these will help improve some individual workers’ health, but should not be considered until the factors that are making workers ill are removed or reduced by primary collective action on work-related stress that protects all workers.
TUC checklist for health and safety reps
If your employer has introduced support for people with stress-related conditions instead of prevention measures, insist that they use the HSE management standards.
The TUC reminds union reps that wellbeing at work initiatives, mental health first aid and mental health awareness programmes can be very popular with workers, and unions can use them as a way of recruiting new members and getting new activists – but they are no substitute for primary prevention of work stress.
Safety reps can use the TUC Tackling Workplace Standards Using the HSE Stress Management Standards: guidance for safety reps which explains the SMS from the worker’s viewpoint and then the practicalities – what you and your employer need to do. It covers setting up a group, the initial questionnaire/ survey to establish the extent of the problem, and the process of risk assessment, analysis and implementation of solutions. The TUC suggests that all members of the group are trained and that safety reps also attend specific TUC training via your TUC regional education officer.
Safety reps can negotiate a work-related stress prevention policy with their employer as part of the HSE SMS approach. This should:
The objectives of a work-related stress policy should be to:
The policy should contain agreed arrangements for joint monitoring and review to assess its effectiveness.
Safety reps need to keep in regular contact with their members and check that stress problems are under control. Ensure that there are suitable procedures for members to report problems, and that any problems can be tackled by reps without exposing the members concerned to risk of victimisation. Safety reps need to use their rights under SRSCC Regulations to be informed and consulted about any aspect of work, or changes, that may cause or increase stress and so affect their members’ health and safety. These include changes to contracts, pay, hours, workload, work organisation, monitoring, staffing levels and working hours/time. Safety reps should ensure that risk assessments of these issues for stress should be conducted.
Safety reps can survey their members using the TUC stress MOT. This will help to identify the areas of the workplace and the stressors that most need risk assessments. Safety reps can also use mapping techniques such as body-mapping and risk-mapping to raise awareness of the links between work-related stress and ill health among members as a start to organising for prevention.
Ten points on work-related stress
A checklist for UCU safety representatives
A quick checklist for UCU representatives on things to do to ensure your employer takes appropriate action on the causes of work-related stress.
Don't allow your employer to dilute the issue by including external factors – we are here concerned with those factors at work, under the employer's control that collectively affect employees; not factors related to a specific individual. Stress is an issue that should appear on the main bargaining agenda, not be sidelined as a peripheral or safety committee only issue.
Finding out about stress
While addressing the structural causes of stress in the first place, trade unions may find it useful to ensure that members suffering from stress are represented and cared for by employers. Individual cases must be dealt with effectively and special arrangements negotiated to protect members’ needs. Some employers have:
These shouldn’t be discouraged, all the while the causes are being dealt with. Trade unions must still demand employers do what the law requires: make primary interventions to remove the causes of stress at work. The actions described above are secondary interventions that deal with a problem that has already been created and, like personal protection, should be considered only once everything has been done to protect everyone by removing and managing the hazards at source. For more see Mental Health and the Workplace: a TUC Education workbook and Your Health at Work: an indispensable guide to physical and mental wellbeing.
(in alphabetical order)
(see Section 7.2 for contact details)
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Trade union information
Many unions provide guidance on stress, for example
Contact your union, or visit your union's website to find out what guidance is available.
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