General practice is under huge strain. For example, record numbers of GPs are seeking mental health support due to ongoing pressures within the NHS, according to recent reports. HR expert Liz Willett shares her top tips on how practice managers can help find solutions for easing workplace stress experienced by staff
What is work-related stress?
Work-related stress is the adverse reaction to excessive pressure or other demands at work. It can become an illness if it’s extensive and prolonged, either physical or mental.
While some work-related pressure is normal and can even keep an individual motivated, too much can have a detrimental effect and result in stress. But the tipping point can differ from person to person, meaning there is no set level of pressure which is just right to avoid stress.
Building a case for stress management
In 2011, stress became the primary cause of long-term sickness absence in the UK. On average, work-related stress, depression or anxiety results in 23.9 days absence per condition.
This can be costly for employers. A survey in 2021 by HR tool XpertHR found that the median cost of sickness absence for stress for respondents was £390 per employee, per year.
In addition to direct costs of stress related absence, there are indirect costs, such as the price of covering the absence, reduced productivity and increased employee turnover.
How can workplace stress be diagnosed and managed?
A great place to start is identifying the specific causes of workplace stress.
Robertson Cooper’s six Essentials of Workplace Wellbeing can be a helpful tool for this task. It is a recognised and peer reviewed framework that has proven effective in diagnosing the causes of stress. It also suggests solutions to workplace stress to try and rehabilitate employees.
These six essentials are:
- Resources and communication: Employers should give employees the tools they need to do their job, for example, by providing adequate training and equipment. They should also keep them informed about relevant matters.
- Control and autonomy: Employers should not unnecessarily limit employees’ freedom to do the job in their way. They should involve employees in setting targets and objectives.
- Balanced workload: Employees should have a good work-life balance, and employers can help them to achieve this by ensuring that they take regular breaks from work. Employers should also ensure that employees do not have too heavy a workload.
- Job security and change: Organisations should keep employees’ transferable skills up to date and manage change actively, empowering people to respond to change positively.
- Work relationships: Employees should be treated with respect by their managers and colleagues.
- Job conditions: Employers should give employees the best working conditions that they can, including salary and other benefits.
The Health and Safety Executive (HSE) also has a free stress risk assessment tool on its website.
This can either be used if an individual reports work related stress, whereby they can be asked to complete the form and then discuss it in a meeting. Or it can be used as an annual stress audit for all staff to identify whether employees are stressed at work. It then collates the outcomes and things organisations can work on.
The questionnaire contains 35 questions about working conditions known to be potential causes of work-related stress. The employee is required to make an assessment which ranges from ‘strongly disagree’ to ‘strongly agree’.
I recommend that this questionnaire is shared with individuals who report work-related stress and a meeting is held to discuss their responses. It is useful to have a copy of the completed questionnaire prior to the meeting, so you can prepare.
The indicator tool can be allocated into five of the six headings of Robertson Cooper’s six essentials to identify where the problems are.
As a reminder, the five headings are:
- Resources and communication
- Control and autonomy
- Balanced workload
- Job security and change
- Work relationships
You should go through the questionnaire and highlight the parts of the report where you feel that the answer indicates a stressor. (It is very unusual for an individual to indicate that everything at work is a stressor.)
Once you have done this, allocate the issue to a workplace stressor – such as work relationships etc. You can then plan what may need to occur in order to address this. The following ideas and resources may be helpful:
- A phased return to work (if the employee has been absent)
- Providing additional training
- Putting in place a workplace buddy
- Adjusting working arrangements to reduce stressors or manage work-life balance
- Providing additional supervision
- Making short or long term changes to the role to reduce stress
- Managing workplace behaviours and bullying appropriately
- Resilience training can be effective in skilling employees to manage their own resilience to stress and take active steps to managing their own mental wellbeing
- Mediation can help resolve interpersonal issues at work without the use of formal grievances
- HR Support can help with diagnostics, interpreting data and bringing together solutions
- Occupational Health referrals can help with understanding what support may be effective for individuals and any reasonable adjustments
- Mental Health First Aiders funding is often available locally to support with the training of Mental Health First Aiders who can identify and respond appropriately to signs of stress in the workplace and support colleagues
- NHS “Looking after you” resources. There are many helpful and free resources including the Headspace App and access to individual and group coaching.
If you are unsure what support may be necessary or you have put in place support and it is not effective, it may be useful to make an occupational health referral. It would be helpful to share the outcomes of the workplace stress indicator tool and what has been done so far and ask if any additional or different adjustments would be beneficial.
Ultimately, if you have done everything that you reasonably can to address the stressors, and the employee is still feeling that workplace stress is a problem, it may be necessary to consider whether the role is suitable for the individual in the long term.
This may mean considering a redeployment to a role where the stressors are not apparent, making permanent adjustments to the role to remove the stressors or, as a last resort, considering dismissal with notice. Please do take HR advice before considering such steps.
Liz Willett is Head of Business Partnership at Kraft HR Consulting Ltd , which works closely with practices, federations and PCNs in the Midlands and further afield.
Practice managers and GPs will be able to hear the latest on how to juggle work and life at this year’s Management in Practice event in Birmingham. Register here for free.