When it comes to stress, everyone seems to agree on two things. Firstly that the effects of workplace stress are a major problem in the UK with over 400,000 people suffering from stress related illnesses caused by their work every year. Secondly, that the solution is to remove or reduce the stressors.

There is no shortage of authoritative advice on how to reduce stress either. The Health and Safety Executive (HSE) stress management standards have now been around for over 10 years. These give a simple and clear process for prevention. Arbitration service ACAS has excellent advice on the issue. Human resource 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 HSE’s materials.

Quite a number of employers, mainly larger public sector organisations, have found the HSE stress management standards to be an effective tool. The HSE has not published any papers showing where the use of the stress management standards has made a difference but some organisations have.

Blackpool, Wyre and Fylde NHS Foundation Trust reported that related interventions contributed to a 40 per cent reduction in cases of work-related stress. Aberdeen University reported that, after one year of implementing the standards, the average days lost per person due to stress reduced by 21 per cent. Scottish Power achieved an 11 per cent reduction in stress-related sickness absence.

Depressing truth

So how come stress is not falling? According to Stress-related and psychological disorders in Great Britain 2014, an October 2014 report from the HSE: “The rates of work-related stress, depression or anxiety, for both total and new cases, have remained broadly flat for more than a decade.”

What that means is that after 10 years of stress management standards sod all has happened, or at least what has happened has made no difference.

Overall sickness absence has gone down. This, though, is mainly because of an increase in “presenteeism” as people fear taking sick leave. The recession and the government’s austerity cuts have also played a part leading to an increase in pressure, especially in the public sector.

Still, the benefits of prevention using the HSE management standards just do not seem to be make any contribution to the reduction in sickness absence. The reason? Most employers are doing nothing, or, where they are, they are not addressing the real problem. The use of the management standards seems to have fallen dramatically in recent years as the HSE has stopped promoting them and issues such as stress are no longer a priority.

In Making health and safety work for business: Removing unnecessary health and safety burdens, the February 2013 report of the government ordered Triennial Review of the HSE, report author Martin Temple, noted: “It was put to me that ten years ago HSE was very active in research and publishing of new guidance on these areas. For example, the HSE management standards for work-related stress published in 2004.

“Following that, HSE has reduced the resources invested in these topics. It was alleged that HSE has lost control of its ‘brand’ in this area and that others, including other government bodies such as Public Health England (PHE), the National Institute for Health and Care Excellence (NICE) or the Advisory, Conciliation and Arbitration Service (ACAS), have stepped into this space to provide advice to businesses. In doing so, the messages for businesses and for individual workers about taking action on stress have become conflated and confused.”

"Those who promote wellbeing in the workplace should not allow it to be confused with health and safety requirements. 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.’

Martin Temple – Triennial review of the HSE

I would go even further and say that for many employers stress is not considered to be a prevention issue like chemicals or musculoskeletal disorders (MSDs). When employers talk about tackling stress nowadays they see it as being a “well-being” initiative, not a health and safety one.

Martin Temple, the chair of the manufacturing industry group EEF who led the review of HSE, issued an explicit warned against this. “Those who promote wellbeing 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.”

Coping doesn’t cop it

The number of employers seriously dealing with the prevention of stress through applying the management standards appears to have plummeted since the HSE stopped promoting them. The number introducing what they call “stress management” programmes, however, has risen massively.

BIG PROBLEM  Stress tops the workplace concerns of union health and safety reps, the TUC’s  biennial TUC survey has found. So why has HSE stopped working on the issue? More

I went through four of these, introduced by a university, an energy company, a health trust and a manufacturer. In each case the model was the same. Stress is identified as a major problem so they introduce an employee support programme aimed at those workers who get stress-related sickness. This is usually a few sessions of cognitive behavioural therapy or counselling aimed at helping them “cope” with stress and return to work.

Secondly they provided general training on how to deal with stress (usually through e-learning). This often also includes “awareness-raising” Thirdly was information or training to line-managers on how to recognise and support those with a stress-related condition. All four linked the programme to “well-being” initiatives.

Two of the programmes also introduced “resilience” training (Hazards 123). Only one actually linked to risk assessment and it only indicated that the assessments would be used to identify individuals at risk so that they could be offered support.

To put it another way, what they all had in common was focusing on the effects of stress – not the problem. 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.

This is comparable to the management in a factory where a lot of the workers were getting back pain because of the lifting and twisting on a production line introducing access to a physiotherapist rather than reducing the manual handling.

No prosecution, no notice

Supporting people with stress is not wrong. Unions should welcome it and 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.

Yet the law is clear. It says that the employer must remove or reduce the problem. So how are employers getting away with it? 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 are the regulators who are meant to be enforcing that requirement. Presumably employers have to either use the standards or something at least as effective or else face prosecution?

The HSE seems to think not. Their website has a question: “Will HSE initiate enforcement action for those organisations who obtain a satisfaction rating below that in the Stress Management Standards?”

The HSE answer is unequivocal. “No. HSE's approach to tackling work related stress is not enforcement led.” However it does go on to say: “ Where appropriate, HSE will investigate complaints relating to work related stress and enforcement action may be taken if there is clear evidence of a breach of health and safety law, and a demonstrable risk to the health and safety of employees.”.

So given that over 400,000 workers are being made ill every year, how many prosecutions has it taken? None.

HSE inspectors are told they cannot prosecute an employer on stress. The HSE’s directions for inspectors says the only formal enforcement action open to them is an improvement notice where an employer has failed to undertake a suitable and sufficient risk assessment for stress, or having undertaken one, has failed to act on the findings.

HSE inspectors have issued a small number of improvement notices since 2002 where stress has been mentioned, usually as part of a more general problem. But there have been none in the past five years. If this was any other hazard and any other condition I think there is little doubt that the HSE would be taking a different approach.

This lack of action means that employers are getting away scot-free. The problem is that tackling stress can mean changing working practices, increasing staffing levels or changing management systems and so it is clear that the majority of employers are just sticking their head in the sand and hoping the problem will go away, or instead, are trying to fix the workers.

The result is hundreds of thousands of workers have to live with totally avoidable depression or anxiety.

Resources

• TUC Safety Reps Guide to the HSE Stress Management Standards [pdf].
• HSE stress webpages.
• Hazards stress webpages.

Safety reps say stress is the top work concern

Stress tops the workplace concerns of union health and safety reps, the TUC’s 11th biennial TUC survey has found. Focus on health and safety: Trade union trends survey, published in October 2014, reveals the top five cited hazards are stress, bullying and harassment, overwork, back strains and slips, and trips and falls on the level.

Over two-thirds of safety reps (67 per cent) taking part in the survey said that stress, and the effect it is having on their colleagues, is one of the main concerns they have to deal with at work. One in six of the workplace reps who completed the survey say their employers are failing to conduct risk assessments, which is a breach of health and safety law.

TUC general secretary Frances O’Grady said: “It’s shocking that so many employers are breaking the law and putting their staff at risk of illness and accidents by their sheer negligence. Not only does this put people in danger while doing their jobs, the consequences also carry a high cost for British businesses and public services because it results in lower productivity and more staff spending time off sick.”

She added: “Stress remains the top concern for health and safety workplace reps. It’s a particular problem in parts of the public sector like the NHS and local government that have been hit by cuts and top-down reorganisations. Sickness and absence from stress is one of the false economies of public sector austerity.”

Sixty-seven per cent of health and safety reps across all sectors cited stress as a top concern. In the public service sector the rate was 87 per cent for central government, 84 per cent for education, 78 per cent for health services and 77 per cent for local government.

Psychosocial risks in Europe: Prevalence and strategies for prevention, published in October by the European Agency for Safety and Health at Work (EU-OSHA) and the European Foundation for the Improvement of Working and Living Conditions (Eurofound), reported that a quarter of workers in Europe report feeling stressed at work all or most of the time, and a similar proportion say that work affects their health negatively.

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Distressing failure

Workplace stress causes heart and other chronic diseases, higher rates of sickness absence and suicides. So why, asks TUC’s Hugh Robertson, are the Health and Safety Executive (HSE) and employers doing ‘sod all’ to tackle the bad management practices at the root of the problem?

Hazards webpages
Stress • Deadly business