Stress is the adverse reaction people have to excessive pressure. It isn’t a disease. But if stress is intense and goes on for some time, it can lead to mental and physical ill health (e.g. depression, nervous breakdown, heart disease).

Stress may show up as high staff turnover, an increase in sickness absence, reduced work performance, poor timekeeping and more complaints from patients. Stress in one person can also lead to stress in staff who have to cover for their colleague. Many of the outward signs of stress in individuals should be noticeable to managers and colleagues. For example, a changes in a person’s mood or behaviour, such as deteriorating relationships with colleagues, irritability, indecisiveness, absenteeism or reduced performance. Those suffering from stress may also smoke or drink alcohol more than usual or even turn to drugs.

Below are broad categories of factors which may cause stress:

• demands of the job - staff may perceive that they have too much to do and not enough time; or may feel they have not received enough training
• lack of control - if staff have no say in planning their work
• relationships - poor working relationships with colleagues, perhaps including bullying or harassment
• role - staff are unsure what is expected of them
• lack of support - lack of support from managers or colleagues
• change - uncertainty about the future and fears about job security
• poor environment - noise, smell, heat, inadequate working space or equipment
• problems outside work, e.g. family or financial difficulties

Stress in the workplace cannot be ignored. Employers have a legal duty to take reasonable care to ensure the health of their employees is not placed at risk through excessive and sustained levels of stress arising from the way work is organised, the way people deal with each other at work, or from the day-to-day demands placed on the workforce.

What can be done to prevent stress becoming a problem?

Employers should:

• show that they take stress seriously by being understanding and listening to staff
• ensure that staff have the necessary skills, training and resources
• if possible, provide flexible working arrangements
• ensure bullying and harassment are not tolerated
• ensure good two way communication with staff

Practice action

The Health & Safety Executive recommend that employers carry out a risk assessment to tackle work-related stress. Performing the risk assessment should identify possible causes of stress and establish actions that should be taken to minimise the risk to staff. A risk assessment for stress involves:

1. Looking for pressures at work that could cause high and long-lasting levels of stress, for example:

• lack of communication
• poor working environment
• too much work for the time and resources available
• bullying or harassment
• fears about job security

2. Identifying who might be harmed by these factors

3. Deciding whether enough is being done to prevent that harm, for example:

• communicate with staff
• introduce clear objectives for staff
• provide training and appraisal
• ensure resources match workload demands
• identify and eradicate discrimination, bullying and harassment

4. Ensure that any actions which have been identified are carried out. The risk assessment should be reviewed periodically

5. Consider the implementation of a policy on stress.

Further information

• FPM HR / employment law guidance - 'Bullying and harassment'
• FPM policies and procedures library: HR index - 'Stress at work policy'
• ACAS guidance booklet - 'Stress at work'
• CIPD guidance booklet - 'Work-related stress: What the law says'
• HSE guidance - 'Work related stress'
• HSE guidance - 'What are the Management Standards for work related stress?'
• HSE guidance - 'Stress: Tools and templates'
• HSE guidance leaflet - 'How to tackle work-related stress: A guide for employers on making the Management Standards work'
• HSE guidance leaflet - 'Working together to reduce stress at work: A guide for employees'