Stress – the balancing act

file9221299618382Tomorrow (Wednesday 5 November) is National Stress Awareness Day, and this year’s theme is ‘stress: the balancing act’. So many of us have such full lives that it’s often difficult to balance our various commitments such as work, family, hobbies, etc. The aim of this awareness day is to get people to stop and think about what is causing stress in their lives and to do something to make a positive change.

Work is by no means the sole cause of stress, but it’s certainly a major contributor for many, particularly for those who struggle to switch off fully from work. Improvements in technology, such as smart phones and the almost universal availability of internet connections, mean that we are always contactable. Even holidays aren’t sacred for most of us – in order to facilitate a smoother return to work after our break, many of us check emails and phone messages throughout our ‘time off’… just in case.

Those who work full time spend over 20% of their lives in the workplace, so it’s not surprising that stress levels at work have a major impact on a person’s wellbeing. Thankfully, organisations can do a number of things to look after the mental and physical health and wellbeing of staff, yet these don’t have to be major undertakings. Simple changes to employees’ daily routines can make a great difference, for example:

  • making sure employees don’t eat lunch at their desks;
  • organising walks and outdoor activities on the day;
  • reminding employees to turn off their smartphones and not to check emails after they leave work;
  • having healthy snacks available and healthy meals in work canteens;
  • encouraging openness about mental wellbeing.

For more information about marking National Stress Awareness Day in your workplace, see the associated website or Facebook page, or the International Stress Management Association’s Twitter page. Or, for more general guidance on work health issues, including stress and mental health issues, take a look at the Health for Work Adviceline’s blog and knowledge base.

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Pregnancy and work – what support to expect

The Duchess of Cambridge’s second pregnancy, which has seen her afflicted again by a rare and debilitating form of morning sickness (‘hyperemesis gravidarum’), has brought the topic of the potentially incapacitating effects of nausea and vomiting during pregnancy to the forefront of many people’s minds.

Whilst the majority of women are not affected by the same serious condition as the Duchess of Cambridge, nausea and vomiting during pregnancy (oddly known as morning sickness, when symptoms are by no means limited to the morning, for many) is a common problem for many pregnant women.

Whilst most people are aware of the potential problem of nausea and vomiting when pregnant, many employers are still unaware of the profoundly detrimental effect that it can have on a woman’s ability to work. It is estimated that 30% of pregnant women need to take time off work due to nausea and vomiting symptoms.

So, what protection is afforded to pregnant women in the workplace? The rights of pregnant women in the workplace are protected under the Equality Act 2010 (Section 18) and it is unlawful for an employer to treat a woman unfavourably because of her pregnancy or an illness relating to her pregnancy.

It is advisable for employers to conduct open and frank discussion with pregnant employees from the very beginning. Rest is essential for women suffering from pregnancy-related nausea and vomiting, so some adjustments to working hours or roles may be advisable. Where potential risks exist in the workplace, a risk assessment should be undertaken to ensure the safety of the mother and unborn child (HSE ‘New and Expectant Mothers at Work’ guidance). And, if a woman has been off work, a phased return to work might be advisable until she is feeling stronger again.

For more information about pregnancy and work, and to find out what pregnant employees can expect in terms of support, see the guide on the Health for Work Adviceline knowledge base (‘new and expectant mothers at work’). Or, for information on other work-health related issues, take a look at the Health for Work Adviceline blog.

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Fit for Work to tackle long-term absence through advice and occupational health assessments

Photo by Alex Proimos via Flickr, under Creative Commons Licence

Photo by Alex Proimos via Flickr, under Creative Commons Licence

It’s been announced that Fit for Work will be launched by the Government later this year to provide health and work advice and an occupational health assessment to employees, employers and GPs in England and Wales to help people return to or stay in work after an illness. A number of names have been suggested for the service during its ongoing development, including:

The renaming to Fit for Work is based on the need for the name to more accurately reflect the nature and impact of the service.

Long-term sickness absence is a considerable drain on the economy and it’s generally accepted that work is essential to health, wellbeing and self-esteem – being off work for extended periods causes a plethora of problems, including mental health issues, social isolation and difficulty returning to work.

A significant number of people meet the criteria of being employed and on a four-week period of absence in England and Wales – according to the Office for National Statistics[1] (ONS), approximately 815,000 people in England are registered as being on long-term sickness absence (four weeks of more) in England [1.54% of the population], compared to 50,000 in Wales [1.71% of population].

According to Lord Freud, Minister for Welfare Reform:

“Being in work is good for people’s wellbeing and can help them to recover. Fit for Work will help employers and their staff to manage sickness absence and aid the return-to-work process and GPs will play a vital role in referring patients they think will benefit from it. This research will build on the learning from the pilot to help us understand how GPs will use this service and how we can support them in the future.

“Fit for Work is a result of the independent review of sickness absence and the government response which accepted the recommendation to introduce an independent assessment service.”

The phased introduction of the service is expected to begin in December, with full roll-out throughout England and Wales planned for March/April 2015.

[1] Office for National Statistics Annual Survey (February 2014).

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Stoptober – kick the smoking habit

Photo by weegeebored via Flickr, under Creative Commons Licence

Photo by weegeebored via Flickr, under Creative Commons Licence

During October 2014, thousands of people across England are taking part in Stoptober, a 28-day challenge to stop smoking, which leads smokers through a detailed step-by-step programme to help them achieve their aim of quitting smoking for good. Giving up for this period of time can have very real benefits – it has been calculated that smokers who quit for 28 days are five times more likely to stay smoke-free in the long-term.

A blog from 2013 on the Health for Work Adviceline website discussed the correlation between smoking and sickness absence. Research carried out by the UK Centre for Tobacco Control Studies (based at The University of Nottingham) found that current smokers are 33% more likely to miss work than non-smokers and were absent for an average of 2.7 extra days per year. This offers a very tangible incentive for organisations to back the Stoptober campaign to encourage their staff to quit smoking.

So what support will be offered to those participating in Stoptober? They will receive:

  •  an interactive app for iPhone and Android smart phones;
  • a free Stoptober pack containing resources to help people get through the 28 days;
  • a 28-day stop smoking text message support programme to keep people motivated;
  • daily emails with tips and advice;
  • support via the Smokefree Facebook page.

Because of the negative impact of smoking not only on workers’ health but, by extension, on the ability of an organisation to remain productive, employers would be well advised to encourage staff to break the habit. Resources are available for organisations that want to promote the Stoptober programme to workers (see the ‘Smokefree resource centre’).

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Chief Medical Officer: More must be done to help those with mental illness to stay in work


Photo by Stefano Corso via Flickr, under Creative Commons Licence

Photo by Stefano Corso via Flickr, under Creative Commons Licence

The Chief Medical Officer’s (CMO) annual report focusing on the mental health of the nation, which was published on 9 September 2014, has made 14 recommendations to improve public mental health services. Specifically, the report makes a number of recommendations relating to mental ill health and work.

70 million working days were lost to mental illness last year at a cost of £70-100 billion cost to the economy. In light of this, more needs to be done to help people with mental illness stay in work. The number of working days lost to stress, depression and anxiety has increased by 24% since 2009 and the number of working days lost to serious mental illness has doubled.

The CMO has called for NICE to analyse the cost benefit of fast-tracking access to treatment for working people who may fall out of work due to mental illness on the basis that rapid access to treatment could improve people’s chances of staying in work. It also recommends simple changes to help people with mental illness stay in work by offering flexible working hours. Where staff are off work, employers are urged to make early and regular contact with them in order to make it easier for them to return to work.

Mental health is just as important as physical health, so mental health services need to be valued and the extent of mental illness and the effect it has on sufferers and the people close to them needs to be acknowledged. Mental ill health isn’t something that ‘happens to other people’. One in four of us will suffer from some form of mental ill health in any one year, so openness is key.

Visit the Gov.UK website to view the full report. Or for more guidance on mental health and work, see the Health for Work Adviceline knowledge base or blog.

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Post summer blues

Photo by Lisa Widerberg via Flickr, under Creative Commons Licence

Photo by Lisa Widerberg via Flickr, under Creative Commons Licence

So, the summer holidays are over. Everyone is relaxed and bronzed and ready to resume with the daily grind. Or, perhaps not…

Research by Bupa, which has combined the views of 2,000 UK workers, shows that 44% of respondents face a ‘dramatic’ workload increase during the summer, mainly due to the sheer number of people who go away at the same time in UK companies.

So, how about those who did manage to enjoy a summer break instead of picking up other people’s work? Well, it’s not all roses for them either. According to the research, two in five people (41%) who went on holiday had to put in extra hours in preparation before their departure, and two thirds (61%) were dreading the return to reality as the holidays came to an end. And, unfortunately, many of those who did take a break didn’t feel like they could fully switch off during their holidays. Even when they were away, nearly one in three (32%) worried about being called or emailed and being expected to respond. More than half (55%) returned to find a ‘huge’ backlog of work and hundreds of emails waiting (54%).

Clearly the solution isn’t to put an end to holiday entitlement altogether – we all need a break. But all employers have a legal responsibility to look after the physical and mental health and wellbeing of their staff and, as such, they have a duty to take staff issues seriously and do what they can to reduce the pressure their staff are under. If you need advice on doing this, why not take a look at the guide on stress in the workplace on the Health for Work Adviceline knowledge base? Or, for information on general work health issues, take a look at our blog or website.

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The new Health and Work Service

As we’ve already reported, the Health and Work Service (HWS) in England and Wales* will be launched towards the end of this year with a phased roll-out until May.

The aim of the service is to cut sickness absence by offering health assessments and return-to-work plans to employees who have been off sick for longer than four weeks. The service will also offer general health and work advice to GPs, employers and employees by telephone and via a website.

Now the Government has just announced that the HWS will be delivered by Health Management, an occupational health provider owned by MAXIMUS (an organisation that partners with governments around the world to deliver health and human services programmes that improve the life of people globally).

According to Lord Freud, minister for welfare reform:

“The introduction of the Health and Work Service is an important step in supporting employees, GPs and employers to manage sickness absence better.

“Providing support where it’s needed most will help to reduce the length of time employees take off sick which, in turn, will cut sick pay costs, improve economic output and reduce the chances of people falling out of work and having to claim benefits, all contributing to the government’s long-term economic plan.”

*In Scotland, the service will be delivered by the Scottish Government on behalf of the UK Government.

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Workplace bullying

Photo by Chiara Vitelozzi Fotographie via Flickr, under Creative Commons Licence

Photo by Chiara Vitelozzi Fotographie via Flickr, under Creative Commons Licence

Workplace bullying is sometimes known as the ‘silent epidemic’ and many workplaces don’t have any structures in place to deal with it. This is partly because it’s not always easy to define bullying and prove that it is actually taking place.

Interestingly, whilst there are laws against harassment in the workplace (i.e. unwanted conduct related to a ‘protected characteristic’, such as weight, disability, age, etc.), there is no law against bullying because it is not related to protected characteristics. Workplace bullying might include insulting, intimidating or demeaning behaviour, or an abuse of power.

The late Tim Field (a world authority on bullying and psychiatric injury), who himself suffered a breakdown after workplace bullying, became passionate about the topic of understanding and dealing with bullying at work. In 1996 he set up the UK National Workplace Bullying Advice Line (no longer in operation) and then an information website, Success Unlimited (later Bully Online), a resource on workplace bullying and related issues.

According to Tim Field, there is a clear connection between workplace bullying and workplace stress:

There’s only one way of dealing with stress – that’s to identify the cause and then work to reduce or eliminate that cause. I believe bullying is the main, but least recognised, cause of stress in the workplace today.

Workplace bullying has a negative impact on the work environment, including (to name a few):

  • significantly higher rates of sickness absence;
  • high employee turnover;
  • high costs of training and retraining (to replace absent staff);
  • low workforce morale;
  • poor industrial relations.

Employers are responsible for preventing bullying and harassment and they are liable for any harassment suffered by their employees. Organisations need to have their own policies in place to prevent bullying in the workplace. For more information, see the ACAS website.

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Alcohol and work

Photo by Kimery Davis via Flickr, under Creative Commons Licence

Photo by Kimery Davis via Flickr, under Creative Commons Licence

Excessive alcohol consumption on the part of employees can manifest itself in various ways, including:

  • employees coming to work with a hangover;
  • staff drinking socially at lunchtime thus becoming less productive and, potentially, putting the safety of other employees at risk;
  • sickness absence through prolonged alcohol misuse outside of work.

A specific aspect of potential over-use of alcohol is drinking covertly at work. It is actually illegal to drink alcohol in safety-sensitive jobs or jobs involving driving but, in general, the regulation of alcohol at work is down to organisations’ specific policies. Employers do have a duty under the Health and Safety at Work etc Act 1974 to look after the health, safety and wellbeing of their employees. This means that employers must take action if they fear that an employee is putting themselves or their colleagues at risk by consuming alcohol.

Any discussion with employees about their suspected alcohol consumption at work must be dealt with sensitively according to organisational alcohol policies. It could be a case of simple misconduct, in which case employers can turn to their disciplinary procedures. However, it may be that the drinking is the manifestation of a drinking problem, in which case employers will need to decide how best to manage the situation and support the employee:

  • What has caused the alcoholism: depression, stress, personal issues?
  • To whom can employers turn to get more information on individuals’ personal circumstances?
  • What adjustments may need to be made at work to support staff?
  • Can employees continue working whilst their cases are being dealt with?

In some situations there may be a case for considering screening workers in safety critical jobs, but screening is only likely to be acceptable if it is part of an organisation’s occupational health and safety, or drug and alcohol, policy. However, screening cannot be seen as a solution in itself. Organisations should consider the inclusion of awareness programmes, which will help with preventing problems from developing in the first place, as well as the provision of support for those who are identified as having a problem.

For more guidance on alcohol in the workplace, see the guide to drugs and alcohol in the workplace on the Health for Work Adviceline knowledge base, or for information on general work health issues, see our blog or website.

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Working safely in the heat

Photo by Daniel Petzold Photography via Flickr, under Creative Commons Licence

Photo by Daniel Petzold Photography via Flickr, under Creative Commons Licence

As the UK experiences one of the most continually warm and sunny summers on record, many people are turning their attention to the challenges and potential perils of working in heat.

There are a number of potential dangers associated with working in the heat, including:

  • Accidents in the heat.
  • Heat stroke (when the body’s regulatory system fails and body temperature rises too high – this can cause brain damage or death).
  • Heat exhaustion (extreme fatigue caused by a drop in blood pressure due to the loss of fluids and salts in the body).
  • Heat cramps (muscle spasms that result from the loss of large amount of salt and water in the heat).

Interestingly, regulating body temperature in hot conditions not only depends on controllable factors (e.g. wearing appropriate clothing, remaining hydrated, etc.). Success (or otherwise) is also determined to a large degree by the body being acclimatised to the heat. Clearly, living in the UK means that we aren’t generally well versed in the art of working in extreme heat. When a person isn’t used to hot temperatures, the body’s first reaction is often to raise the body’s internal temperature (i.e. to create a fever), which can be dangerous because it increases the pulse rate and puts strain on the heart. The body will then work to bring down the temperature by sweating to cool the body.

Whether or not a person sweats efficiently is dictated by a number of factors such as the level of humidity in the air and whether or not a person’s clothing allows for evaporation. It is also determined by the extent to which the body is used to hot conditions – bodies that aren’t acclimatised to the heat often produce sweat that can be high in salt, which depletes the body of electrolytes.

The other way the body sheds excess heat is by altering the blood circulation. The heart begins to pump more blood into the small blood vessels near the skin’s surface, where the heat of the blood is transferred to the cooler outside environment. If the outside environment is not cooler than body temperature, however, this method is ineffective, and this change in circulation can put extra stress on the heart.

So, whilst this year’s glorious British summer is being lauded by many, it’s clear that it’s not altogether easy for the body to cope with the heat. This is why employers/managers need to ensure that the appropriate precautions are taken to protect those who are working in the heat. For more information on working in high temperatures, or on other work health topics, see the guides on the Health for Work Adviceline knowledge base (e.g. our guide to working in high temperatures) or search our blog.

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