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Managing Stress and Sickness Absence
Progress of the Sector Implementation Plan Phase 2

Broughton A, Tyers C, Wilson S, O’Regan S
Research Report RR694, Health and Safety Executive, March 2009

commissioned by the Health and Safety Executive

The Health and Safety Executive (HSE) is working with organisations to reduce the causes of work-related stress, and has developed the Management Standards to assist them. This is part of its work to meet the targets set in ‘Securing Health Together’(2000) and the delivery of Public Service Agreement (PSA) targets (for 2004 to 2007) to reduce work-related ill-health and work-related sickness absence.

The Institute for Employment Studies was commissioned to conduct research to examine the progress of Phase 2 of the HSE’s implementation plan (called the Sector Implementation Plan Phase 2, or SIP2) for the Management Standards. A separate piece of research has been conducted looking at Phase 1.

The specific aims of this research were to:

• Explore the effectiveness of the intervention in influencing procedures for managing work-related stress and sickness absence in organisations in the target sectors.
• Explore existing policies and procedures in sickness absence management and stress management practices and assess progress on implementing Management Standards for managing the causes of work-related stress and robust sickness absence management practices.
• Explore the extent to which any changes made to the management of stress and sickness absence in the organisation worked, and barriers and solutions to any problems encountered.

Research approach

This research consisted of three main elements:

1. An analysis of feedback forms collected from over around 1,300 delegates at workshops held as part of the SIP2 initiative during 2006 and 2007.
2. A telephone survey of 500 workshop participants conducted during 2008.
3. Case study work with nine organisations (with additional in-depth interviews conducted with a tenth). These were designed to cover a range of sectors, geographical locations, size of businesses and degrees of progress made in implementing the Management Standards process.

The case study work consisted of:

• between six and seven interviews with managers
• four focus group discussions (two with line managers and two with staff)
• a review of policy documents (provided by seven out of the nine case study organisations).

Organisational starting points

This research initially examined the policies and procedures in place within organisations that attended the events run within the framework of the SIP2 initiative, before their involvement began. All the organisations recognised the need to deal with stress and absence and were in the process of addressing these issues. An array of well-being related policies existed in each of the case study organisations before the SIP2 intervention, normally covering flexible working, sickness absence, stress and often bullying, harassment, diversity and dignity at work. Additionally, some organisations were at the start of the Management Standards process or not implementing it at all, while others were familiar with it and had implemented at least one full cycle.

Managing stress

The majority of organisations taking part in SIP2 were aware of work-related stress, took it seriously, and were trying to deal with it. Around three-quarters of the organisations involved in SIP2 were implementing the HSE Management Standards by the time of the 2008 survey. Managers and staff who were aware of the Management Standards agreed that these highlighted important risk areas but also pointed out other factors that they felt should be considered, such as non-work related elements and a range of factors connected to an employee’s role and the job content.

Managing absence

Absence was viewed as a key priority in almost all of the organisations in this research, with employers keen to reduce their current absence rates. The problems caused by sickness absence, however, were broader than this. Line managers experienced practical difficulties covering short-term absence, HR managers found short-term absence difficult to attribute to specific causes, and senior management had an eye to the financial implications of longer-term absences for the organisation. There was also widespread awareness of the difficulties in getting people back to work after a period of long-term absence.

All of the case study organisations collected data on sickness absence and its causes, although there was variation in the sophistication of systems used and the level of analysis that was undertaken. Most cases of absence were attributed to genuine sickness, although where flexible working was available, non-health related absences were felt to be less common.

Health and welfare promotion

Organisations intervened directly to manage staff health in two main ways: firstly through occupational health provision (by in-house services); and secondly through health initiatives either promoting the benefits of a healthy lifestyle, or alerting staff to aspects of their own fitness. There was some form of occupational health provision in all of the case study organisations and in many cases it was outsourced. Some organisations had access to an occupational health physician or a GP with an occupational medicine specialisation. Many organisations had an employee assistance programme and/or access to a counselling service. In addition, staff and managers from the larger case study organisations described a range of health initiatives that had been introduced on either a one-off or long-running basis.

Dealing with specific stressors

The case study organisations experienced a range of difficulties and problems that could be mapped on to the six stressor areas of the Management Standards. The most common issue, however, was workload, although this impacted on other areas of the Management Standards (eg sheer volume of work reduced the amount of control individuals felt that they had over their work).

Work to reduce the impact of work-related stress focused on a number of areas:

• training and career development, which was a key aspect of support within most organisations, mainly through formal training programmes
• line manager enabling
• the use of anti-bullying, anti-harassment, diversity and dignity at work policies
• ensuring role clarity
• minimising the impact of (often extensive) organisational change, although this was found to be particularly challenging.

Implementing the management standards

A range of drivers prompted organisations to engage with the SIP2 initiative and in many cases, involvement was driven by one key individual. Organisations were generally looking for reassurance that their existing approaches were appropriate. A minority of organisations sought an opportunity to learn more about implementing the Management Standards, whereas the majority had independently made a decision about whether to engage in the Management Standards implementation process. SIP2 was frequently seen as a means of validating and benchmarking existing practice and developments, and for many organisations, part of a process of continuous learning and improvement.

Although all of the case study organisations were committed to improving management of stress and reducing stress-related absence, only half declared a commitment to completing one cycle or more of the Management Standards process. Many had already implemented some form of intervention to address stress-related absence prior to their attendance at SIP2 events, and were reluctant to commit resources to a process that replicated elements of existing or previous initiatives.

Generally, organisations where the Management Standards were being implemented had not progressed beyond surveying staff and/or forming a steering group. There was, therefore, limited awareness or knowledge of the Management Standards process amongst staff who did not have a managerial role.

Policy development

Seven of the nine full case studies provided absence and stress policies for analysis. Overall, the ethos and drivers communicated in the policies mainly relate to the organisation’s commitment to protect employees from harm, explicitly or implicitly reflecting the organisation’s legal duty of care. Further, there was evidence that all of the organisations had been influenced by the HSE approach in that some mention of the risk assessment process featured in at least some of the documents of every organisation. Organisations also seem to have been influenced by the HSE’s understanding of stress in the sense that the HSE definition was quoted widely and the Management Standards had been adopted in some form by most organisations. The physical environmental and personal factors were added by several organisations as additional potential stressors. The degree to which the risk assessment process appears to have been used as a preventative or reactive tool varies, however, as not all organisations are taking an organisation-wide approach.

Factors affecting progress

The main barriers to taking forward absence and stress management identified by the surveys were a lack of money, a lack of information and training, and a lack of commitment to implement changes.

These issues were also reflected in the case study data, although other factors also emerged. Line manager commitment to managing absence and implementing change was seen as key. It was therefore a priority to ensure that line managers adopt a consistent approach to application of the policy. Other key enablers were seen as the existence of a good policy to underpin absence management, good data collection and the effective management of long-term sickness.

The management of the causes of work-related stress also raised a number of specific issues for organisations. These included defining and recognising stress, addressing the stigma of stress and talking openly about stress. Ensuring ongoing senior management support for stress management was also perceived to be difficult in many organisations, particularly when many other issues were competing for senior management time, particularly when they were asked to take a preventative approach. Nevertheless, where organisations were putting a preventative approach into place, this was perceived to be working well. External support from reputable organisations was also seen as effective.

Impact of involvement in SIP2

Organisational progress was difficult to measure in terms of concrete outcomes. Organisations generally did not keep precise records that would enable comparisons to be made before and after particular interventions had been put into place. Further, it was difficult to isolate the impact of particular interventions and, in addition, organisational change made it difficult for organisations to make meaningful comparisons. However, overall, organisations did feel that they were making progress.

The SIP2 intervention provided a relatively light level of support, centred on workshops and masterclasses for a broad range of organisations. It is therefore difficult to pinpoint with any confidence the exact nature of the benefit of this intervention to organisations. However, it is clear that delegates enjoyed the workshops and masterclasses and felt that they had gained something from attending them. They appreciated the networking and benchmarking opportunities and felt reassured that there were other organisations with similar problems. Some organisations went further and felt that attending the SIP2 events had sharpened their general approach and as a result it had influenced the information and training given to line managers on stress and absence. Others had introduced steering groups on stress. More common, however, was the experience that organisations now had a greater focus on stress and absence management having attended SIP2 events.

Conclusions

In terms of the existing policies and procedures that organisations had in place to manage absence and stress, this research found that there was a range of practice and that organisations were at different points, certainly in terms of stress management. However, all case study organisations were committed to improving their management of these issues.

A range of barriers and solutions to successful stress and absence management were identified. The barriers included lack of time and money, lack of line manager competence, lack of senior management buy-in and lack of openness around stress. The enablers included policy underpinning, senior management buy-in, good application by line managers, good data collection, and a generally supportive environment.

In terms of the effectiveness of the SIP2 intervention, it was difficult to measure the concrete impact, due to factors such as the limited nature of the intervention. However, some tangible benefits had resulted, such as changes to policies and procedures, and more concrete implementation of the Management Standards process. Further benefits included increased focus on stress and absence and improved confidence in dealing with these issues.

Managing Stress and Sickness Absence: Progress of the Sector Implementation Plan Phase 2, Broughton A, Tyers C, Wilson S, O’Regan S. Research Report RR694, Health and Safety Executive, 2009.
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