08_psychosocial_agents_20140117153107

Question 1

The characteristic symptoms of PTSD involve:

Answer 1

 re-experiencing the traumatic event  avoidance of stimuli associated with the event  numbing of general responsiveness  increased arousal, for example: difficulty falling asleep, staying awake, irritability or outbursts of anger.

Question 2

As work related stress does not constitute a reportable occupational disease under RIDDOR the information available regarding the incidence and prevalence of work-related stress comes from two sources:

Answer 2

 Self-reported work related illnesses (SWI) from the Labour Force Survey (LFS).  Surveillance of occupational stress and mental illness (SOSMI), which tracks reports from consultant psychiatrists as part of the THOR (The Health and Occupation Research Network) programme, run by the Centre for Occupational and Environmental Health at the University of Manchester.

Question 3

Research provides strong links between stress and: 3

Answer 3

 Physical effects such as heart disease, back pain, headaches, gastrointestinal disturbances or various minor illnesses.  Psychological effects such as anxiety and depression, loss of concentration and poor decision making.  Behavioural effects such as reliance on drugs and alcohol, lack of confidence, relationship difficulties, lack of concentration, mood swings and aggression.

Question 4

There are several different types of information or data that can be used to help identify, in broad terms, whether work-related stress is a potential problem and, if so, which employees might be at risk. These can be broadly categorised as: 4

Answer 4

 existing sources of information available within the organisation  surveys  other ways of obtaining information about groups  other initiatives.

Question 5

Existing sources of information The following information may be useful in identifying work-related stress ‘hot-spots’

Answer 5

Sickness absence data Productivity data Staff turnover Performance appraisal Team meetings Informal talks ‘Walk-throughs’ and ‘talk-throughs’

Question 6

Other ways of obtaining information about groups 2

Answer 6

Toolbox talks Focus groups

Question 7

Preliminary analysis All available data should be systematically analysed to establish where the organisation is in terms of performance against the Management Standards ‘states to be achieved’ or other benchmarks. A preliminary report should: 5

Answer 7

 Identify any areas of current good practice.  Identify areas where the organisation appears to be performing less well.  Compare the current level of performance against the ‘states to be achieved’ or other benchmarks.  Identify areas of good practice to build on.  Identify appropriate actions to take to close the gap between the current state and the target state.

Question 8

The HSE’s Management Standards define the characteristics of an organisation where the risks from work-related stress are being effectively managed. The standards cover six primary sources of stress at work: 6

Answer 8

 Demands – issues related to workload, work patterns and the work environment.  Control – how much say the person has in the way they do their work.  Support – levels of encouragement, sponsorship and resources provided by the organisation, line management and colleagues.  Relationships – promoting positive working to avoid conflict and dealing with unacceptable behaviour.  Role – whether people understand their role within the organisation and whether the organisation ensures they do not have conflicting roles.  Change – how organisational change is managed and communicated in the organisation.

Question 9

Desirable conditions Demands 4

Answer 9

 Realistic and achievable demands for the agreed hours of work.  Skills and abilities are matched to the job demands.  Jobs are designed to be within the capabilities of employees.  Employees’ concerns about their work environment are addressed.

Question 10

Desirable conditions Control 5

Answer 10

 Employees have control over their pace of work.  Employees are encouraged to use their skills and initiative.  The organisation encourages employees are encouraged to develop new skills and undertake new challenges.  Employees have a say over when breaks can be taken.  Employees are consulted over their work patterns.

Question 11

Desirable conditions Support 6

Answer 11

 Policies and procedures are in place to adequately support employees.  Systems enable and encourage managers to support their staff.  Systems enable and encourage employees to support their colleagues.  Employees know what support is available and how to access it.  Employees know how to access resources to do their job.  Employees receive regular and constructive feedback.

Question 12

Desirable conditions Relationships 5

Answer 12

 The organisation promotes positive behaviours at work to avoid conflict and ensure fairness.  Employees share information relevant to their work.  Policies and procedures are in place to prevent or resolve unacceptable behaviour.  Systems enable and encourage managers to deal with unacceptable behaviour.  Systems enable and encourage employees to report unacceptable behaviour.

Question 13

Desirable conditions Role 4

Answer 13

 The organisation ensures that the different requirements it places upon employees are compatible.  Employees are clearly informed of their role and responsibilities.  The organisation ensures that, as far as possible, the requirements it places upon employees are clear.  Employees are able to raise concerns about any uncertainties or conflicts they regarding role or responsibilities.

Question 14

Desirable conditions Change 5

Answer 14

 Timely information is provided to enable employees to understand the reasons for proposed changes.  Employees are adequately consulted on changes and given opportunities to influence proposals.  Employees are aware of the probable impact of any changes to their jobs and given necessary support and training to adapt.  Employees are aware of timetables for changes.  Employees have access to relevant support during changes.

Question 15

The main focus of the Management Standards approach is on issues that are likely to be potential sources of stress for groups of employees. There is still a need to address the needs of individual workers whose experiences may be different to that of the group. This may involve:

Answer 15

 Creating an environment of open communication where employees are encouraged to talk, both formally and informally, to managers.  Reminding employees that issues can also be raised via health and safety representatives, or human resources personnel.  Encouraging employees to seek medical advice if concerned about their health.  Mentoring and other forms of co-worker support.  Provision of counselling services.

Question 16

A well-managed early return-to-work will reduce the risk of a stress related absence becoming long-term (more than one month). This is important as people generally find it more difficult to return to work after a long-term absence. Good practice in managing an early return to work requires the following actions: 5

Answer 16

(1) Keeping in regular contact with the employee helps to keep work on their agenda and offers good opportunities to plan the return to work. (2) Reviewing the situation - the employee should regularly review their situation with their GP. (3) Return to work discussions to help to identify reasons for the absence and what adjustments the manager may need to make. A structured questionnaire addressing the management standards and domestic / other non-work related pressures is helpful in identifying key issues. (4) Staged returns such as working part-time hours for the first few weeks can help to ease the employee back into their work. (5) Reasonable adjustments to reduce the pressure of work over the short-term may also help the employee when they return, for example: - temporary reduction in workload - temporary adaptations and/or changes to the job - a review may clarify the aims of the job and the tasks they are expected to complete.

Question 17

Petch v HM Commissioners of Customs and Excise 1991

Answer 17

 Petch lost his case – his employers were considered to have acted reasonably.  The case established that the employers’ duty of care to their employees covered psychological wellbeing as well as physical wellbeing.

Question 18

Walker v Northumberland County Council 1995

Answer 18

 Confirmed that ordinary principles of tortuous liability apply and the employer’s duty of care extends to protection against psychiatric as well as physical injury.

Question 19

Sutherland v Hatton 2002

Answer 19

 Signs of stress in a worker must be obvious to the employer for the worker to succeed.  Provision of a confidential counselling service is likely to be a complete defence.  An employer can usually assume that an employee can withstand normal job pressures.  The onus is normally on the worker to complain about stress or bring it to the attention of the employer.  There is no breach of duty in allowing a willing worker to continue in a stressful job.  The employer has a duty to be pro-active and not merely re-active.

Question 20

Barber v Somerset County Council 2004

Answer 20

 The employer should at least make ‘sympathetic enquiries’ and consider what could be done to help.  Ordinarily an employer may assume that employees are up to their job but a duty may arise if steps that could be taken to assist an employee who is having difficulty coping are not taken.

Question 21

Intel v Daw 2007

Answer 21

 Daw won the case despite Intel offering free counselling to staff who felt stressed.  A counselling service alone was of little or no help as it could not reduce the workload.

Question 22

The risk of violence is managed in the same way as any other health and safety risk. The key aspects of successful management are to identify the risks and decide what measures can be taken to prevent or control those risks. A straightforward four-stage approach is set out below:

Answer 22

(1) Finding out if there is a problem. (2) Deciding what action to take. (3) Taking action. (4) Checking that the action was effective.

Question 23

Techniques or tools that may be used to build up a picture of workplace violence incidents include: 6

Answer 23

 existing health and safety and security reports  safety representatives / representatives of employee safety and health and safety committees  interviews with individual staff  employee questionnaires  small staff discussion groups  specific staff meetings.

Question 24

Cases of workplace violence may be categorised in various ways. Table 8.7 identifies three categories of work related violence, and a fourth category which is not directly work-related but can occur in the workplace.

Answer 24

Criminal intent Customer / client Worker-on-worker Personal relationship

Question 25

Examples of triggers and escalators in a high-school classroom and a NHS Accident and Emergency waiting room are shown in Table 8.8.

Answer 25

Classroom  Conflicts  Denial of something needed  Something negative is inflicted  Changes in routine  Provocations  Pressure  Interruptions  Ineffective problem-solving  Academic errors  Corrections A&E waiting room  Clash of people  Lack of progression/waiting times  Inhospitable environments  Dehumanising environments  Physical pain  Intense emotions in a practical space  Unsafe environments  Perceived inefficiency  Inconsistent response to ‘undesirable’ behaviour  Staff fatigue

Question 26

In any workplace with a problem with violence it will be appropriate to devise and communicate a specific policy addressing workplace violence. A clear zero tolerance policy that is strongly communicated has been seen to have a positive impact in workplaces such as airport security check areas, NHS A&E waiting rooms and pubs and clubs. The policy should also include:

Answer 26

 detailed responsibilities of managers and staff  procedures for dealing with an incident  procedures for recording and reporting the details of an incident  control measures in place  arrangements for post-incident support.

Question 27

Workplace violence control measures will usually involve a combination of measures to:

Answer 27

 Improve the working environment (Physical).  Design the job to reduce risk (Organisational).  Provide staff with appropriate information and training (Behavioural).

Question 28

Following a violent incident involving an employee it is important to respond quickly to avoid any long-term distress to the directly affected employee or others. When planning post incident support the following should be considered: 4

Answer 28

 Debriefing: victims may need to talk through their experience as soon as possible after the event. Specialist counselling may be required.  Time off work: will depend on the degree of physical or psychological harm and the individual’s recovery process. The return to work may well need to be managed.  Legal help: in serious cases there may be criminal and civil legal action. Legal help may well be appropriate.  Other employees: may need guidance and/or training to help them respond appropriately.

Question 29

A person may use such force as is reasonable in the circumstances for the purposes of:

Answer 29

 self-defence  defence of another  defence of property  prevention of crime  lawful arrest.

Question 30

In assessing the reasonableness of the force used, prosecutors should ask two questions:

Answer 30

 Was the use of force necessary in the circumstances, i.e. was there a need for any force at all?  Was the force used reasonable in the circumstances?

Question 31

Section 76(7) sets out two considerations that should be taken into account when deciding whether the force used was reasonable. Both are adopted from existing case law. They are:

Answer 31

 that a person acting for a legitimate purpose may not be able to weigh to a nicety the exact measure of any necessary action  that evidence of a person’s having only done what the person honestly and instinctively thought was necessary for a legitimate purpose constitutes strong evidence that only reasonable action was taken by that person for that purpose. This section adopts almost precisely the words of Lord Morris in Palmer v R (1971) above.

Question 32

The burden of proof remains with the prosecution when the issue of self-defence is raised. The prosecution must provide sufficient evidence to satisfy a jury beyond reasonable doubt that the defendant was:

Answer 32

 not acting to defend himself/herself or another  not acting to defend property  not acting to prevent a crime or to apprehend an offender … and if he was so acting, the force used was excessive.