Stress accounts for 30% of sickness absence within the NHS and costs the service between £300 million and £400 million every single year.

Yet that those figures are only related to the acknowledged cases of stress. Many people suffer from its symptoms and consequential illnesses without even realizing it. Illnesses related to stress are often unacknowledged as being caused by, or contributed to, by the stress in the workplace, and these can ultimately include life threatening illnesses such as diabetes, heart disease, and even certain forms of cancer.

Stress is a real problem that increasingly seriously affects the very fabric of the NHS. And it’s not limited simply to overworking, but is caused by a whole range of work-related issues including but not limited to:

Working conditions: Being in unpleasant working conditions can have significant effects on your psychological health as well as your physical health. Noise, heat, lack of natural light, humidity can all contribute.

Lack of Involvement and Engagement: Being denied any say in the decisions in the way you work and/or in your working conditions. When staff are denied the opportunity to be genuinely engaged in decisions which affect the way they carry out their duties, and the subsequent manner in which the provide their contribution to patient care, that itself can cause stress. Applying for Foundation Trust status requires the employer to provide proof that Managers actively engage staff in decision making processes, and in not doing so, those Managers fail their employer, as well as their employees.

Bullying: There is a Bullying Section on this site specifically dedicated to the issue of bullying, so we won’t detail it here, but suffice it to say that bullying, from individual bullying by a single colleague, to bullying by a Manager of a whole department, or even a directorate, can be a significant factor in relation to work related stress.

Existing sickness: When management persecute staff with genuine physical illness, they frequently only succeed in compounding the illness with stress, and extending the period of sickness. The more that pressures increase on NHS staff, the more that stress affects more members of staff; the more draconian become the policies and the increasingly counterproductive attempts to reduce sickness levels, which only serves to make the situation even worse. If you feel you are suffering from the effects of work-related stress, or your physical illness is caused by, contributed to, or made worse by work-related stress, then talk to your GP. If your GP considers that your job is a contributory factor to your illness, then ask them to specify that it is "Work Related" or that there is a "work-related" element to your illness on any medical certificate they feel it is appropriate to issue. You employer has a duty to at least investigate any causes of work-related stress before you return to work. Incidentally, on a side issue, UNISON is increasingly hearing about staff who are being told they have to take annual leave for hospital appointments. This is absolutely not the case and you are entitled under the present sickness policy to time off work for hospital appointments.

Firstly, do NOT be dismissive of colleagues suffering from stress. Understand the causes and real effects it can have on people. You’re not helping them, and even if not now, long-term you’re probably not helping yourself. Managers need to take the issue of stress seriously, and they are hardly encouraged to do so if colleagues of people suffering from stress are being dismissive, trivialising or even ridiculing them. (Incidentally, and just to be clear, if you are ridiculing staff because of a biggoted unqualified opinions you hold about stress, then YOU are a bully). Take the time to learn about stress, understand the impact, both obvious and subtle, that stress can have, and may be having, on your colleagues, and on yourself. If your colleagues are suffering from stress, they will need all the support they can get.

If you are working in an un-managed work-related stress environment, request that a suitable and sufficient departmental risk assessment be carried out, which includes a work-related stress assessment, and the more of you request it at the same time, the better. I can't emphasize this enough - colleagues need to be united to encourage managers to address this problem, and bad managers will find any excuse not to take this issue seriously if nobody else is. Staff need to work together to combat stress in the workplace, not only take an interest when and if it affects you. Your employer has obligations under law not just to carry out a competent assessment, and its not merely limited to taking effective initial actions to respond to the findings of that assessment, but it is also to regularly review and re-assess the situation, and to monitor the ongoing effectiveness of any actions they take in response to that assessment. Don't let the issue slide, if an issue isn't being addressed or resloved, keep raising the issue, preferably in writing, preferably with the backing of colleagues.

Keep a diary and write details of incidents, conversations, how you feel, how work is affecting you, and keep copies of all correspondence sent and received related to these issues, no matter how irrelevant they may seem at the time. Keeping such records can help you in regard to your employer's management of the sittuation, but it can also help you understand the different phases and processes and how it is affecting you at different times.

Give serious consideration to joining a trade union that will represent you and defend your legal right to have the causes of your stress resolved or at least minimized.

Lastly, UNISON firmly believes that the best and the only way to reduce work-related stress and subsequent sickness levels throughout the NHS, is to modernize its antiquated and rigid hierarchical structure, and to genuinely involve and engage staff in the decisions that affect their working conditions and their contribution to the services they provide, and to genuinely embrace the experience, knowledge, commitment, and passion of all staff, at every single level.

The pages in this section are to provide an insight into the causes and the effects of stress, the obligations of employers and managers to manage that stress, but also to your obligations to yourself and to your colleagues.

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