Healthy workplaces staff support and stress at work policy

1 Introduction

The trust is committed to supporting the wellbeing of its employees and recognises that maintaining both the physical and mental health of its workforce results not only in more effective delivery of services but also in the trust being a good place to work. The trust has a commitment to work in a trauma informed way.

Many of the factors which impact upon physical health are addressed through existing health and safety policies. This policy therefore:

places emphasis on maintaining positive mental health and in particular recognises how, unless proper arrangements are in place, stress in the workplace can impact adversely on this objective and people may become re-traumatised. The policy recognises the importance of identifying and managing workplace pressures and of providing a positive and supportive environment and climate
sets out a framework, the roles and responsibilities for providing support to employees involved in potential traumatic or stressful incidents, situations, complaints or claims and how the emotional impact can be minimalized or managed
describes the support and advice available to employees who have been requested to attend or prepare a formal witness statement for proceedings or hearings or if they have been called to give evidence in a case related to the trust

2 Purpose

The purpose of this policy is to demonstrate the trust’s commitment to the wellbeing of its employees by providing a framework to identify, support and positively manage workplace stress and the impact of traumatic incidents. The support arrangements which are available are detailed in appendix D.

2.1 Definitions

Workplace stressors are defined as organisational factors identified by undertaking a systematic risk assessment.

Stress is defined by the health and safety executive (HSE) as the adverse reaction people have to excessive pressure and other types of demands placed on them.

This policy brings to the attention of both managers and employees the distinction between pressure which, if managed correctly, can be positive, but excessive pressure can lead to stress which can be detrimental to health. This policy considers suitable measures to be implemented to reduce and eliminate stress and promote positive mental health.

A stressful incident can be described as any event which has a stressful impact sufficient to overwhelm the usual coping skills of an individual or group.

2.2 Examples of traumatic incidents

Examples of traumatic incidents, complaints and claims may include examples of the following:

traumatic or stressful incidents (including suicides, homicides, assault and injury)
serious incident investigations
coroners inquests
complaints
clinical negligence claim
non-clinical litigation
police enquiries or investigations
professional conduct hearings (not internal disciplinary procedures which is covered by a separate policy)
child protection or care proceedings
tribunals
investigation and disciplinary hearings
grievance
professional body concern
pandemic management
chronic excessive workload related to absenteeism
support following death or serious illness of a colleague
employment tribunals and coroners inquest

3 Scope

The policy applies to all directly employed employees and to volunteers. It also applies to those indirectly employed in the provision of our services where we have a shared responsibility with others, for example, students on placement; colleagues from other statutory and voluntary agencies; agency staff; etc.

The policy covers a range of issues, set out below, which contribute to the framework of support necessary for this policy to be effective.

This policy must be read and implemented in conjunction with a number of complimentary policies and initiatives which either address specific issues of relevance to the wellbeing of employees at work, both mental and physical, or provide more general support for the development of an appropriate management culture and work environment.

4 Responsibilities, accountabilities and duties under the policy

4.1 Chief executive and board of directors

The chief executive and directors are responsible for the health and wellbeing of trust employees, and to achieve this must have effective systems in place to support and manage stress in the workplace and traumatic incidents. They are responsible for ensuring that there is good communication in place between managers and employees, a safe working environment and that the approach to employees or volunteers is managed in a trauma informed with fairness and consistently.

4.2 Care group directors, directors, corporate heads of service or deputy care group directors

The corporate directors, corporate heads of service and deputy care group directors are responsible for the implementation of this policy within their directorate or care group.

They are responsible for ensuring a proactive approach to stress management and have a duty to ensure that line managers follow the framework of this policy and that it is communicated with in their area of responsibility.

4.3 Service managers or modern matrons

The service managers are responsible for reviewing all incidents and offering the appropriate support as detailed in appendix D.

4.4 Occupational health service

The occupational health service following a management referral will provide advice and support where appropriate and sign post the employee to alternative sources of support.

4.5 Human resources department

In conjunction with the occupational health service, be responsible for advising the line manager on appropriate methods of support to an employee suffering from work related stress or any ill health as a consequence of involvement in a traumatic incident. They will provide guidance to managers and employees on the implementation of the policy.
Involved in supporting the process undertaken to investigate any concerns raised by an employee involved in an incident, complaint or claim raised though the trust grievance and dispute procedure.
Provide appropriate support and advice for any employees who are called as a witness under HR policies and procedures.

4.6 Line managers

Responsibilities are to:

identify incidents to staff that may result in stress (for example, death of a patient)
assist employees in managing stress in others and themselves
follow the correct reporting and support procedures for employees who have been involved in traumatic incidents, appendix D
identify workplace stressors and conduct risk assessments to eliminate or reduce stress and control the risks from stress including the implementation of any recommendations
have an awareness of and promote the courses or support networks which are available internally within the trust, such as resilience training and the employee assistance programme
ensure that employees are clear on their roles and are appropriately trained to undertake their roles effectively
set realistic workloads, review and monitor the management of workload of employees
keep managers informed of factors such as increased service requirements, high employee absences and knock-on effects to remaining employees and highlight any conflicting demands to the directors
maintain a local culture of support particularly for employees returning to work from a stress related absence
be aware of issues such as bereavement, debt, separation, divorce and illness of close relatives, which can all have an effect on work performance
be aware of illnesses such as depression and other diagnosed mental health conditions, which manifest quite gradually and affect performance and thought logic, which in time can lead to anxiety, stress or other diagnosed mental health condition
use available resources such as occupational health service, counselling and promote the 24-hour employee assistance programme or helpline where individuals give cause for, or express concern, see appendix A for further details
be aware of and implement other trust policies which may provide assistance in particular cases
highlight to both employees and directors the consequences of not managing work related stress for the trust in terms of potential litigation, increased levels of absence, loss in productivity and employee engagement
share any organisational risk assessment with the relevant director or head of service who will then review the risk assessment

4.7 Employees

Employees have a responsibility to ensure they access and complete mandatory and statutory training in a timely manner and where appropriate, additional training relevant to their job role to ensure effective working practices.
Employees are encouraged to raise issues in an appropriate and timely way with their line manager, or if they feel unable to do this, with another appropriate party. Employees may also wish to raise concerns in accordance with the freedom to speak up policy. Employees can also raise concerns with their trade union or professional organisation representative or human resources.
Employees shall take responsibility for their own health and welling including working healthily, taking regular breaks, rest and holidays and supporting one another. Employees have the responsibility to raise issues if breaks are regularly being missed and unsupported.
Employees should engage with the support offered, where it is considered to be beneficial to the employee and advise the line manager if they are absent from work as a result of work related stress or a traumatic incident.

4.8 Trust health, safety and security forum and trust staff council

The health safety and security forum has an overview of all areas of health and safety which includes stress at work and traumatic incidents, they will work in collaboration with the trust staff council as appropriate.

4.9 Trade unions or professional organisation representatives (staff side representatives)

Trade union or professional organisation representatives support the trust:

in its efforts to ensure that all employees are supported when they experience pressure or stress in the workforce or a traumatic incident
to raise any concerns in relation to pressure or stress in the workplace with the line manager or human resources
to inform the workforce of the policy and to encourage employees who may have problems, to use the facilities and support mechanisms available within this policy and procedure
to advise members of their rights and responsibilities under the policy and to be available to represent individuals as appropriate

5 Action to address, reduce and minimise workplace stress

5.1 Causes of workplace stress

In order to manage workplace stress it is important to consider where and how stress can be caused. There are three key areas which need to be considered as potential areas where work place stress can develop, namely the ‘employees feeling or developing stress, working in a stressful environment and also stress developing in relation to the job itself

5.2 Health and safety executive (HSE) categories

Line managers are best placed to identify early signs of stress and will be responsible for ensuring that work place risk assessments are completed for the purposes of identifying possible sources of work-related stress and developing specific service action plans to address areas of identified risk. Further details are provided in appendix C.

The health and safety executive has identified six broad categories or standards for work-related stress. These management standards are designed to support organisations working in partnership with their employees and representatives to undertake regular risk assessments and develop shared action plans. These are, with some examples:

demand, including high workload, work patterns, the working environment.
control, how much say a person has in the way they do their work.
support, includes the encouragement, sponsorship and resources provided by the trust, line management and colleagues.
roles, whether people understand their role within the trust and whether the trust ensures they do not have conflicting roles.
change, how organisational change is managed and communicated in the trust.
relationships, promoting positive working to avoid conflict and dealing with unacceptable behaviour.

5.3 Identifying signs and symptoms

There are a number of signs and symptoms which can be related to employees developing or experiencing work related stress which is detailed further in appendix B. If any of these signs and symptoms are identified it is important their line manager is made aware in order to support and put in place any action that is required.

Where stress has been identified the employee and line manager should complete the stress risk assessment detailed in appendix F to develop an action plan to tackle and if possible reduce or eliminate work related stress.

Workplace stressors are identified through a number of different sources, the list is provided for illustrative purposes only and is not exhaustive

supervision sessions
PDR meetings
sickness absence meetings or return to work interviews
individual risk assessments
team or organisational risk assessments
staff survey results, which will identify any team reported issues linked to stress
complaints analysis
shadowing or observations
FTSU concerns
staff diversity network meetings’

It should also be remembered that the source of stress may be from outside the workplace. Employees experiencing stress from home, family, long term conditions or financial pressures may find it difficult to separate these from their working life and consequently are not able to deal with work matters efficiently and effectively. Line managers should be aware of the physical and behavioural effects of stress (see appendix B) and if they observe any changes in behaviour this should be immediately discussed with the employee in a supportive manner in an attempt to prevent the escalation of stress.

5.4 Departmental stress

Where stress hazards have been identified in a department it is important for all employees to have the opportunity to work in partnership to develop an action plan to reduce the effects of workplace stress. A participative team approach is essential to tackle the causes of workplace stress which describes methods of involving employees to tackle workplace stress. It is the responsibility of the manager to escalate departmental stress and utilise the stress tool to identify the underlying causes and then the possible actions or recommendations to address the issue.

5.5 Traumatic incidents

The trust recognises there may be situations where employees are involved in stressful events, traumatic incidents, claims or complaints that may adversely affect those individuals where ongoing support may be required. Traumatic incidents can be described as:

traumatic or stressful incidents
serious incident investigations
coroners inquests
complaints
allegations of negligence (clinical negligence claims)
non-clinical litigation (for example, claims brought by employees or visitors)
police enquiries or investigations
professional conduct hearings (for example, GMC, Nursing and Midwifery Council)
child protection or care proceedings
court hearings (such as clinical negligence claims)
tribunals

5.6 Accessing support

The customary procedure to be followed when supporting an employee involved in any kind of traumatic incident is set out in a flow chart (appendix D).

Each line manager will be responsible for supporting their employees which should take the form of an initial discussion to ascertain how they are feeling; the impact of the incident on their wellbeing and to identify what support would be most beneficial to them. For serious traumatic incidents the employee may require immediate emotional support prior to the end of their shift. Follow-up meetings should be arranged to ensure the employee is not suffering ill effects such as post traumatic stress disorder (PTSD) and further support should be arranged as required. Consideration can also be given to temporary or permanent redeployment, which would require support from the occupational health service. Further information is available in appendix E.

The occupational health service, internal psychological therapy service, employee assistance programme and the trust chaplaincy may also be considered for immediate support. Details of these are in appendix A.

If the traumatic incident is specifically related to a resuscitation or restraint situation, subject-matter experts in the Learning and Development team also have a responsibility to provide team and individual support which may benefit employees to manage the trauma

Details of other policies and procedures which may be of benefit are listed in section 9.

5.7 Ongoing support

Where employees continue to suffer from the effects or experience difficulties associated with the traumatic incident consideration should be given by the manager and the employee to engage further support from internal and external sources.

Individuals, regardless of grade, banding or position, may often feel anxious about their involvement in an incident, complaint or claim and their future role in the process. Support needed may vary, depending on the issues and the specific needs of the individual. The following are examples of support arrangements that may be made available to employees.

Provision of a named contact who will ensure that appropriate support is made available on an ongoing basis.
Provision of regular, clear, concise information regarding any investigation or proceedings.
Advice from relevant professional groups or staff side (for example, RCN, RCM, GMC, Unison) that may be able to help.
Agreed timetable with the individual for review and communication.
Support for witnesses at Hearings etc. as appropriate.
Access to legal and professional advice if appropriate.
Regular updates on case outcomes and recommendations, as appropriate.
Opportunity to evaluate the effectiveness of the support offered and provide suggestions on improvement.
Referral to occupational health as required.
Increased clinical or management supervision.
Adjustment of current caseload.
Temporary or permanent redeployment.

In circumstances where a conflict of interest exists between the organisation and an employee, employees will be encouraged to seek external advice from professional groups for example the RCN, GMC or their union representative. They may also choose to seek external legal advice from groups such as the medical defence union or medical protection society.

Examples of such support are:

employees may require some phasing back in to the normal duties after a significant incident
adjustment to case load or workload
temporary or permanent redeployment
being provided with a named contact
regular updates on the incident and developments
increased supervision
advice from relevant professional groups or staff side help
concise review and communication on outcomes and recommendations
access to legal and professional advice if appropriate

5.8 Being called as a witness

According to the circumstances, specialist support, for example, the trust legal advisors, may be available where the employee is required as a witness to give evidence in court proceedings. This requirement should be recognised by the line manager or incident investigator and agreed by the director, corporate head of service and deputy care group director.

Employees when required to give evidence in court or are witnesses in HR procedures, such as disciplinary proceedings or a bullying and harassment investigation, may also consult with their trade union or professional body, who will be able to support and assist the employee.

Should an employee be required to act as a witness and need further support or advise on time off to attend, they should speak to their line manager or seek advice from the human resources department.

6 Training implications

6.1 Employees

How often should this be undertaken: On revision of the policy or new appointments or promotions.
Delivery method: Employees will be made aware of the policy and its contents following the issuing of the policy on the internet and as part of discussions with employees in PDR or supervision sessions
Training delivered by whom: Line managers.

6.2 Managers

How often should this be undertaken: On revision of the policy or new appointments or promotions.
Delivery method: The risk assessment pro forma is self-explanatory. The HR department and the trust health and safety advisor will offer support where needed.
Training delivered by whom: Line managers or human resources.

7 Monitoring arrangements

7.1 Duties under the policy

How: Stress risk factors reported through staff survey, for example, excessive workload staff survey results stress-related sickness absence levels, through ESR.
Who by: HR manager.
Reported to: Care group meetings and relevant corporate heads of service or deputy care group directors.
Frequency: Annually.

8 Equality impact assessment screening

To access the equality impact assessment for this policy, please see the overarching equality impact assessment.

8.1 Privacy, dignity and respect

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, “not just clinically but in terms of dignity and respect”.

As a consequence the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity and respect, (when appropriate this should also include how same sex accommodation is provided).

8.1.1 How this will be met

This policy does not apply to patients; it is an employment policy.

8.2 Mental Capacity Act (2005)

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individuals’ capacity to participate in the decision-making process. Consequently, no intervention should be carried out without either the individuals informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all employees working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005) to ensure that the interests of an individual whose capacity is in question can continue to make as many decisions for themselves as possible.

8.2.1 How this will be met

All individuals involved in the implementation of this policy should do so in accordance with the guiding principles of the Mental Capacity Act (2005) (section 1).

9 Associated documents

10 References

Health and Safety at Work etc Act 1974 (opens in new window).
Management of Health and Safety at Work Regulations 1999 (opens in new window).
Equality Act 2010 (opens in new window).
Making the stress management standards work. How to apply the standards in your workplace, HSE 2005.
Nice guidance on PTSD (opens in new window).
Supporting our NHS people facing stress, NHS employers (opens in new window).
Agenda for change terms and conditions handbook, annex 7.
The NHS people plan.

11 Appendices

11.1 Appendix A Management of pressure or stress, useful contacts

11.1.1 Occupational health

Occupational health (opens in new window)

11.1.2 HR teams

Tickhill Road site
Phone: 03000 213 000
Email: rdash.askhr@nhs.net

11.1.3 Trust chaplains

Tickhill Road site
Phone: 03000 213 000
Email: rdash.chaplaincy@nhs.net

11.1.4 Employee assistance programme or helpline

Phone: 03303 800 658
Vivup (opens in new window)

11.1.5 Health and safety executive

11.1.6 Mental health foundation

Mental health foundation (opens in new window)

11.1.7 Advisory conciliation and arbitration service (ACAS)

11.1.8 Citizens advice bureau

Phone: 03444 111 444
Citizens advice (opens in new window)

11.1.9 FTSU Champions

FTSU champions (staff access only) (opens in new window)

11.2 Appendix B Line managers should take action when they observe or if a staff member reports any of the following effects

Physical effects:

raised heart rate
blurred vision
increased sweating
aching neck or shoulder
headaches
skin rashes
dizziness
loss or gain in weight
tiredness
faster breathing or pulse
lowering resistance to infections

Behavioural effects:

poor work
mood swings or depression
lack of self esteem
more accident prone
changing sleep patterns
no enthusiasm
poor concentration
irritability
inability to deal calmly with everyday tasks or situations
increased anxiety, irritability, frustration, or aggression
tendency to drink more alcohol or smoke more

11.3 Appendix C The health and safety executive stress management standards

The health and safety executive stress management standards identify potential stressors at work in six key areas of the environment, and within each of these, the trust will identify actions which will both pro-actively assist employees to maintain health at work and assist in the event that difficulties begin to be experienced.

11.3.1 Work element, role

Characteristic: Clarity.

Action required: Ensure employees have a clear statement of their role.

Characteristic: Supervision.

Action required: Ensure employees have regular time set aside to discuss with their line manager their performance, progress and anything else of relevance to their effective contribution and to their job satisfaction.

11.3.2 Work element, demands

Characteristic: Workload.

Action required: Ensure managers assess workload ‘(and to use any available tools or resources to assess workloads) and ‘and take the appropriate action to rectify this as part of the regular supervision with employees.

Characteristic: Training.

Action required: Ensure employees have the necessary skills to be able to undertake their role.

Characteristic: Working time directive.

Action required: Ensure managers and employees are aware of Working Time regulations.

11.3.3 Work element, control

Characteristic: Communication.

Action required: Ensure employees, as a minimum, are kept fully informed about all matters that affect them.

Characteristic: Involvement.

Action required: Ensure employees and their representatives continue to become an integral part of the decision-making process

Characteristic: Work-life balance.

Action required: Maintain and develop policies to support employees in securing a realistic work-life balance, including flexible working and support for employees with carer responsibilities.

11.3.4 Work element, relationship

Characteristic: Culture.

Action required: Ensure that employees are supported and treated fairly, and that decisions are rational and transparent.

Characteristic: Rights and responsibilities behaviours.

Action required: The trust will affirm the rights and responsibilities of all employees as set out in the NHS constitution.

Characteristic: Bullying and harassment.

Action required: The trust will promote behaviours in which employees treat each other with civility, consideration and respect. The trust will have in place a policy which affirms the unacceptability of bullying and harassment and offers both a process and tangible support to assist employees in addressing such problems.

11.3.5 Work element, support

Characteristic: Risk assessment.

Action required: The trust will ensure that a risk assessment is undertaken for any activity which may compromise physical or mental wellbeing.

Characteristic: Occupational health.

Action required: The trust will provide access for employees to occupational health services.

Characteristic: Counselling.

Action required: The trust where appropriate will provide counselling for employees affected by stressful situations where such support is not already being received.

Characteristic: 24 hour employee assistance programme or helpline.

Action required: The trust will provide access for employees to the confidential employee assistance programme or helpline.

11.3.6 Work element, change

Characteristic: Consultation.

Action required: Ensure the trust has effective two way communication systems in place to consult with employees on any change management programmes. Support employees prior and during change management and ensure that they are resilience support.

The above elements are neither an exhaustive list nor mutually exclusive in their nature. They offer a framework through which to consider varying areas of action.

11.4 Appendix D Flowchart, employee or managers guide, steps to follow

I am stress or my employee is stressed.
Is it health related? Do I need to seek support through occupational health or contact the employee assistance programme?
- refer to sickness absence policy
- refer to policy and procedure in relation to employees with drug and alcohol related problems
- refer to management of HIV or AIDS infected health workers policy
- refer to smoke free policy
Is it home related?
- do I need to speak to HR or union rep?
  - Go to step 7.
Do I need to speak to an independent person?
- FTSU guardian or champions or staff side representative, refer to respect, civility and resolution policy (formally bullying and harassment policy
Is it work related? Do I need to speak to my manager or employee?
Have a meeting with manager or employee to discuss problem.
Problem identified, has risk assessment been undertaken?
- is it bullying? refer to respect, civility and resolution policy (formally bullying and harassment policy
- is it to do with work pattern? refer to flexible working policy arrangement or discuss other options
- is it to do with domestic, personal and family issues? refer to policy in relation to special leave
- is it to do with concern about healthcare provision? refer to disclosure of concerns on healthcare matters policy and procedure (whistleblowing)
- do I feel I have been mistreated in any way? refer to grievance and dispute procedure, refer to policy for the prevention of work-related violence and aggression and or refer to change management policy and procedure

11.5 Appendix E Flow diagram for the provision of support to employees

Traumatic or stressful incident or event occurs.
Employee(s) affected are identified. Debrief, this is a specific term in the PTSD guidance, it may be better to use 1 to 1 meeting arranged for the employee with their line manager or other appropriate manager (if meeting with line manager might compromise any investigation).
Options for support are discussed:
- offer access to psychological or clinical support, 24 hours employee assistance program
- further sessions of managerial support or supervision
- temporary or permanent adjustment to working arrangements
- support via Chaplaincy team
- refer occupational health service
Regular meeting with, and review by, line or appropriate manager to assess for symptoms of continuing adverse impact on member of employees, including PTSD. Where sever symptoms are reported and or evident refer to occupational health service and or advise to individual to see GP.
Further interview with manager to take place routinely to ascertain impact of event or experience on employees member and effectiveness of support to date. Ongoing support offered if required. All support to be clearly documented on personal file.
- no symptoms report or evident, continue to monitor informally during supervision
- symptoms report or evident, refer (back) to occupational health service or further discussion of support options available

11.6 Appendix F Post traumatic stress disorder

NICE guidance says that post-traumatic stress disorder (PTSD) develops following a stressful event or situation of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone. PTSD does not therefore develop following those upsetting situations that are described as ‘traumatic’ in everyday language, for example, divorce, loss of job, or failing an exam. PTSD is a disorder that can affect people of all ages. Around 25 to 30% of people experiencing a traumatic event may go on to develop PTSD.

In the event of a major traumatic incident the trust managers may see large numbers of employees requiring support and or psychological therapy interventions. It will be necessary, if this were the case, to consider the following:

offering overtime to psychological therapy employees
requiring employees to temporarily suspend non-urgent service user appointments (under supervision)
contracting with external providers of psychological therapists.

11.6.1 The symptoms of PTSD (DH, 2005)

The most characteristic symptoms of PTSD are re-experiencing symptoms. PTSD sufferers involuntarily re-experience aspects of the traumatic event in a very vivid and distressing way. This includes flashbacks where the person acts or feels as if the event was recurring; nightmares; and repetitive and distressing intrusive images or other sensory impressions from the event. Reminders of the traumatic event arouse intense distress and or physiological reactions. In children, re-experiencing symptoms may take the form of re-enacting the experience, repetitive play or frightening dreams without recognisable content.

Avoidance of reminders of the trauma is another core symptom of PTSD. This includes people, situations or circumstances resembling or associated with the event. People with PTSD often try to push memories of the event out of their mind and avoid thinking or talking about it in detail, particularly about its worst moments. On the other hand, many ruminate excessively about questions that prevent them from coming to terms with the event (for example, about why the event happened to them, about how it could have been prevented, or about how they could take revenge).

PTSD sufferers also experience symptoms of hyperarousal including hypervigilance for threat, exaggerated startle responses, irritability and difficulty concentrating, and sleep problems. Others with PTSD also describe symptoms of emotional numbing. These include lack of ability to experience feelings, feeling detached from other people, giving up previously significant activities, and amnesia for significant parts of the event.

Symptoms of PTSD often develop immediately after the traumatic event but in some (less than 15% of all sufferers) the onset of symptoms may be delayed. PTSD sufferers may not present for treatment for months or years after the onset of symptoms despite the considerable distress experienced, but PTSD is a treatable disorder even when problems present many years after the traumatic event. Assessment of PTSD can, however, present significant challenges as many people avoid talking about their problems even when presenting with associated complaints.

11.7 Appendix G Stress risk assessment

Appendix G Stress risk assessment (staff access only) (opens in new window)

Document control

Version: 3.1.
Unique reference number: 445.
Approved by: Corporate policy approval group (CPAG).
Date approved: 8 January 2024.
Name of originator or author: Human resource advisor.
Name of responsible individual: Director for people and organisational development.
Date Issued: 9 January 2024.
Review date: September 2024.
Target audience: All employees, volunteers, students and those working in partnership with the trust (those working in partnership with the trust are also likely to be covered by their own employing organisations policy for managing stress in the workplace).
Description of changes: Three year review.

Page last reviewed: December 06, 2024
Next review due: December 06, 2025

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