UK. HSE report into the effects of teamworking on work-related stress

Citation

(2002), "UK. HSE report into the effects of teamworking on work-related stress", International Journal of Health Care Quality Assurance, Vol. 15 No. 5. https://doi.org/10.1108/ijhcqa.2002.06215eab.002

UK. HSE report into the effects of teamworking on work-related stress

UK

HSE report into the effects of teamworking on work-related stress

In December the Health and Safety Executive (HSE) published a report, Effective Teamworking: Reducing the Psychosocial Risks Case Studies in Practitioner Format providing a detailed analysis of teamworking. The report shows that teamworking can both increase or decrease work-related stress levels, depending on the team design and methods of implementation adopted by employers.

A team involves more than a group of people working near to each other. Members of teams work collaboratively together, co-ordinating inter-dependent activities, in order to achieve shared goals. Such team working is increasingly common within modern companies as they strive to be more flexible, cost-effective and innovative. The mid-1990s saw 55 per cent of UK manufacturers using teamworking and this usage is expected to increase.

The review identifies two schools of thought. Successful teamworking can reduce employees' work-related stress through enabling greater discretion over their work environment and increasing job challenge. On the other hand, there is a danger that team working could escalate employee stress levels through increasing workload and raising uncertainty about what is expected of employees under a new approach.

A model for understanding teamworking has been put forward showing that teams can be successful if they have a positive impact on aspects such as job autonomy, skill variety and feedback. In contrast, teams that remove job discretion and increase workload are likely to have negative effects for employees. This can be the case with "lean production teams" involving employees working together on tightly linked tasks that have highly standardised methods. In addition, the model suggests that employee well-being can be better safe-guarded by designing an appropriate context within which teams work, particularly with regard to an appropriate team design, an effective implementation process, and a supportive culture.

Current research by Professor Sharon Parker and Dr Helen Williams at the Institute of Work Psychology (Sheffield University) reviews existing teamworking research in relation to employee work stress, providing background information, reviewing major theories and other studies of teamworking. In the context of the model the research reports on the results of three studies, each considering a different type of production team:

1. 1.

   Study A. A longitudinal study of the effects of implementing flexible work teams in a wire-making company.

2. 2.

   Study B. A longitudinal study of lean production teams in a vehicle manufacturing company.

3. 3.

   Study C. An investigation of self-managed teams in a chemical processing company.

Dr Helen Williams said: "implementing team working is implicitly neither good nor bad for employee well-being. Rather, the effects of team working will depend on a number of organisational, design, strategic, individual, and implementation factors.

"The important point is that organisations need to recognise that they can make choices that have important consequences for employee well-being. By pro-actively considering the factors outlined in the report, employers can make choices that enrich employees' work characteristics and thereby promote mental health at work. Employers need to be fully informed about the choices available to them, and the consequences of these choices."

Copies of Effective Teamworking: Reducing the Psychosocial Risks Case Studies in Practitioner Format, CRR393, can be ordered online at http://www.hsebooks.co.uk or are available from HSE Books, PO Box 1999, Sudbury, Suffolk, CO10 2WA. Tel: 01787 881165; Fax: 01787 313995. HSE's Contract Research Reports are available on the HSE Web site at www.hse.gov.uk/research/content/crr/index.htm

Childhood mental health problems lead to higher costs in adulthood in mental health services and criminal justice system

A major new study reported in the January 2002 issue of the British Journal of Psychiatry shows that children who suffered from depression together with conduct disorder are more likely in adulthood to incur long-term costs associated with the use of mental health services and criminal justice services. The Maudsley long-term follow-up of childhood and adult depression collected data on service use and other cost-related data from former patients.

Comparisons were made between those people with depression alone and those with depression and conduct disorder in childhood, and with data for the general population. Data on 91 people with depression and 49 with depression and conduct disorder revealed high adulthood service use rates and costs. The depression and conduct disorder group used in-patient health care and criminal justice services more frequently, and total costs were significantly higher.

The authors comment that the study confirms that there are high and long-term costs associated with childhood depression, and especially with depression and conduct disorder occurring together. Early, effective treatment could do much to reduce these cost consequences whilst also improving the quality of life of the people concerned.

For further information contact Prof. Martin Knapp. Tel: 020 7848 0174 or 01227 761 539.

New Director of Patient Experience and Public Involvement appointed

In May, Harry Cayton, Chief Executive of the Alzheimer's Society, was appointed to the new role of Director of Patient Experience and Public Involvement in the Department of Health. Mr Cayton has been Chief Executive of the Alzheimer's Society since October 1991. His professional background is in social work and special needs education and he has family experience of caring for someone with dementia. From 1982 to 1991 he was Director of the National Deaf Children's Society. He will take on this role on secondment on a flexible part-time basis from the Alzheimer's Society.

Announcing the appointment, Health Minister Hazel Blears said: "our vision in the NHS plan is for prompt, convenient, high quality services which treat patients as partners. The Director of Patient Experience and Public Involvement will play a key role in guiding the department and the NHS towards realising this vision."

Mr Cayton is also a member of the NHS Modernisation Board, a member of the Central Research and Development Committee of the NHS and vice chair of Consumers in NHS Research. He is a member of the Human Genetics Commission public involvement subgroup and St Mary's NHS Trust research and development committee.

Wider access to medicines to allow patients to manage their own health care

In May, Lord Philip Hunt announced further measures to expand patient choice in the NHS by launching a new strategy to provide wider availability of medicines. Changes to the law allow for medicines to be considered for wider availability (over the counter rather than on prescription only) by means of a streamlined process that retains essential safeguards but which dispenses with the need to amend legislation each time the legal status of a medicine is changed. The system it replaces was tied into amending legislation twice a year, on fixed time-tables. The new system, designed by the Medicines Control Agency (MCA), will more than halve the time taken for medicines currently available only on prescription, to be switched to over-the-counter (OTC) medicines. It also marks a major step in the Government's commitment to expand the range of medicines available for self-medication through pharmacies.

Launching the new process, Lord Hunt said: "today marks an important step in delivering a key NHS plan challenge of making more medicines more widely available and is another example of the Government's commitment to build a patient focused NHS. The UK already leads the way in Europe on the availability of medicines and these changes launched today will build on widening patient choice and providing an opportunity for patients to play a more active role in their healthcare."

He said that the NHS plan set out a radical action plan to put patients and people at the heart of the health service and to drive every decision made about the organisation and delivery of care. Making a wider range of OTC medicines available where it is safe to do so would give people faster access to the treatments they need. In halving the time taken for pharmaceutical companies to reclassify their products, the streamlined process will help to deliver wider access to medicines, giving patients greater control of their treatment. It will also lead to more efficient use of resources by freeing up GP time and enable pharmacists to use their expertise to help more patients manage minor ailments and chronic conditions.

Lord Hunt added: "many patients, especially those with chronic conditions, don't want to spend any more time than is necessary visiting their GPs and many are experts in their own conditions. Enabling patients to make a choice of how they access such medicines empowers patients to help them manage their own care, with the help of skilled healthcare staff."

Since the NHS plan was published in 2000 the MCA has worked on a range of options to enable wider availability of medicines over the counter, in conjunction with key stakeholders including industry professional bodies and patient groups (Long-term Medical Conditions Alliance – LMCA). The new reclassification process is part of a long-term strategy of initiatives to bring about a greater availability of medicines.

In the last ten years some 50 substances have been removed from prescription only status and made more accessible. Under the new process it is hoped that the number of changes will double.

Patient safety is a key element of the new process, and before any medicine is made more widely available it will be assessed against strict criteria relating to its safety in use.

Sheila Kelly, Executive Director of the Proprietary Association of Great Britain (PAGB) said: "PAGB welcomes the new measures announced today by the Minister. We hope they will encourage more medicines to become available over the counter and that the new working party will help to drive forward and accelerate this development."

Marshall Davies, President of the Royal Pharmaceutical Society of Great Britain (RPSGB) commented: "the Royal Pharmaceutical Society of Great Britain strongly supports the principle of increasing the number of medicines available over the counter to patients, where it is safe to do so. This is not only in the public interest but also makes greater use of pharmacists' expertise to help patients manage minor ailments and chronic conditions."

New report says NHS staff are disillusioned and demoralised

A new report from the King's Fund, Counting the Smiles, by Belinda Finlayson, says that morale is low in the NHS, putting at risk the Government's plans to modernise the service. The two biggest causes of low morale are chronic staff shortages, which make working conditions difficult, and the strong perception among staff that their work is not valued.

The research for the report, funded by the Edgar Lawley Foundation, was based on focus groups with NHS staff and managers. It says that morale is lowest where NHS staff feel their views are not heard by managers, especially where political imperatives prevail over local priorities. Many staff said training and development opportunities were denied them because shortages forced them to take extra shifts instead. In this atmosphere, it is hard for them to provide the best possible care to patients or to improve the quality of service they deliver.

Counting the Smiles argues that morale can be improved if managers spend more time listening to staff and communicate patients' thanks for their efforts. While staff shortages are being tackled, NHS organisations should ensure flexible working arrangements are made, adequate training opportunities are provided and staff are involved in efforts to improve the service.

King's Fund chief executive Rabbi Julia Neuberger said: "the NHS needs highly-motivated staff. Too many nurses, doctors, managers, therapists, care assistants and ancillary staff are demoralised. That damages their motivation and contributes to the dangerously high levels of staff turnover experienced by many NHS Trusts.

"It is crucial that NHS staff know that their political masters value their work, not merely through rhetoric but through concerted action to promote the value of public service, to continue improving pay and career opportunities, and to make their working lives considerably better. Politicians of all hues should listen intently to the views of NHS staff and patients when making plans for the service's future."

Counting the Smiles: Morale and Motivation in the NHS, by Belinda Finlayson, is available in PDF format at http://www.kingsfund.org.uk/eKingsfund/assets/applets/Counting_the_Smiles.pdf

Review of health policy since 1997

A review, published by the King's Fund, says that health policy in Labour's first five years in government leaves "an overwhelming impression of relentless, almost hyperactive intervention". Five-year Health Check, edited by John Appleby and Anna Coote, shows that the Government has introduced many new policies since 1997, trying to iron out health inequalities, raise care standards, improve NHS productivity, increase responsiveness and extend services.

The review says that there is no doubt about the Government's commitment to a national health care system available according to need and funded through taxation. It has led an unprecedented drive to put more resources into the NHS, by increasing funding, tackling longstanding staff shortages and making increasing use of the private sector. However, Labour has not yet developed a coherent and principled set of criteria to guide its decisions. Its rhetoric is often radical, but its actions, however plentiful, are essentially conservative. The Government's reforms of long-term care have failed to mend a rickety system, leaving both users and carers dissatisfied. It has entered into a massive hospital building programme with the private sector, without a clear assessment of how future needs will be met, and without transferring any substantial risk.

Rabbi Julia Neuberger, King's Fund chief executive, said: "as it approaches its fifth anniversary in Government, Labour has a lot to be proud of. It has shown real commitment to a publicly funded NHS and to improving people's chances of living healthily.

"But investment and reform have been a double-edged sword. The NHS is overwhelmed with well-meaning policy directives, must-do targets and structural changes. Primary care trusts in particular are struggling to meet all of the policy imperatives Labour has set them."

She added that if Labour really can turn around the long-term trend towards widening health inequalities, it would have made a remarkable achievement. However, she said it was evident that there are conflicting tendencies in Labour's health policies, which must be resolved if Labour is to avoid storing up problems for the future.

Five-year Health Check reviews health policy since 1997 in ten key areas, including NHS funding, quality assurance and the reorganisation of primary care services. It concludes that Labour has achieved some important and far-reaching reforms, not least setting up new organisations to improve the quality of care patients receive and opening up access to primary care, for example through NHS Direct.

However, there are also serious gaps. Too much store has been set on structural solutions to problems caused by decades of under-investment and over-centralisation.

The report concludes that the Government is travelling in the right direction, towards a more robustly funded NHS, improved standards of health and social care, more patient-centred services and a system that is trying to reduce health inequalities. But it has raised public expectations of the NHS, putting it under enormous pressure. It recommends that the Government should now:

• •

  Keep the money flowing, but dispelany remaining illusions that money alone will save the NHS.

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  Stop the incessant flow of orders from the centre, build the morale and confidence of the workforce, and enable them to take ownership of the reform process.

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  Have fewer, broader targets for the NHS, which are costed and funded appropriately.

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  Give a higher priority to improving health and reducing health inequalities.

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  Prepare the public for the long haul: stop making heroic promises and buckle down to the unglamorous detail of building a good-enough health system for the twenty-first century.