Stress fractures

Managers can no longer ignore the human and financial costs of
stress, especially as workers are beginning to take action – and
win – in the courts, writes Henrietta Bond.

Janet Ballantyne, a former residential social worker in
Strathclyde, received £66,000 last month in an out of court
settlement after being forced to take early retirement because of
stress-related illness. John Walker, a former senior social worker
with Northumberland, made history when he became the first worker
to sue his employer successfully for stress and overwork. He won
compensation of £175,000 earlier this year.

Stress has long been regarded as part of the job. But, in an
environment of ever-increasing workloads and reduced resources, for
how much longer can employers ignore the human and financial costs,
now that workers have proved they are prepared to fight back?

Though cases of legislative action against social services and
social work departments are still rare enough to warrant media
attention, since the Walker case hit the headlines Unison has
witnessed a huge increase in numbers seeking help for
stress-related problems.

Many of these problems are handled locally, through stewards who
receive regularly updated guidelines. But the union makes clear
that it will take whatever action is necessary to combat
unrealistic demands on its workers.

‘The message coming through to us is that people are fed up with
work pressures at every level of social services and social care,’
says John Findlay, Unison’s national officer for social services.
‘The main areas of concern are staffing levels, reduced resources,
increasing demands and the changing nature of clients’ needs –
whether you’re a social worker, a home help or a care
assistant.

‘Under community care legislation, social workers may find
themselves with a doubled case load working for clients with
complex problems, who would have received care from other services.
Workers in residential units for elderly people may be caring for
people who previously would have been in hospital units. And while
we hear increasing reports of workers facing threats of violence or
verbal abuse from clients, we have a situation where more staff are
going to home visits alone. It’s no wonder so many face
burn-out.’

Some authorities have tried to find remedies for stress,
responding with staff care programmes or by instructing staff only
to undertake the amount of work they are capable of handling. But
Findlay says there has been an upsurge in complaints from other
departments, which are pursuing punitive policies on staff
sickness, some of which arise from stress. Rather than ask why the
levels of absence may be rising, some senior managers are taking
disciplinary action against workers who are considered to be taking
too much time off.

Together with the British Association of Social Workers, Unison
is launching a policy statement on violence, abuse and stress. ‘We
hope to generate a wider debate,’ Findlay says. ‘There are plenty
of individual cases and everybody is moaning, but so far we haven’t
said clearly to managers, enough is enough.

‘Our members should not have to tolerate punitive responses to
problems caused by too much pressure. We may have to say to
members, if your caseload used to be half its current size and is
now far too large, then you must insist that you will not do more
than a certain amount.’

Worst of all for staff is the failure to acknowledge that they
are working with greater demands and less time to meet them, says
Bob Lewis, senior vice president of the Association of Directors of
Social Services. Managers have a responsibility to help staff cope
with the pressures and to give priority to working methods which
avoid making unrealistic demands. At times, he says, this may
involve informing a social services committee and other elected
members there are certain areas of work which cannot be
performed.

A written supervision policy is crucial if the type of situation
which occurred in the Northumberland case is to be avoided. It was
claimed managers knew about stress but did nothing to alleviate it.
Lewis says: ‘When you are under pressure to deliver, it’s easy to
say you can’t do anything. But, through supervision, you have an
opportunity to look at ways of supporting your staff, either by
helping them develop coping strategies, developing their skills or
diverting work away from them. I won’t claim we always practise
what we preach – but it’s definitely something we must aim
for.’

Jeff Hopkins, head of staff care at Keele University and a
consultant with BASW, believes no one can afford to ignore the
effects of stress on the workforce. ‘With the increasing focus on
the primacy of the customer, we are seeing an increase in client
complaints and possible litigation, which has recently become a
problem for health trusts. And with these pressures from clients
come pressures on staff, who must deliver these services and who in
turn may resort to litigation.

Insurance companies are looking to employers to show they have
addressed employees’ grievances about overwork before they insure
against big compensation pay-outs of the kind made to Ballantyne
and Walker. ‘We have seen the role insurers can play, in the case
of Clwyd and the report which was blocked,’ Hopkins says.

According to Hopkins, most counselling programmes for stressed
employees carry the wrong emphasis. Many of them have been imported
from America and were designed to help staff cope with alcohol- and
drug-related problems. Instead, Hopkins argues, employers should
develop the ‘staff care’ approach, a comprehensive programme which
makes prevention rather than cure the priority.

‘Picking up the casualties is not enough and, without the will
from managers, any service will just be fractured,’ Hopkins claims.
‘Surveys show the most stressed people in social services are
managers who know they are asking the impossible of their staff,
because they, in turn, are responding to unrealistic expectations
from government. That way the stress just goes on down through the
organisation.’

Services to clients are likely to suffer unless there is a
change of heart. The prevailing mood is one of, ‘if you can’t cope
with the heat, get out of the kitchen’, says Mike Evans, a
consultant in management organisation at the National Institute for
Social Work. ‘We need to say that if the heat is too great, then
let’s put in air conditioning.

‘To do this we need to develop a competent workplace, which is
able to listen and learn from its workers. The only thing which
really matters is the interaction between front-line workers and
users; everything needs to work towards supporting this work and
developing the quality of that service.’

Evans feels the emphasis in some departments is placed on the
wrong aspects of service delivery, generating unnecessary stress
for workers and little benefit for clients. Performance targets
imported willy-nilly from the commercial sector do not dovetail
with the social worker’s role, he says.

Consequently, bureaucracy mushrooms around the minutiae of the
job, stipulating, for instance, that the phone is answered by the
third ring, which often means the caller is put on hold or answered
by the wrong person. ‘Most service users would rather wait and be
answered by someone who can really help them, rather than getting
the “have a nice day” approach.’

Just as front line workers are required to have strong
professional principles involving openness, honesty and a spirit of
partnership with clients, Evans believes managers must demonstrate
the same principles in the way they treat staff. ‘Some authorities
have a long way to go in achieving these aims, but generally
there’s an interest in creating a culture which is responsive
rather than prescriptive,’ he says.

Sandwell social services department has an in-house staff care
service which offers training, consultancy and counselling. Anne
Gilbert has been with the service since it started in 1989 and
there is now a vacancy for a worker with black staff. Gilbert says
there is no shortage of takers when courses are offered on topics
such as stress management, assertiveness and planning for
retirement, from staff at every level in social services.

‘My work is about removing the stigma around stress and
providing an independent service which staff can use and managers
can refer people to,’ Gilbert says. ‘The number of people coming to
us remain fairly consistent from year-to-year, but sometimes there
are higher numbers from an area where restructuring is taking
place.

‘Disciplinaries, inter-personal conflicts and problems at home
are all issues which people bring to us, and there is also
frustration about feelings of responsibility staff have towards
their clients when services are cut.

‘As an in-house service we are able to feed back to senior
managers if we see particular problem trends occurring. We see
ourselves as part of an overall support system, including
individual support groups, for example for black workers and
disabled workers, with support from management, line managers and
unions. We are raising awareness and encouraging everybody to be
involved in caring for staff welfare.’