What is The cost of unmanaged stress at work?

SA Law’s Employment law experts Chris Cook and Keely Rushmore together with guest contributor Adam Shaw share their experience of identifying, reducing & preventing workplace stress.

According to The Health and Safety Executive (HSE) in the UK stress was directly responsible for 11.7M sick days in 2015/2016, 37% of all work-related illness, and 45% of days off sick. Each individual case on average led to 23.9 days off work per employee.

Whilst there are vastly differing views on what illnesses are directly attributable to stress, the cost to UK businesses of stress is around £100Bn per year according to MIND, the mental health charity.

Stress-related illness is notably increased for health workers, those in education, media and public administrators. Also, women are far more likely to be affected than men. Between 2013-2016 in the UK the cases per 100,000 people showed 1190 for men, and 1820 for women. 

Stress in the workplace: A legal perspective

Stress at work is a major issue for employers and by failing to manage its effects, businesses run the increased risk of stress-related claims, including personal injury, discrimination and bullying and harassment. It is therefore important for you to consider the impact of stress in the workplace and the methods to manage it.

  1. Health and safety of employees
    It is an implied term of every employment contract that employers will take reasonable steps to ensure the safety of their employees. This includes a duty to take reasonable care not to cause psychiatric harm by reason of the type or amount of work imposed on them.

  2. Implement a stress policy
    The policy should make it clear that stress is an issue you take very seriously. It should give employees guidance on how to deal with the effects of stress and how to raise any concerns with management staff.You should also review your other policies to ensure they are adequate in dealing with the issues. Anti-bullying and harassment policies, grievance procedures, disciplinary procedures, and any flexible working policy should all be carefully considered.

  3. Carry out stress audits
    Talking informally to staff, either individually or in groups, will help you to find out any about any causes of stress and help you to establish whether any reasonable adjustments could be made. It is important to engage employees in the process and let them know why you are carrying out the audit and what you are trying to achieve. Well-executed stress audits will help identify and treat problems that already exist, or alleviate issues before they come to a head.

  4. Conduct return-to-work interviews following sickness absence
    You should welcome employees back to work and ensure they are fully fit to return. Interviews should identify the reasons for the absence and how the employer can help alleviate future absence by making reasonable adjustments.

  5. Discuss change with employees
    Generally, people are uncomfortable with change and it can be a source of stress. You should consult regularly with employees, their representatives, staff associations or unions on organisational changes and openly invite employees to comment on their concerns, should they have any.

  6. Provide adequate training to managers
    Managers are likely to see the problems that cause stress and will often be the initial point of contact when an individual is feeling stressed. Management staff should be provided with adequate training on how to be aware of stress amongst employees, how to avoid placing unreasonable demands on employees and appropriately delegating duties.

The hidden cost of stress at work: Presenteeism

Adam Shaw shares his experiences of helping others to understand and manage stress, and why it is so important to get it right. 

During my days working as a nurse there were certain staff members who were clearly not happy at work and would spend their time complaining to anyone who happened to be around. These staff were toxic to the hospital and the other staff. I found myself avoiding shifts as often as possible when I saw their names on the rota. I have known many people call in sick because they did not want to work with certain people.

From looking after several people during over 13 years of nursing I found stress to be a very common factor.

For every patient who had been admitted with a stroke, heart attack or cancer I always asked the same question: “Have you been experiencing abnormal levels of stress in the past 6-12 months?”

I have yet to ask this question to this demographic and not have them answer the question instantly. The two most common factors are stress at work and stress at home. One generally influences the other. The main factors cited by the respondents of the HSE stress at work survey were tight deadlines, too much pressure and a lack of managerial support.

A study by University College London backs this up with their correlation of 27 studies of over 550,000 people. Longer working hours (55/week or more) has been shown to have a 13% higher risk of coronary heart disease and a 33% higher risk of strokes (2).

When workplace stress affects your health

A particular case that springs to mind as an example of when extreme stress can be dangerous to health involves a patient of mine called Paul.
Paul had been admitted to hospital with a heart attack (or Myocardial Infarction as the medical establishment likes to call it!). This involves permanent damage to the heart caused by not getting enough blood to it. Whilst doctors will point you towards mainly genetic factors causing fatty deposits to block your arteries as the main cause, this is always exacerbated by stress.

Paul had been working 16 hour days, 6 days a week to keep on top of his workload. The promotion last year had led to a substantial pay rise but his workload had now increased. Between this and the long-term sickness of his PA he had been slowly falling behind with the deadlines set by his boss.

This led to arguments with his wife about the lack of time he spent with her and his daughter, and the cancellation of a weekend away.

This almost permanent state of stress had also led to Paul becoming very short-tempered with the staff who were there, his wife and daughter. And now he had more stress because although he had permanently damaged his heart, he wanted to get back to work to hit his deadlines. Paul’s story is one of hundreds of similar cases faced by people in the UK everyday.

What can you do to prevent stress in the workplace?

I have worked with small companies and blue chip organisations with their stress management/resilience programmes. Quite simply, by providing a safe place to air concerns about the things that cause stress and finding easy to implement solutions to manage them better, providing welcome relief for all concerned.

The main source of stress

When I worked with one management team it was incredible to find out the main sources of their stress. Because they all worked across 4 offices nationally, many had never spoken, met or ever got to know each other beyond seeing a name on an email. They only knew that a person with a certain name kept sending them demanding emails, often well outside of office hours, which caused them stress. Even outside of working hours people were not able to switch off, or sometimes not even sleep because of the stress of the demands being made on them at all hours of the day and night.

Simple things like taking the time to get to know each other better, realise that everyone is dealing with their own stressors, and agreeing to do simple things like pick up the phone and talk occasionally were big breakthroughs for the team. Also, simply becoming aware of the effects of dehydration on performance and stress levels at work was a huge realisation.

Knowing how to identify the early warning symptoms of stress and manage it appropriately through breathing techniques or simply going for a short walk are critical for workplace harmony, and even sanity. After all, who likes working for a grumpy, angry boss, even if they are going through a messy divorce and have just lost access to their children in a custody claim?

Stress does not happen by accident, and is a very primal reaction

If you as an employer or organisation are not providing educational programmes to manage this then be prepared to pay several times more for the unhappy employees who complain about their job and go sick more often. When people love their work and workplace they are happier, enjoy their job and are more productive. As an employer do you want your staff to be happy? And can you afford for them not to be?


1. HSE http://www.hse.gov.uk/statistics/causdis/stress/

2. https://www.bhf.org.uk/news-from-the-bhf/news-archive/2015/august/working-long-hours-linked-to-stroke-and-heart-disease

Adam Shaw

Adam worked as a nurse in the NHS for over 13 years, helping hundreds of employees who had been admitted to with serious illness. He has worked as a heart stress expert since leaving the NHS in 2008, and now runs corporate wellbeing programmes, most recently with Lloyds Banking Group.

To find out more about Adam please click here



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