Psychosocial risk management: The UK approach Professor Tom Cox  CBE Institute of Work, Health & Organisations School of C...
Changing World of Work <ul><li>Changing nature of  workers, work, work organisations and working  life: </li></ul><ul><ul>...
Working people <ul><li>Change in age-related demography of work force </li></ul><ul><li>Inclusion of increasing numbers of...
Work   <ul><li>Move from primary extractive and secondary manufacturing sectors to tertiary service sector </li></ul><ul><...
Working life <ul><li>Move away from linear careers to career portfolios </li></ul><ul><li>Changing nature of psychological...
Work organisations <ul><li>Globalisation: free market economics </li></ul><ul><li>Increasingly competitive environment wit...
Impact of change <ul><li>New challenges to:  </li></ul><ul><li>Employee health  and safety </li></ul><ul><li>Employee moti...
Self-reported Work-related Illness in the UK (SWI 1995) <ul><li>Labour Force Survey: 1990 (Hodgson et al 1993) </li></ul><...
Risk factors for work-related ill health <ul><li>Labour Force Survey (1995) </li></ul><ul><li>Risk factors: </li></ul><ul>...
Prevalence of work-related illness  UK 2003-2004
SWI 2008 2009 <ul><li>Prevalence:  </li></ul><ul><li>An estimated 415 000 people (GB): annual prevalence rate of 1.4% ~ si...
SWI 2008 2009 <ul><li>At risk sectors: </li></ul><ul><li>Public administration  </li></ul><ul><li>Defence </li></ul><ul><l...
Psychosocial Hazards: Failures of Work Design & Management <ul><li>Content </li></ul><ul><ul><li>Aversive tasks </li></ul>...
Self-reported Work-related Illness in the UK (SWI 1995) <ul><li>Two main clinical problems  (as 1993): </li></ul><ul><li>M...
Mechanisms Physical Hazards Psychosocial Hazards: Design & Management of Work Direct physico-chemcial pathway Stress  (psy...
Psychosocial risk management <ul><li>Reducing risk to employee and organisational  </li></ul><ul><li>health from failures ...
Identification of psychosocial hazards <ul><li>Management Standards Initiative  (HSE):  Indicator Tool :  </li></ul><ul><l...
Management Standards UK http://www.hse.gov.uk/stress/standards/ <ul><li>Demands – this includes issues such as workload, w...
Translation Likely Risk Factors r1 r2 r3 r4 r5 r6 rn Clarify & Explore Structured Account Underlying Organisational Pathol...
Action Innovation: Organisational Interventions <ul><li>Primary prevention :  prevention by design </li></ul><ul><ul><li>C...
Action Innovation: Organisational Interventions <ul><li>Secondary prevention </li></ul><ul><ul><li>Management development ...
Employee education and engagement <ul><li>Employeess are key stakeholders and active players in process of psychosocial ri...
Conclusions <ul><li>The world of work is changing and is creating new challenges to employee health among these are psycho...
Thank You Professor Tom Cox  CBE Institute of Work, Health & Organisations School of Community Health Sciences
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  1. 1. Psychosocial risk management: The UK approach Professor Tom Cox CBE Institute of Work, Health & Organisations School of Community Health Sciences
  2. 2. Changing World of Work <ul><li>Changing nature of workers, work, work organisations and working life: </li></ul><ul><ul><li>Globalisation </li></ul></ul><ul><ul><li>Free market economics </li></ul></ul><ul><ul><li>New IC technology </li></ul></ul><ul><ul><li>Unstable banking and trading systems </li></ul></ul><ul><ul><li>Recession </li></ul></ul><ul><li>Changing world of work brings new challenges to occupational health ~ psychosocial hazards </li></ul>
  3. 3. Working people <ul><li>Change in age-related demography of work force </li></ul><ul><li>Inclusion of increasing numbers of migrant workers in work force </li></ul><ul><li>Increasingly multi cultural work force </li></ul><ul><li>Declining standards of literacy and numeracy, declining interest in science and declining ability of young people to think creatively </li></ul>
  4. 4. Work <ul><li>Move from primary extractive and secondary manufacturing sectors to tertiary service sector </li></ul><ul><li>Work less physical and increasingly knowledge-based </li></ul><ul><li>Greater reliance on information and communication technology (ICT) </li></ul><ul><li>Move to 24/7 working </li></ul><ul><li>More part time, temporary, flexible and mobile jobs: precarious work and increased job insecurity </li></ul>
  5. 5. Working life <ul><li>Move away from linear careers to career portfolios </li></ul><ul><li>Changing nature of psychological and social contracts between employee and employer </li></ul><ul><li>Increasing requirement for self management, intrinsic motivation and creativity </li></ul><ul><li>Longer working hours </li></ul><ul><li>Greater intrusion on non work time: work life balance </li></ul>
  6. 6. Work organisations <ul><li>Globalisation: free market economics </li></ul><ul><li>Increasingly competitive environment with continual search for innovation, increased efficiencies and increased cost effectiveness: organisational restructuring, down sizing and out sourcing </li></ul><ul><li>Tighter margins but greater expectation for profit and growth </li></ul><ul><li>Rapid development of advanced information and communication technologies </li></ul><ul><li>Change in requirements on human capital </li></ul>
  7. 7. Impact of change <ul><li>New challenges to: </li></ul><ul><li>Employee health and safety </li></ul><ul><li>Employee motivation, trust and loyalty </li></ul><ul><li>Employee behaviour in relation to work </li></ul><ul><li>Social cohesion at work </li></ul><ul><li>Employee performance </li></ul><ul><li>Employees’ work life balance </li></ul><ul><li>Risks to: </li></ul><ul><li>Organisational healthiness </li></ul><ul><li>Image and reputation </li></ul><ul><li>Organisational performance </li></ul>
  8. 8. Self-reported Work-related Illness in the UK (SWI 1995) <ul><li>Labour Force Survey: 1990 (Hodgson et al 1993) </li></ul><ul><li>Labour Force Survey: Fifth Wave 1995 (Jones et al, 1998) </li></ul><ul><li>1995 Sample </li></ul><ul><li>40,000 men and women </li></ul><ul><li>Working or had worked </li></ul><ul><li>Had they suffered any work-related illness in last 12 months ? </li></ul><ul><li>70% of those answering YES were interviewed in depth about working conditions and health </li></ul><ul><li>Control population asked same question about working conditions </li></ul><ul><li>With subjects consent, doctors asked to confirm reports of ill-health </li></ul>Jones et al (1998) Self-reported Work-related Illness . Sudbury: HSE Books
  9. 9. Risk factors for work-related ill health <ul><li>Labour Force Survey (1995) </li></ul><ul><li>Risk factors: </li></ul><ul><ul><li>workload and work pace </li></ul></ul><ul><ul><li>work schedule </li></ul></ul><ul><ul><li>lack of support </li></ul></ul><ul><ul><li>lack of control </li></ul></ul><ul><li>At risk groups: </li></ul><ul><ul><li>Professional workers </li></ul></ul><ul><ul><li>Older workers </li></ul></ul><ul><li>II European Survey (2000) </li></ul><ul><li>Physical work factors (pages 10-11): 2 pages </li></ul><ul><li>Psychosocial hazards : 22 pages </li></ul><ul><li>Nature of work </li></ul><ul><li>Work organisation </li></ul><ul><li>Time issues </li></ul><ul><li>Information and consultation </li></ul>
  10. 10. Prevalence of work-related illness UK 2003-2004
  11. 11. SWI 2008 2009 <ul><li>Prevalence: </li></ul><ul><li>An estimated 415 000 people (GB): annual prevalence rate of 1.4% ~ similar to that for 2007/08 and significantly lower than for 2006/07. </li></ul><ul><li>Incidence: </li></ul><ul><li>An estimated 230 000 people (GB): an annual incidence rate of 0.76% ~ similar to previous years. </li></ul><ul><li>Days lost: </li></ul><ul><li>An estimated 11.4 million working days (full-day equivalent) were lost of a similar order to those in earlier years. </li></ul>
  12. 12. SWI 2008 2009 <ul><li>At risk sectors: </li></ul><ul><li>Public administration </li></ul><ul><li>Defence </li></ul><ul><li>Human services: health, social work and education </li></ul><ul><li>At risk occupations: </li></ul><ul><ul><li>Health and social welfare professionals </li></ul></ul><ul><ul><li>Teaching and research professionals </li></ul></ul><ul><ul><li>Corporate managers </li></ul></ul><ul><ul><li>Business and public service professionals </li></ul></ul>
  13. 13. Psychosocial Hazards: Failures of Work Design & Management <ul><li>Content </li></ul><ul><ul><li>Aversive tasks </li></ul></ul><ul><ul><li>Workload and work pace </li></ul></ul><ul><ul><li>Organisation of working hours </li></ul></ul><ul><ul><li>Control over work </li></ul></ul><ul><li>Context </li></ul><ul><ul><li>Organisation structure, function and culture </li></ul></ul><ul><ul><li>Role in organisation and involvement </li></ul></ul><ul><ul><li>Social climate </li></ul></ul><ul><ul><li>Job security and pay </li></ul></ul><ul><ul><li>Work-life balance </li></ul></ul>Cox, Griffiths & Rial-Gonzalezs (2000) Work Stress . Luxembourg: European Commission Cox (1998) Work-related stress: from environmental exposure to ill health. In: McCaig & Harrington (eds) Changing Nature of Occupational Health . Sudbury: HSE Books
  14. 14. Self-reported Work-related Illness in the UK (SWI 1995) <ul><li>Two main clinical problems (as 1993): </li></ul><ul><li>Musculo-skeletal disorders </li></ul><ul><li>Stress (26% of those reporting a work-related illness: prevalence estimate 500,000 employees) </li></ul><ul><li>Supportive findings from survey of working conditions across European Union (2000) N= 21,000: </li></ul><ul><li>25-33% reported musculo-skeletal problems </li></ul><ul><li>28-29% reported stress </li></ul>Jones et al (1998) Self-reported Work-related Illness . Sudbury: HSE Books Paoli and Merllie (2001) Third European Survey of Working Conditions . Dublin: European Foundation
  15. 15. Mechanisms Physical Hazards Psychosocial Hazards: Design & Management of Work Direct physico-chemcial pathway Stress (psycho-physiological) pathway Harm to health: physical, psychological, social & organisational HAZARDS Mediating pathway HARM Cox, Griffiths & Rial-Gonzalezs (2000) Work Stress . Luxembourg: European Commission
  16. 16. Psychosocial risk management <ul><li>Reducing risk to employee and organisational </li></ul><ul><li>health from failures of work design and </li></ul><ul><li>management through application of evidence </li></ul><ul><li>based and systematic problem solving </li></ul><ul><ul><li>Hazard Identification and Risk Assessment </li></ul></ul><ul><ul><li>Translation & Action Innovation </li></ul></ul><ul><ul><li>Risk Reduction (control interventions) </li></ul></ul><ul><ul><li>Evaluation </li></ul></ul><ul><ul><li>Feedback: organisational learning </li></ul></ul><ul><ul><li>Cycle of continuous improvement </li></ul></ul>Leka and Cox (2008) PRIMA-EF: Guidance on the European Framework for Psychosocial Risk Management . Geneva: World Health Organisation
  17. 17. Identification of psychosocial hazards <ul><li>Management Standards Initiative (HSE): Indicator Tool : </li></ul><ul><li>Based on six factors (scales): </li></ul><ul><ul><li>Demand </li></ul></ul><ul><ul><li>Control </li></ul></ul><ul><ul><li>Support </li></ul></ul><ul><ul><li>Role </li></ul></ul><ul><ul><li>Relationships </li></ul></ul><ul><ul><li>Change </li></ul></ul><ul><li>Alternative instruments : sector specific ~ Engineering and manufacturing sectors: Work Organisation Assessment Questionnaire (WAOQ) </li></ul>Mackay et al (2004) Work & Stress, 3, 2-12 Griffiths et al (2006) Occupational and Environmental Medicine 63, 669-675
  18. 18. Management Standards UK http://www.hse.gov.uk/stress/standards/ <ul><li>Demands – this includes issues such as workload, work patterns and the work environment. </li></ul><ul><li>Control – how much say the person has in the way they do their work. </li></ul><ul><li>Support – this includes the encouragement, sponsorship and resources provided by the organisation, line management and colleagues. </li></ul><ul><li>Relationships – this includes promoting positive working to avoid conflict and dealing with unacceptable behaviour. </li></ul><ul><li>Role – whether people understand their role within the organisation and whether the organisation ensures that they do not have conflicting roles. </li></ul><ul><li>Change – how organisational change (large or small) is managed and communicated in the organisation. </li></ul><ul><li>The Management Standards represent a set of conditions that, if present, reflect a high level of health well-being and organisational performance. </li></ul>
  19. 19. Translation Likely Risk Factors r1 r2 r3 r4 r5 r6 rn Clarify & Explore Structured Account Underlying Organisational Pathology Interventions: Action Innovation Negotiating a common language for social dialogue within organisations
  20. 20. Action Innovation: Organisational Interventions <ul><li>Primary prevention : prevention by design </li></ul><ul><ul><li>Culture change </li></ul></ul><ul><ul><li>Organisational redesign & development </li></ul></ul><ul><ul><li>Management development, mentoring & coaching </li></ul></ul><ul><ul><li>Work systems design </li></ul></ul><ul><ul><li>Job redesign </li></ul></ul><ul><ul><li>Environmental engineering </li></ul></ul><ul><ul><li>Ergonomic improvement </li></ul></ul>
  21. 21. Action Innovation: Organisational Interventions <ul><li>Secondary prevention </li></ul><ul><ul><li>Management development and staff training </li></ul></ul><ul><li>Tertiary prevention </li></ul><ul><ul><li>Enhanced employee support </li></ul></ul><ul><ul><li>Treatment </li></ul></ul><ul><ul><li>Rehabilitation </li></ul></ul><ul><li>Timely and appropriate action </li></ul><ul><li>Balanced approach </li></ul>
  22. 22. Employee education and engagement <ul><li>Employeess are key stakeholders and active players in process of psychosocial risk management </li></ul><ul><ul><li>Source of data: expert judgements </li></ul></ul><ul><ul><li>Change agents </li></ul></ul><ul><li>Need to respect and draw on their expertise </li></ul><ul><li>Need to encourage and reinforce engagement </li></ul><ul><li>Requires that workers are educated to participate in the risk management process </li></ul><ul><li>Requires a shared language of psychosocial risk management </li></ul><ul><li>Requires a positive culture in relation to health and safety ~ social dialogue and trust </li></ul>
  23. 23. Conclusions <ul><li>The world of work is changing and is creating new challenges to employee health among these are psychosocial risks largely associated with work-related stress </li></ul><ul><li>Work-related stress and musculo-skeletal disorders, both partly driven by exposure to psychosocial hazards, are the two main current challenges to employee health </li></ul><ul><li>These can be managed at a number of levels including organisational and policy interventions </li></ul>
  24. 24. Thank You Professor Tom Cox CBE Institute of Work, Health & Organisations School of Community Health Sciences
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