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​How to Destress Your Employees and Keep on the Outstanding side of the CQC

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Stress in the GP practice is at the highest it’s been for a decade. That was the conclusion of the University of Manchester’s recent GP Worklife Survey. Though the finger of blame can be pointed at overcrowded appointment lists, a lack of funding, fewer doctors coming through and a very unpopular regulator – playing the blame game doesn’t help reduce stress.

What is stress?

Stress at work has dire consequences. It disrupts workplace harmony, causes absenteeism, and, ultimately, makes people want to leave. According to the GP Worklife Survey, more than a third of GPs find their work so stressful that they think it likely they will quit their job within five years.

The BMA has produced a guide to help practices manage a ballooning workload, but this is only a partial response to managing stress. Workload equals pressure. It’s the way we respond to that pressure that equals stress:

  -  Pressure can be motivating

  -  Stress is debilitating

Stress increases anxiety and can manifest itself in a number of ways. It can send someone into fits of depression, or it can make someone else act out of character and become aggressive. The same person suffering from stress can react in multiple ways to the same situation. It causes unpredictability and reduces productiveness. Then there are the physical health problems it can induce. This can directly influence the standard of care and call in to question one of the CQC’S five key questions –“Are they well-led?”

How to help a stressed employee

A main cause of stress is poor employment relations or working environment. Therefore, the first stress relief strategy should be to look inward. Make sure that HR procedures and policies are effective, especially when dealing with absenteeism and discipline.

Some of the best help that an employer can give to an employee is to help the employee familiarise himself or herself with their rights at work. Creating an open and fair working environment will not only encourage the employee to come forward with problems before they become stressful but promote the culture of one of the CQCs five questions

  - Employee feedback should be sought, and listened to, when developing stress risk assessments as part of business planning

 - Stress management training should be provided for all, helping employees to understand stress and discover their own coping routines

How to help managers help their people

Of course, managers have a key role to play in the management of employee stress. If they don’t manage effectively, they could be the cause of the stress.

Managers should be coached to deal with stress in the workplace, dealing with their people with empathy and patience and helping the employee to cope with the pressure at work that is leading to the stress suffered.

Managers that are approachable find their employees are more open and willing to discuss their stressors. Once these are identified, the manager should seek ways to relieve that stress; perhaps by altering working patterns, altering duties and responsibilities of the affected employee, and arranging stress counselling.

Recognising the risks of stress

As an employer, a GP practice has a legal responsibility of duty of care toward their employees. The CQC looks for employees that are a fit and proper persons and who are able to provide care and treatment. The risk assessments should include the risk of stress at work, and these can be classified in six distinct areas:

  - Demands of the job

  - Control over work

  - Support from colleagues and managers

  - Relationships at work

  - The role in the organization

  - Change and the management of change

Identifying the cause of stress as being in one of these areas enables managers to identify strategies to help employees cope with stress. For example:

  - Reduce demands on an individual

  - Give the employee more control over their work routine, such as offering flexi-time where possible

  - Offer extra support or training

  - Keep ‘warring’ employees separated – move into different departments, or hold mediation meetings

  - Change the role of the individual to one less stressful

  - Involve the employee in the change process

The headache of unplanned absenteeism can prove to a CQC area for concern (and contribute to inadequate ratings) but the GP practice that ensures it has policies and procedures in place to coach their managers to help stressed employees, and creates an open and caring work environment, will find its staff are absent less often and more productive during each working day.

Stress is Contagious

Finally, it is worth mentioning that stress is contagious. A study conducted at the Max Planck Institute found that stress rubs off on people. Test subjects were put into stressful situations, while others merely observed. Of those purposely placed under stress, 95% showed physical signs of stress. Most interestingly, more than a quarter of the group of observers also showed visible signs of stress. The lesson is that our stress affects people around us.

When doctors are stressed, the nurses and administration staff they work with are put at risk of stress themselves. As are patients.

Knowing this, the importance for Jeremy Hunt to deliver on his promise to reduce GP burnout is increased in line with the stress that doctors find themselves under. 

For more information, download the HSE guidance on working together to reduce stress at work.


If you have any questions or feedback, please do not hesitate to contact me - alex.henman@esuppliesmedical.co.uk - 01865 261451

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CorrectionIn my blog on Monday, Can You Refuse a Patient Registration Application?, I wrote "Under the NHS Constitution, any member of the public can choose to register at any GP practice". However, this was ambiguous. This should have read "..,any member of the public within the practice boundary..". Thank you to Eve and Andrew for pointing out this error. It was very much appreciated.

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