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Cheshire and Wirral Partnership NHS Trust - stress case study

Who are they?

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Cheshire and Wirral Partnership NHS Foundation Trust provides mental health services for children, adults and older people, as well as learning disability and drug and alcohol services. It is also contracted to deliver community services throughout Western Cheshire under the title Community Care Western Cheshire (CCWC).

No of employees:
The Trust has approximately 3500 employees over 75 sites throughout Cheshire and Wirral, including hospitals, wards, resource centres, supported housing and out-reach teams.
Business Sector:

What had they done when we last saw them?

We last visited the trust in 2006 to understand their approach to managing work-related stress. The trust had adopted the Management Standards approach using the indicator tool to identify hotspots. The trust had two Acas advisors, whose main role was to train staff to become facilitators for the focus groups. In total they ran 33 focus groups.

Following the focus groups, facilitators presented staff’s views to an action-planning sub-group, containing senior staff from each area of the Trust, using this information the sub group looked at the stressors (demands, control, role, relationships, support and change) and identified three priority issues from each stressor. This data was reviewed and an action plan was developed, identifying the key actions to be implemented for each stressor. The steering group then monitored this.

The Trust had some implementation issues regarding the levels of resource needed, project planning, the management structure and financial issue as well as overcoming staff reluctance to take part. These problems almost caused the collapse of the project and it needed management support at executive level to endorse the project and encourage staff to take part.

What has happened since?

As a mental health trust, the organisation is aware of the need to be able to recognise and address work related stress, and the repercussions of failing to tackle it. Prolonged exposure to stress has been shown to lead to mental conditions such as anxiety or depression. For this reason the Trust continued to review the results of actions taken and tackled new areas of potential risk as they arose. They have also adapted the project as new initiatives came on line. These are some of the further issues, actions and solutions they have faced:


The Boorman Report and the closing of PCTs under the review of the NHS have presented various challenges which required action to assess the impact on staff. The Trust

What worked particularly well?

Measuring data:

The trust has expanded the sources it uses in decision making and:


Steps have been taken to promote both the policy and the benefits of tackling stress. Specifically, promotion has taken place to address the stigma of mental illness. Volunteers, including some senior managers, who had suffered from some mental condition agreed to take part in an informal buddy system for those who were experiencing problems. In a Poster campaign, they acknowledged they had suffered from a mental illness and supplied their telephone number for other staff who could call them for support. 36% of people acknowledged in a survey, that they had suffered or were suffering from a mental illness.


New training regimes have been implemented in the trust:

Following implementation of these new services, the Trust carried out a review asking managers what they thought of it – their view was that the improvements were useful but there needed to be some kind of improved communication. In response, the Trust has created a leaflet about the Stress policy, a copy of which is provided to everyone in the trust and its occupational health service.

The Future

As a mental health trust, the organisation is aware that it cannot rest on the positives it has achieved but it needs to ensure it continues to recognise and address work related stress, to minimise the impact stress may have on its staff especially any psychosocial problems such as anxiety and depression.

For this reason the Trust will maintain and regularly review its policy and will aim to tackle the challenges identified above. They are fully aware that the process of improvement is ongoing and they still have to review the action plan since not all actions are yet complete.

Updated 2011-08-11 -->