Stress case study – NHS Hospital Trust

The situation

An NHS Trust ran an employee well-being programme - this identified a potential issue with work-related stress. They decided to take a more proactive, preventative approach to managing stress-related ill health.

Assessing the risks

The Trust gathered data on:

  • rates of sickness absence
  • how much sickness was due to stress and anxiety
  • staff turnover
  • employee relations
  • grievance and disciplinary issues

Developing solutions

A steering group was set up, led by the Director of Workforce Organisation Development. The group was made up of staff, trade union representatives and a consultant clinical psychologist. 

The Trust held informal 'coffee table sessions' where staff could share their ideas. An independent psychologist acted as the facilitator and created a non-judgemental environment, which helped people to contribute. The steering group developed some ideas into solutions, consulted on them and implemented them.  

A 'hot spot' approach was taken, identifying departments which needed action most. Measures used were:

  • sickness absence records
  • analysis of how much sickness was due to stress or anxiety
  • staff turnover figures
  • employee relations data

More in-depth, qualitative surveys provided additional data for the risk assessment. This informed the plan for intervention.

Unions were involved at every stage.  Their contribution was invaluable and gave the project added credibility. Staff felt they had a voice and could participate in discussions about the process, as well as in the process itself.

The solutions developed for these hot spots were assessed for their potential to be rolled out to other areas of the Trust. A record of the lessons learned was kept.


  • By raising awareness of work-related stress and encouraging early reporting and therefore intervention, sickness absence was reduced, with savings in salary costs
  • There were also signs of cultural change, including:
  • Clearer communication between managers and staff
  • Greater ownership of change
  • Increased recognition of the need to encourage peer support
  • Improved communication within the organisation
  • Improvements in constructive and positive feedback throughout the organisation

Tips for others

Implementing the process was made easier by ensuring that:

  • there was senior management sponsorship
  • sufficient time was spent engaging all key stakeholders, especially front-line staff, union/staff reps, HR and senior managers, middle and line managers –the expertise of staff was valued  

Find out more about how others have tackled stress.

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Updated 2021-05-11