Stress Awareness Month 2022

April is Stress Awareness Month. Stress is something everyone feels at times and there are all kinds of stressful situations that can be part of daily life. Workload pressures, deadlines, issues coping with or adapting to the demands of a job, unsupportive managers and difficult relationships with colleagues are common reasons for work-related stress.

What is stress?

Stress is the body’s reaction to feeling threatened or under pressure. It is very common and can be motivating to help us achieve things in our work, home and family life. However, too much stress can affect our mood, our body and our relationships. It can make us feel anxious and irritable and affect our self-esteem.

Experiencing a lot of stress over a prolonged period can also lead to anxiety, depression and burnout. Work can also aggravate pre-existing conditions and issues, with problems at work triggering symptoms or making their effects worse.

Signs of stress and burnout
•           Feeling overwhelmed
•           Have racing thoughts or difficulty concentrating
•           Irritability
•           Feeling constantly worried, anxious or scared
•           A lack of self-confidence
•           Trouble sleeping or feeling tired all the time
•           Avoiding things or people you are having problems with
•           Eating more or less than usual
•           Drinking or smoking more than usual.

Mental health and work
The government’s Health and Safety Executive (HSE) found that in the UK in 2020 to 2021, 822,000 workers reported experiencing work-related stress, depression or anxiety. The mental health charity, Mind, found that 2 in 5 employees reported that their mental health had worsened during the pandemic. Even before the pandemic, it was estimated that mental health problems cost UK employers up to £45 billion a year. Work-related stress is the number one reason given for sick days in the UK.

Legal duty and stress
Whether you are a small business or a large corporation, the law requires all employers to prevent work-related stress by promoting, supporting and sustaining good mental health in the workplace. The law requires all employers to assess potential risks from work-related stress and to take steps to tackle it where it is identified. This can reduce sickness absence, boost morale and therefore help improve productivity. Both managers and workers should take steps to spot and tackle the causes of workplace stress by:

  • Looking out for colleagues who might be struggling and encouraging them to seek help
  • Participating in discussions about mental health
  • Promoting open and honest conversations.

HSE has created a Talking Toolkit to assist employers in speaking to their employees and taking the important first step towards preventing work-related stress and developing the actions and stress risk assessment employers need to comply with the law. www.hse.gov.uk/stress/talking-toolkit.htm

The toolkit has six templates for six different conversations. Each of these has a different theme designed to get managers and employees talking about issues that may be causing work-related stress or issues which could have the potential to become future causes if not managed properly. The earlier a problem is tackled the less impact it will have. Employers have reported improvements in productivity, retention of staff and a reduction in sickness absence when addressing work-related stress.

How Medwyn Occupational Health can help
We offer a range of services to assess, prevent and tackle work-related stress. These include:

  • Advice regarding differentiating stress from anxiety, depression and more serious mental health disorders
  • Advice regarding short-term role adjustments
  • Advice regarding the affect an employee’s health may be having in the workplace or the effect the workplace may be having on the employee’s health
  • Ensure the identification of all contributing factors to stress
  • Specific health-related advice on how best to support an employee with workplace stress – ensuring they receive the right medical support
  • Access to counselling and psychological therapy
  • Development of work-related stress policy
  • Advice and promotion of health and wellbeing at work.

Resources

Returning to the Workplace: Updated Guidance

On 19th July we moved to Step 4 of the government’s roadmap out of lockdown. There are two key changes for businesses. Firstly, the government is no longer advising people to work from home. Consequently, employers can start to plan a return to the workplace.  The government has recommended a gradual return over the summer and working arrangements that meet both the needs of the individual and the business. The timing and phasing of employees’ return should be discussed and agreed. Secondly, businesses do not need to implement social distancing in their workplace or venue and customers and employees do not need to social distance from people they do not live with.

People will be expected (although this is voluntary) to still cover their faces in crowded and enclosed indoor areas, such as public transport and shops. Some airlines and transport networks (for example Transport for London) and retailers have also indicated that they will still require face coverings.

The Working Safely During Coronavirus (Covid-19) guidance has been published. It offers advice for safe working in a range of settings including offices, factories, laboratories, restaurants, pubs, nightclubs, construction, events and retail.

In this updated guidance, a few restrictions remain in place including:

  • The need to self-isolate if someone tests positive for coronavirus (unless exempt).
  • The need to self-isolate for those in close contact with someone who tests positive until 16th August (unless exempt). After that date under-18s and those who have received a second COVID-19 vaccination at least 10 days before the contact no longer need to isolate.
  • Border restrictions remain in place, depending on the status of the departure country.
The government is now advising clinically extremely vulnerable people, as a minimum, to follow the same guidance as everyone else. However, employers still have a legal responsibility to protect their employees from risks to their health and safety. Employers are encouraged to talk to any clinically extremely vulnerable workers returning to their workplace, so they can explain the measures being taken to ensure they can work safely.

If an employee requires support to work at home or in the workplace that are beyond standard reasonable adjustments, they can apply for funding from Access to Work. Access to Work will prioritise applications from disabled people who are in the clinically extremely vulnerable group.  Occupational Health can provide a range of physical and mental health support and advice for employees who have been identified as extremely clinically vulnerable.

Protecting People who are Extremely Clinically Vulnerable from COVID-19
Medwyn Occupational Health would recommend a more cautious approach for extremely clinically vulnerable employees who have:

  • not been vaccinated
  • been vaccinated whilst prescribed immunosuppressant medication
  • received the AstraZeneca vaccine.

In these latter two categories, we have anecdotally seen evidence of a limited protective response to the vaccination.  Additionally, the latest Beta variant may be more resistant to the AstraZeneca vaccine compared to the Pfizer vaccine.

Pregnant women 
Pregnant women should continue to be referred to occupational health for a Clinical COVID-19 Risk Assessment at 28 weeks.
Priority Actions
The government has recommended some priority actions for businesses in order to manage risk and returning employees to the workplace safely and with confidence:

  1. Health and Safety Risk Assessment

As businesses have a legal duty to manage risks to those affected by their business, the guidance recommends that employers carry out a health and safety risk assessment, including the risk of COVID-19 and to take reasonable steps to mitigate the risks identified. COVID-19 is a workplace hazard and should be managed in the same way as other workplace hazards. By law, businesses must not allow a self-isolating employee to come to work (unless exempt). Businesses should also consider reasonable adjustments required for employees and customers with disabilities.

  1. Adequate Ventilation

The main way of spreading COVID-19 is through close contact with an infected person. Particles (droplets and aerosols) containing the virus that causes COVID-19 can be released when someone with COVID-19 breathes, speaks, sneezes or coughs. These particles can then be breathed in by another person. As the rate of COVID-19 infection remains high, businesses should ensure there is a supply of fresh air to indoor spaces. This can be natural ventilation through opening windows and doors, mechanical ventilation using fans and ducts, or a combination of both. The HSE website provides useful advice on air conditioning and ventilation.

  1. Regular Cleaning

Employees and customers should be encouraged to use hand sanitiser and to clean their hands frequently. It is essential to maintain regular cleaning of surfaces, particularly surfaces that people touch regularly.

  1. Self-Isolation for Employees

Unless exempt, employees should self-isolate if they or someone in their household has a persistent cough, a high temperature or has lost their sense of taste or smell. They must also self-isolate if they or a close contact has had a positive COVID-19 result, or if they have been told to self-isolate by NHS Test and Trace. If you know that an employee is self-isolating, it is an offence to allow them to come to work.

  1. Workplace Check In

Businesses are no longer legally required to collect the contact details of visitors, customers or contractors, however, doing so will support NHS Test and Trace to contact those who may have been exposed to COVID-19 so that they can book a test. You can enable people to check in to your venue by displaying an NHS QR code poster. You do not need to ask people to check-in or turn people away if they refuse. If you choose to display a QR code, you should also have a system in place to record contact details for people who want to check in but do not have the app.

  1. Communicate and Train

It remains important to keep your employees, visitors and contractors up-to-date on how your business is using and updating safety measures.
The government is now advising clinically extremely vulnerable people, as a minimum, to follow the same guidance as everyone else. However, employers still have a legal responsibility to protect their employees from risks to their health and safety. Employers are encouraged to talk to any clinically extremely vulnerable workers returning to their workplace, so they can explain the measures being taken to ensure they can work safely.
If an employee requires support to work at home or in the workplace that are beyond standard reasonable adjustments, they can apply for Access to Work. Access to Work will prioritise applications from disabled people who are in the clinically extremely vulnerable group.  Occupational Health can provide a range of physical and mental health support and advice for employees who have been identified as extremely clinically vulnerable.

Wellbeing and Mental Health
As employees return to the workplace, some may have mixed feelings about the new normal, feel anxious about the risk of COVID-19 – in the workplace and during their commute and how their employer will be protecting them.  Mental health and wellbeing support is a key principle of a good return to work. Employers should identify any concerns and obstacles that may prevent or delay an employee’s return to work. Occupational Health can be key in providing advice and guidance to ensure that employees feel confident about their return.

Hybrid Working
A wide range of research, including a YouGov survey and CIPD research, show that after the pandemic the majority of workers want to continue to work from home at least some of the time. This provides businesses with new opportunities for re-configuring and adapting the workplace to create new ways of working and supporting a positive work-life balance. A hybrid working policy can be useful to help to set the ground rules for employees working within this model.

Workers Exempt From Self-Isolation
The government has created a framework for exemption for some critical workers. The exemption only applies to some fully vaccinated workers employed in a number of key industries. The government has stated that it is not a ‘blanket exemption’ for all workers in a sector but applies to named employees in specifically approved workplaces who have had their final vaccine dose at least 14 days ago. Once approved, workers contacted by test and trace or the NHS app will need a negative PCR test and must do daily lateral flow tests for 10 days.

The guidance lists 16 sectors: energy, civil nuclear, digital infrastructure, food production and supply, waste, water, veterinary medicines, essential chemicals, essential transport, medicines, medical devices, clinical consumable supplies, emergency services, border control, essential defence outputs, and local government.  Those workers identified as close contacts of a positive case of the virus should only go to work if their absence would lead to the ‘loss or compromise’ of ‘critical elements of national infrastructure’. Any business which believes its workers should be exempt are requested to contact the relevant government department.

Those covered will be able to travel to work and do their jobs after a negative daily test but must remain at home otherwise and go straight into quarantine if they receive a positive result.

It is essential that businesses adhere to their obligations under the Health and Safety at Work Act 1974 to keep all staff and clients safe.  The new guidance places a significant degree of responsibility on employers to prove that they have implemented and maintained the updated government guidance regarding precautions to manage the risk of COVID-19. Occupational Health works in collaboration with organisations to manage this risk, taking into account employees with underlying health conditions and their workplace environment and activities, alongside a business’s legal obligations.

How Medwyn Occupational Health can help

  • Provide best practice advice and guidance to managers
  • The development of policies and procedures
  • Health risk assessments
  • Supporting employees with pre-existing or new health issues, or those with difficulties in recovering from COVID-19.

Please do not hesitate to contact us if you would like to learn more about how we can help your organisation.

 

Clinically Vulnerable and Pregnant Employees: Lockdown Guidance

National restrictions will be imposed across England from Thursday 5th November. To help contain the virus, the government have advised that everyone who can work effectively from home must do so. Where people cannot do so – including but not limited to – people who work in national infrastructure, construction and manufacturing – they should continue to travel to their workplace. Public sector employees working in essential services, including health, childcare or education, should also continue to go into work. The risk of transmission is substantially reduced provided COVID-19 secure work guidelines are followed closely.

This morning, guidance has been published defining clinically extremely vulnerable groups – Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19.

Clinically extremely vulnerable groups are those individuals likely to require hospitalisation and be at serious risk of death or long-term health complications as a consequence of COVID-19 infection. It is employees who fall into this category who are advised to work only from home. If they cannot work from home, they may be eligible for Statutory Sick Pay or Employment Support Allowance if their normal salary is not continued. The government has indicated they will write to everybody who is clinically extremely vulnerable to set out detailed advice confirming they fall into this category in the coming days.

Same Household: People living in the same household as someone defined as clinically extremely vulnerable, but who are not clinically extremely vulnerable themselves, can still attend work.

Clinically extremely vulnerable children of employees: The government state ‘evidence has shown there is a very low risk of children becoming very unwell from COVID-19, most children originally on the shielded patient list no longer need to be and therefore can still attend school. If they are unsure, parents should contact their child’s usual GP or hospital clinician to check whether they should still be considered clinically extremely vulnerable. If a GP or clinician has advised that a child should remain on the shielded patient list, they are advised not to attend school. Children who live with someone who is clinically extremely vulnerable, but aren’t themselves, should still attend school’.

For clinically vulnerable employees, there is a higher risk of severe illness from COVID-19, but less so than in the group of clinically extremely vulnerable individuals. These employees should be especially careful with hand hygiene, minimise contact with others and be careful to follow strict 2 m distancing in the workplace. Provided these new national restrictions are met, the employee may continue to attend work in a COVID-secure environment. If they cannot be met, even with adjustments to the usual employed role, the employee should work from home on health grounds.

Currently published government guidance is ambiguous in defining clinically vulnerable people. It makes reference to age 60 or over. But within the same document it states:

  • Aged 70 or over (regardless of medical conditions)
  • Under 70 with an underlying health condition listed below (that is, anyone instructed to get a flu jab each year on medical grounds):
    • Chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
    • Chronic heart disease, such as heart failure
    • Chronic kidney disease
    • Chronic liver disease, such as hepatitis
    • Chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS) or cerebral palsy
    • Diabetes
    • A weakened immune system as the result of certain conditions or medicines they are taking (such as steroid tablets)
    • Being seriously overweight (a body mass index (BMI) of 40 or above)
    • Pregnant.

Our belief is there is an error in the document that will be revised, so watch out for updates. For now, we recommend you implement an age threshold of 60 rather than 70 in the guidance above.

Pregnant employees should be considered as clinically vulnerable, unless they have also been diagnosed with a cardiac disorder or other medical condition that falls within the clinically extremely vulnerable category. These employees may continue to work at least until 28 weeks of pregnancy in a COVID-secure environment. At 28 weeks pregnancy, an occupational health assessment should be considered to stratify their overall clinical risks and to confirm the appropriateness of continuing to attend work. It is not an absolute requirement for all pregnant employees to work from home from Thursday 5th November .

Where Medwyn Occupational Health has already provided a health risk assessment of your employee the grading of moderate or high risk is unlikely to have changed. Please refer to the original risk certificate to confirm if the employee is fit to attend work, requires role adjustments, or should only work from home. There is no need to undertake a new risk assessment unless health status has changed in the last 8 months.

Anxiety and uncertainty around individual health risks is likely to present amongst those employees required to attend work. If these individuals have not already had an occupational health risk assessment you may wish to consider referring to Medwyn Occupational Health for further advice.

Please don’t hesitate to contact the team on 01306 873936, or email admin@medwynoh.co.uk for further support.

COVID-19 Testing & Symptom Checker

Flu and COVID-19 are both contagious respiratory illnesses but they are caused by different viruses. COVID-19 is caused by infection with a new coronavirus (called SARS-CoV-2) and flu is caused by infection with influenza viruses. Some of the symptoms of flu and COVID-19 are virtually indistinguishable based on symptoms alone and a PCR test may be needed to help confirm a diagnosis.

Both COVID-19 and flu can spread from person-to-person, between people who are in close contact with one another (within approximately 2 metres). Both are spread mainly by droplets made when people with the illness (COVID-19 or flu) cough, sneeze, or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

It may be possible that a person can get infected by physical human contact, such as shaking hands, or by touching a surface or object that has virus on it and then touching their own mouth, nose, or possibly their eyes.

The flu virus and the virus that causes COVID-19 may be spread to others by people before they begin showing symptoms, with very mild symptoms or who never developed symptoms (asymptomatic).

If a person has COVID-19, it could take them longer to develop symptoms than if they had flu.  Typically, a person develops COVID-19 symptoms 5 days after being infected but symptoms can appear as early as 2 days after infection or as late as 14 days after infection.

Flu and COVID-19 share many characteristics but there are some key differences between the two. While both illnesses can cause a cough, a COVID-19 cough can be particularly severe. It is also unusual for flu to have long-lasting symptoms, while many people experience a slow recovery from COVID-19.

If you are experiencing symptoms of a cold, such as coughing, sneezing, a high temperature or a runny nose it is important to stay at home as COVID-19 can be transmitted by coughing and sneezing – droplet transmission. It is essential to get tested as soon as possible, as you will need to self-isolate for at least ten days if you have a positive COVID-19 test.

Due to many of the symptoms of COVID-19, flu and colds being so similar, the only way to confidently know for certain whether you have COVID-19 is by taking a PCR test. An increase in demand for free NHS COVID-19 tests has led to local shortages. Medwyn Occupational Health is now able to offer a home testing kit at a cost of £125. Lab results are usually available within 48 hours of the lab receiving the sample.

To download the symptom & flu checker as an A4 PDF, click on this here

Returning to the Workplace – Latest updates

Shielding Guidance for People at High risk of Coronavirus (Clinically Extremely Vulnerable)

The government has announced that from 1st August, shielding employees can return to the workplace. The government has made this decision because infection rates in the community are falling. One in 1,700 people are estimated to have the virus now, down from 1 in 500 four weeks ago.

What changes from 1st August?

Extremely vulnerable people who are most at risk from becoming ill with coronavirus will no longer need to shield.

This means that employees can return to work, if they cannot work from home, as long as the workplace is COVID secure. Employees will no longer be eligible for statutory sick pay – unless they develop coronavirus symptoms, or someone they know develops symptoms and they are told to self-isolate and cannot work from home.

Inevitably, some employees may feel uncertain about returning to work. The government is asking employers to ease the transition for their clinically vulnerable employees by ensuring robust support measures are put in place. Employees should be advised about specific policies in relation to COVID-19, agree a plan for returning to work and any adjustments that may be needed before they return. 

If it is not possible to strictly adhere to your COVID secure business requirements for employees  identified as shielding before the employee returns to the workplace, we would recommend referring your employee to Medwyn Occupational Health for guidance on adjustments to ensure their safety and to manage health risks.  

What happens if there us a second wave?

The government will continue to monitor the evidence closely and adjust any advice accordingly. Should shielding need to resume, it is not necessarily the case that everyone who has been shielding over the past three months will have to do so again.

What does One Meter plus Guidance mean for workers?

The move to one metre plus is not currently consistent with published COVID secure guidance for each business sector, so this will inevitably cause some confusion for employers. Where possible, two metre distancing between employees should be maintained – but where this is not possible – it allows alternative working practices to be considered, with additional measures such as perspex screens and other PPE. Guidance on how to implement this in context of employee health risks has not been published, so until further scientific evidence is available, Medwyn recommends the following approach for employees who have returned to work sites:

Standard/Low Health Risk Employees – To maintain standard two metre distancing, but where this is not feasible, one metre plus distancing can be adopted in line with government advice on risk management.

Medium & High Health Risk Employees – To continue maintaining stringent two metre distancing.

HSE Guidance on Health Surveillance

The Health and Safety Executive (HSE) has advised that statutory health surveillance should continue where employees are working on-site and exposed to hazards. Occupational health providers have been asked to offer a tiered approach to health surveillance.

Medwyn Occupational Health will be providing online symptom questionnaires which can be completed remotely and submitted by the employee. Where symptoms or health concerns are identified, a telephone or video consultation will be organised.  If a face-to-face examination is required following the initial remote consultation, this will be undertaken with appropriate safeguards recommended by Public Health England (PHE).

Hand-Arm Vibration at Work

Hand arm vibration (HAVS) online questionnaires can be sent to employees who continue to work with vibratory tools. For any individuals identified with potential HAVS symptoms, a clinical assessment will be performed by video and a decision made if a face-to-face examination is justified.

Control of noise at Work and Respiratory Health Hazards

Hearing and respiratory health hazards will be assessed with an online questionnaire to identify any individuals at risk of associated health problems. Providing the employee does not identify any relevant problems, audiometry or spirometry will be deferred for up to 6 months.

Safety Critical Medicals

Medwyn Occupational Health will perform a task analysis to ascertain if it is appropriate to undertake assessments remotely by telephone or video consultation and defer a face-to-face examination. If the assessment is conducted remotely, a ‘fitness to work certificate’ may be restricted by duration until the employee has been seen for a face-to-face consultation.

Safety Critical Medicals will be provided to employees where the risks to themselves or others outweigh the risk of exposure to COVID-19 for our clinical team and the individual. PPE will be worn if a face-to-face medical is required.

We are aware that clients have employees now due health surveillance. We will contact those we believe are due over the next two weeks to discuss next steps. If you have not used Medwyn for health surveillance in the past and your COVID work risk assessments have identified exposure to noise, vibration or respiratory hazards please contact us to discuss your requirements.