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Taking work-related stress seriously

The member, a consultant, had been off sick for many months; the diagnosis was work-related stress. There had been anger and tears leading up to him going off sick.

That was then, and this was now. The member had been passed fit to return to work, and had met with the OH (occupational health) consultant, who had made a report recommending a phased return over several weeks.

I had met the member, and we identified some changes that needed to be made.

Clearly, it was important that he was able to control his workload; in the run-up to his illness, he had felt increasingly unable to say no to work due to the lack of resources in the unit.

We also identified that no one had listened when he raised concerns about his workload in the past. Now that he had suffered a work-related illness, people would need to pay close attention to this.

We arranged a return-to-work meeting with the clinical director, a senior manager from the service, and the OH consultant.

Prior to the meeting, I wrote to them all, outlining our agenda and aims, which were; a revised job plan; guarantees about what would happen if the workload was unmanageable; a hotline to the clinical director to alert her to problems.

A phased return approved by OH, which included two weeks of limited attendance with no patient contact, and then gradually introducing clinics with a review meeting of the same team one month in.

I also phoned the clinical director to discuss the job plan with her, and to ascertain the current staffing levels in the unit.

At the meeting, I reminded everyone of the case Walker v Northumberland County Council. It established that no one could predict with certainty what might trigger work-related illness but it was entirely predictable that such illness would recur if conditions did not change on return to work, and that the employer would be liable for negligence if that happened.

The OH doctor confirmed fitness to return and outlined a programme for a phased return, which was agreed after some flesh was put on its bones. This included a review meeting.

Then we worked through the job plan in the light of the information I had gleaned from the clinical director about changes in staffing and referral patterns, and made some adjustments. After that, we established the safety-valve arrangements in the event of difficulties arising.

The manager wanted to ensure that mandatory training was up to date; we arranged a session prior to the return date. We also arranged for the member to meet the two team members who had been recruited in his absence. Finally, we agreed a date for return and what would be said to the team.

No drama, no crisis and the member returned as planned with no recurrence of his illness.

Doctors well being