Dignity at work Dr Rekha Elaswarapu Independent Dignity

Dignity at work Dr Rekha Elaswarapu Independent Dignity Adviser Board member, National Dignity Council

Dignity at work • Evidence suggests that if staff are treated with dignity and respect then they would in turn treat patients with dignity, respect and compassion. • This has led to the concept of ‘Dignity at Work’ which protects and enables the staff to be treated with dignity at their workplace.

Dignity at work • Every individual who comes into contact with the NHS and organisations providing health services should always be treated with respect and dignity, regardless of whether they are a patient, carer or member of staff. • This value seeks to ensure that organisations value and respect different needs, aspirations and priorities, and take them into account when designing and delivering services. • The NHS aims to foster a spirit of candour and a culture of humility, openness and honesty, where staff communicate clearly and openly with patients, relatives and carers. (NHS Constitution)

Dignity at work • Dignity at work involves ensuring that staff are valued and counted in their work environment. • Staff and employers should build a workplace culture that promotes respect for all. • No staff member should be subjected to bullying and harassment in any respect.

Bullying The BMA defines bullying as where an individual or group abuses a position of power or authority over another person or persons that leaves the victim(s) feeling hurt, vulnerable, angry, or powerless

Harassment 'It is any behaviour, whether verbal, non-verbal, or physical, which has the purpose or effect of violating an individual’s dignity or creating an intimidating, humiliating or offensive environment for that individual or group. NHS Employers- Briefing 74: , The Equality Act 2010

Impact of bullying • Workplace bullying can lead to lost productivity, fraud, worker abuse and more. • Lack of dignity at work can affect an individual's emotional, psychological and physiological health. These affects can extend to their interaction with family and friends too.

Impact of bullying – Mental health • Debilitating Anxiety (80%) • Panic Attacks (52%) • Clinical Depression: new to person or exacerbated condition previously controlled (49%) • Post-traumatic Stress (PTSD) from deliberate human-inflicted abuse (30%) • Shame (the desired result of humiliating tactics by the bully) - sense of deserving a bad fate • Guilt (for having "allowed" the bully to control you) • Overwhelming sense of Injustice (Equity - the unfairness of targeting you who works so hard; Procedural - the inadequacy of the employer's response to your complaint)

Impact of bullying - Physical health • Cardiovascular Problems: Hypertension (60%) to Strokes, Heart Attacks • Adverse Neurological Changes: Neurotransmitter Disruption, Hippocampus and Amygdala atrophy • Gastrointestinal: IBD, colitis • Immunological Impairment: More frequent infections of greater severity • Auto-immune disorders • Fibromyalgia (21%), • Chronic Fatigue Syndrome (33%) • Diabetes (10%) • Skin Disorders (17%)

Stress related problems resulting from bullying or harassment ✦ sickness absence ✦ erratic or poor timekeeping ✦ increases in patient complaints ✦ increase in number of employees taking counselling ✦ increase in grievances ✦ poor working relationships ✦ conflict between colleagues Source: RCN: Bullying and harassment at work – a guide for RCN managers and negotiators

Impact of bullying – Economic harm • Lost skills due to people leaving jobs • Forced to transfer from loved job, often a punitive transfer (13%) • Constructively discharged without reasonable cause (24%) • Lost productivity due to stress related sickness

NHS staff survey 2014 • Sixty-five percent of staff reported that they had attended work in the previous three months despite not feeling well enough to perform duties • Of those who had attended work while unwell, 91% stated that they had put themselves under pressure to attend; 30% felt under pressure from their manager and 23% from other colleagues to attend. • Thirty-nine percent of NHS staff reported that during the last 12 months they have felt unwell as a result of work related stress. • Around 3% of all staff said they had experienced physical violence from other staff. Twenty-four percent of staff reported they had experienced bullying, harassment or abuse from either their line manager or other colleagues. • Two thirds (66%) of incidents of physical violence and 44% of bullying, harassment or abuse cases were reported

Dignity at work policies: ACAS guidance (1) • statement of commitment from senior management • acknowledgement that bullying and harassment are problems for the organisation • clear statement that bullying and harassment is unlawful, will not be tolerated and that decisions should not be taken on the basis or whether someone submitted to or rejected a particular instance of harassment • examples of unacceptable behaviour • statement that bullying and harassment may be treated as disciplinary offences • the steps the organisation takes to prevent bullying and harassment

Dignity at work policies: ACAS guidance (2) • responsibilities of supervisors and managers • confidentiality for any complainant • reference to grievance procedures (formal and informal), including timescales for action • investigation procedures, including timescales for action • reference to disciplinary procedures, including timescales for action counselling and support availability • training for managers • protection from victimisation • how the policy is to be implemented, reviewed and monitored.

Overarching themes integral to the effective function of an organisation particularly for ensuring dignity at work for staff • Culture • Leadership • Accessibility of the policy • Handling of concerns • Support for staff during and after the investigation • Training

Key success factors for ensuring a bullying free culture • Acknowledge bullying and harassment culture exists • Respond quickly • Don’t be defensive • Be open

Effective leadership • Lead by example • Lead from the front • Non-negotiable values • Practice the values and behaviours • Create a staff friendly culture • Set the standards and ensure its adherence at all times • Robust governance framework • Good communication including minding the tone • Give feedback professionally • Value your staff

Dignity is everyone’s business Thank you for listening Dr Rekha Elaswarapu Independent Dignity Adviser Board member, National Dignity Council rekha_elaswarapu@yahoo. co. uk