Step 3: Evaluate the risks – explore problems and develop solutions

The main aim of this step in HSE's Management Standards approach is to take the data collection and analysis from the previous step, and talk the conclusions through with a representative sample of employees and work with them to develop solutions.

Data analysis can only give a broad indication of the underlying issues affecting the health of employees. If you want to know what is affecting employees, you have to ask them.

How you choose to evaluate the risks will be dictated by your organisational structure and the way you have chosen to follow the Management Standards approach.

Focus Groups

Why focus groups are helpful

Focus groups can be helpful because:

issues highlighted as important in Step 2 may not turn out to be the most important issues for your employees
even when the data appear to suggest clear hot spots, it is important to check this out with your employees
new issues often emerge during these group discussions. This may reflect more recent changes in working conditions, for example as a result of organisational change. However, it could be because focus groups allow employees to discuss, analyse and articulate issues in ways they may not previously have had the chance to

Use focus groups to link problems to solutions

Focus groups, or similar discussion groups, also allow you to explore possible solutions to problems.

It is critical that your employees and their representatives participate in this process as:

they are often closest to the issues identified
they may know better what will work in practice and what will not work
they are more likely to help ensure the success of any agreed actions if they have taken an active part in developing and agreeing solutions

Groups of between 6 and 10 people work best, but the numbers of your employees involved in this stage will depend on the size of your organisation and local circumstances.

During the focus group or discussion group, you may find it useful to consider the good practice detailed in the Management Standards, and whether this is actually happening in your organisation. This can help provide structure to some of your discussions.

For further information on setting up and running focus groups see How to organise and run focus groups

If you use your own approach to consult with staff and their representatives rather than focus groups, it is important that you ensure all stakeholders (management, employees and their representatives) are either represented in the process or have a route into any forum used.

Develop focus group action plans

A key output from the focus group would be a proposed or preliminary action plan, containing suggestions and recommendations for action at different levels of the organisation.

Since there may be a number of preliminary action plans produced by different focus groups, these will have to be reviewed and turned into a single action plan for the organisation. Step 4 – Developing an action plan gives more information on this.

Communicate the results

You should keep managers, employees and their representatives updated as you go through this process. For example, it is a good idea to share the outcome of the focus groups with group participants soon afterwards.

Deal with individual concerns

Each of the six Management Standards requires that you have systems in place to deal with individual concerns.

Further information

'Peer support showed as a problem on the staff survey but not in focus groups!'
NHS Trust

This quotation highlights a potential issue. A survey such as the HSE Indicator Tool questionnaires and its analysis will provide data to indicate possible issues.

In the current example, peer support was indicated as a possible issue for discussion at the focus group. However, the focus group did not agree that this was an issue. This situation is not uncommon and demonstrates that one of the functions of running focus groups is to validate the data analysis. The reason behind this apparent error could be simply that for the employees attending the focus groups, peer support was not the primary issue. This situation also reinforces the need to use more than one source of data, only a survey was used in this example.

HSE Indicator Tool

The Indicator Tool is a 35-item questionnaire developed by HSE for use with the Management Standards approach. The questions map across to the six Management Standards: demand, control, support, role, relationships and change. Indicator Tool, as its name suggests, provides a broad indication of your organisation's performance in these six areas. It should not be used as the only data source, but should be used with other relevant data to provide a more accurate and holistic picture of your organisation's performance.

The 'Indicator Tool User Manual' provides advice and guidance on how to use the Indicator Tool as a stand-alone measuring device or as part of an existing staff survey device.

Analysis Tool

The Analysis Tool was developed by HSE specifically to process completed Indicator Tool questionnaires. The analysis tool was first launched in 2004 and has continued to develop in response to feedback from users.

Since the Analysis Tool was published we have had a number of complaints that the tool 'isn't working'. When checking with the complainants there are the some recurrent themes:

Trying to run the Analysis Tool from the HSE website – it should be saved to your own system
When importing data from a third-party survey, users do not ensure the scoring of questions within the HSE Indicator Tool is correct. They assume that all questions are scored in the same direction. Some questions are asked in the negative and therefore are reverse scored
People fail to read the instructions: the opening page of the tool is an embedded instruction leaflet. If you double click it will open as a four page guide which describes how to use the tool properly
The work sheet is password protected: If you are entering a single year's data, you need access only the 'Raw Data' worksheet. All the information is entered on this one page and the rest is populated as the analysis is completed. You don't need a password
Column B: Whether you use demographic questions or not, there must be an entry in column B for each row of data. This can be the date, the name of the organisation or anything else. This clarifies that the data entered in that row is valid and a record number is allocated to column A
Too few responses: The tool is designed to work when there are 10 or more records, the analysis will not be done until there are 10 records - if you have fewer you can copy and paste all the records until the total exceeds 10
Transfer of data from other tools: The analysis tool is an excel document that analyses numeric data. If you are creating a digital version of the questionnaire using some data gathering package, you need to ensure that the tool identifies the score (1 - 5) rather than the 'answer' (sometimes, often, never etc,)

How to develop interventions

Interventions are the steps you will take to address the causes of work-related stress; their development is the key output from the Management Standards approach. Interventions will be focused on closing the gap between the organisation's current level of performance and that described by the Management Standards.

Those who will be asked to implement an intervention should be involved in its design (bottom-up approach) by involving employees in focus or other groups.

A key output from each focus group, or other discussion group, should be a preliminary action plan. In developing an action or intervention it is worthwhile considering the following factors.

Intervention type

Primary: these are focused at addressing issues at source, preventing the problem from continuing and having an adverse effect on employee health. These are the ideal type of intervention and are normally the most cost-effective
Secondary: these focus on helping employees deal with the situation. However, they do not address the underlying cause of the problem
Tertiary: these interventions are aimed at improving the health of employees who have been made ill by their work and if absent, help their return to work

Level of the organisation

Organisation (strategic): this is where the issue is having a detrimental impact on the performance of employees across the organisation
Team or group (macro): where an issue is affecting a number of different groups of employees. That is, the intervention is outside the control of a single group
Individual (micro): typically interventions at this level would focus on a local issue affecting a small number of individuals. These interventions can be important as they demonstrate that the organisation is listening to their concerns and is taking action to address them.

Time period

Short: if an intervention can be designed to deliver a positive outcome in a short time period, take the opportunity for a quick win
Medium: interventions that are expected to deliver their results in months rather than days or weeks. In this instance you should consider how employees will be kept informed of progress
Long: where an intervention will not deliver a positive outcome for a number of months or possibly years. Again, it is important to consider how employees will be kept informed of progress

We have provided, in appendix 6 of the Management Standards workbook some suggestions for interventions for each of the Management Standards. They are not meant to offer pre-packaged, off-the-shelf interventions, but as a resource to use to when considering your own interventions.

Step 4: Record your findings gives guidance on the next stage of the approach.