Occupational Health
Work Assessment
The risk assessment consists of four stages:
1. The individual who is the subject of the assessment completes the ‘individual
assessment’ questionnaire.
2. The manager who is undertaking the assessment completes the ‘manager’s
assessment’ questionnaire.
3. The manager and the individual meet to review the questionnaires, to identify
issues for attention and to agree on an action plan.
4. At an agreed time, the manager and the individual meet to review progress
with the action plan and to determine whether any additional actions are
required
1 Individual Assessment
The Health and Safety Executive defines work-related issues resulting in stress as
‘the adverse reaction people have to excessive pressures or other types of demand
placed on them’
By completing this form, you will help your manager assess the need for any
changes that might help you undertake your job more effectively. Your manager will
complete a similar form to gain a complete picture and will review the findings with
you.
Date of Assessment:
Name of Individual:
Job Title:
Line Manager:
Please review the following statements and place a tick in the appropriate box.
never
1.
2.
3.
4.
5.
6.
7.
8.
9.
I am clear what is expected of me
at work
I can decide when to take a break
Different groups at work demand
things from me that are hard to
combine
I know how to go about getting
my job done
I am subject to personal
harassment in the form of unkind
words or behaviour
I have unachievable deadlines
If work gets difficult, my
colleagues will help me
I am given supportive feedback
on the work I do
I have to work very intensively
10. I have a say in my own work
speed
11. I am clear what my duties and
responsibilities are
12. I have to neglect some tasks
because I have too much to do
13. I am clear about the goals and
objectives for my department
14. There is friction or anger between
colleagues
15. I have a choice in deciding how I
do my work
16. I am unable to take sufficient
breaks
17. I understand how my work fits into
the overall aim of the organisation
18. I am pressured to do long working
hours
19. I have a choice in deciding what I
do at work
20. I have to work very fast
21. I am subject to demanding
behaviour from work colleagues
22. I have unrealistic time pressures
23. I can rely on my line manager to
help me out with a work problem
24. I get help and support I need from
colleagues
25. I have some say over the way I
work
seldom
sometimes
often
always
never
26. I have sufficient opportunities to
question managers about change
at work
27. I receive the respect at work I
deserve from my colleagues
28. Staff are always consulted about
change at work
29. I can talk to my line manager
about something that has upset or
annoyed me about work
30. My working time can be flexible
31. My colleagues are willing to listen
to my work-related problems
32. When changes are made at work,
I am clear how they will work out
in practice
33. I
am
supported
through
emotionally demanding work
34. Relationships at work are strained
35. My line manager encourages me
at work
seldom
sometimes
often
always
2 Manager’s Assessment
This form will assist you to assess the level of pressure being faced by an individual
member of staff who has either complained of stress-related symptoms or appears to
be suffering from work-related stress.
Date of Assessment:
Name of Individual:
Job Title:
Your Name:
Relationship to Individual:
Please review the following statements and place a tick in the appropriate box.
never
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
The individual is clear what is
expected of them at work
They can decide when to take a
break
Different groups at work demand
things from the individual that are
hard to combine
The individual knows how to go
about getting their job done
The individual is subject to
personal harassment in the form
of unkind words or behaviour
The individual has unachievable
deadlines
If work gets difficult, colleagues
will help
The individual is given supportive
feedback on the work they do
They have to work very
intensively
The individual has a say in their
own work speed
They are clear what their duties
and responsibilities are
They have to neglect some tasks
because they have too much to
do
The individual is clear about the
goals and objectives for their
department
There is friction or anger between
colleagues
They have a choice in deciding
how they do their work
The individual is unable to take
sufficient breaks
seldom
sometimes
often
always
never
17. The individual understands how
their work fits into the overall aim
of the organisation
18. They are pressured to do long
working hours
19. The individual has a choice in
deciding what they do at work
20. They have to work very fast
21. They are subject to bullying at
work
22. They have unrealistic time
pressures
23. The individual can rely on their
line manager to help them out
with a work problem
24. They get the help and support
they need from colleagues
25. They have some say over the
way they work
26. The individual has sufficient
opportunities
to
question
managers about change at work
27. They receive the respect at work
they deserve from colleagues
28. Staff are always consulted about
change at work
29. They can talk to their line
manager about something that
has upset or annoyed them about
work
30. Working time can be flexible
31. Colleagues are willing to listen to
their work-related problems
32. When changes are made at work,
the individual is clear how they
will work out in practice
33. The individual is supported
through emotionally demanding
work
34. Relationships at work are strained
35. Their line manager encourages
them at work
seldom
sometimes
often
always
3 Action Plan
Agreed action
Date for completion
Date for action review meeting ……………………
Signed:
Individual ………………………………………..Date…………………..
Manager …………………………………………Date………………….