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When is work-related stress 'reasonably foreseeable'?

5 February 2007
case report

Amicus - the third largest trade union in the NHS - is investigating the level of excessive working nationally, following the case of a health visitor awarded £64,000 after suffering a breakdown because of overwork.

Tina Hiles was awarded £64,000 in compensation by the High Court after the workload imposed on her by her trust - South Gloucestershire Primary Care Trust (PCT) - caused a breakdown.

Judge Robert Moxon-Browne ruled that South Gloucestershire PCT had been in breach of its duty to Hiles, and that the stress she had suffered at work had been the cause of her breakdown. He commented that he believed "this particularly injury was foreseen and could have been prevented by the exercise of reasonable care".

The fact that Hiles' injury was foreseeable meant the Trust was liable for her stress. Whether an injury is foreseeable rests on considerations such as; what the employer knows (or ought reasonably to know) about the individual employees; the nature and extent of the work done; and signs from the employee of impending harm to health.

The Trust failed to act on some of these indications. For example, at one point Hiles burst into tears at a work review. The Court decided that this should have been viewed as not being the normal behaviour of an ordinary employee when discussing workload and as such should have been seen as a sign that the claimant was being affected by stress.

The PCT had its application to appeal the judgement rejected.

In a similar case last year, an employee was awarded £140,000 compensation after her excessive workload, resulting from the need to cover for absent colleagues, made her ill.

The High Court heard that Melanie Garrod suffered two breakdowns when, she claimed, North Devon Primary Care Trust failed to bring in temporary staff to cover for colleagues on sickness or maternity leave.

She was supposed to do a 30-hour week but often had to work many more hours unpaid to cope with the workload.

Garrod claimed that she fell ill with depression on two occasions due to pressure of work. Following her second period of illness she returned to work with assurances from the Trust that she would not be required to take on any more extra caseload.

However, when another colleague went on maternity leave and was not replaced Garrod had to cope with two workloads again. She went off sick and did not return to work; her employment was terminated on grounds of ill health.

Due to Garrod's excessive workload, the court ruled that the Trust was liable for the subsequent psychiatric illness she suffered. It said that this psychiatric harm was reasonably foreseeable and that a reasonable employer should have foreseen that deciding which appointments to prioritise, which to cancel, attempts to find alternative staff, and the demands of Garrod's own duties created a significant risk of psychiatric harm. It also ruled that the Trust had failed to take steps to replace absent staff, something that it was reasonable to expect it to do.