Team Prevent want to involve staff in identifying how they can improve the promotion of Health and Wellbeing in the workplace. The purpose of this questionnaire is to help us identify the key health issues and plan the Health and Wellbeing strategy. 

The Health and Wellbeing strategy will then aim to reduce the risk of work related illness and injuries and help staff to enhance their health and wellbeing and make healthy lifestyle changes if they wish to do so.

To help us achieve this we would be most grateful if you could work through the below questions carefully. It will probably take about 10 minutes to complete.

If you are unsure how to answer a question, please give the best answer you can.  Place a tick in the appropriate box or write brief comments where this is indicated.

All of your answers will remain completely confidential.


SECTION A
The following questions ask for your views about possible effects of work upon your health. If you feel any questions do not apply to you or you don’t have an answer – just leave them blank.

Question Title

* 1. During the last 12 months to what extent have you felt that your physical and/or mental health might be at risk from the following aspects of your work environment?

  Not at all A little Some Extent Considerable Extent
1. Temperature inside your office/department (too hot or too cold)
2. Air quality inside your office/department (e.g. too stuffy, not enough fresh air)
3. Noise or vibration levels inside the workplace
4. Noise or vibration levels outside the workplace
5. Lighting problems (e.g. too dim, too bright)
6. Poor workspace/not enough workspace
7. Hazards caused by litter or general clutter in the workplace.
8. Unsafe equipment or machinery
9. Fire or explosion hazards
10. Electrical hazards
11. Dangerous chemicals
12. Eyestrain (e.g. from use of visual display terminals)
13. Repetitive strain injury from use of keyboards
14. Lifting or moving heavy loads/equipment

Question Title

* 2. Have you ticked the box ‘Considerable extent’ for any of the items numbered 1–19 above? If so, and if you have any suggestions for changes needed to improve these aspects of workplace health, please briefly list them below.

Question Title

* 3. During the last four weeks, on how many occasions have you had each of the following problems which you think are primarily a result of your working life?

  Never Once or twice 3-10 times More than 10 times
22. Headaches
23. Feeling very tired or exhausted
24. Tendency to eat, drink or smoke more than usual

Question Title

* 4. Has a risk assessment been undertaken in your department?

SECTION B
Lifestyle issues

Question Title

* 5. These statements seek your views on the way Moorfields is using the workplace as an opportunity to help you live a healthy lifestyle.

  Agree Disagree Don't Know
1. If I smoke and want to cut down or stop, my employer provides facilities to help me succeed (e.g. self-help groups).
2. If I want to eat a healthy diet, there are usually healthy snacks and meals available in the canteen and/or vending machines.
3. If I want to be more physically active, there is advice and support available for me within the workplace.
4. If I need help to relax, there are facilities I can make use of at work (e.g, stress management workshops, counselling and relaxation sessions).
5. If I want to cut down the amount of alcohol I drink, my employer provides advice and support to help me succeed.

Question Title

* 6. Briefly describe up to three ways in which your employer could most help you to maintain a good standard of physical and/or mental health.

SECTION C
Background information
To help us identify what we need to do to help you improve your health, we need to know a little about you. These details will help us compare the situations of different groups of staff. For all questions, please tick or enter information in the box that applies to you.

Question Title

* 7. Please specify the department in which you primarily work

Question Title

* 8. Which is your staff group?

Question Title

* 9. Are you:

Question Title

* 10. Do you work:

Question Title

* 11. How long have you worked for your employer?

SECTION D 
Managing Attendance/ Sickness Absence

Question Title

* 12. These statements seek your views about how the trust deals with staff being off sick. Tick the box which best describes how much you agree or disagree with the statement

  Strongly Agree Agree Disagree Strongly Disagree Don't Know
1. The attendance management/sickness absence policy is well publicised in the trust.
2. The Trust's attendance management/sickness absence policy is clear and easy to understand.
3. My immediate manager's attitude and actions make me believe that my personal health and well-being are considered important by him/her.

Question Title

* 13. If there are any comments you would like to make regarding the management of attendance, please use the box below.

Question Title

* 14. If you have been off sick during the last 12 months, please also respond to the statements below.

  Strongly Agree Agree Disagree Strongly Disagree Don't Know
1. My immediate manager is fair and consistent in the way he/she applies the attendance management/sickness absence policy.
2. My immediate manager is sympathetic when I am off sick.
3. I feel guilty if I take time off for sickness

Question Title

* 15. If there are any comments you would like to make regarding the management of attendance, please use the box below.

SECTION E
Experience of working life

Question Title

* 16. These statements seek your views about the way in which staff and work are managed within the Trust. Tick the box which best describes how much you agree or disagree with the statement.

  Strongly Agree Agree Disagree Strongly Disagree Don't Know
1. The physical surroundings where I work are reasonably good.
2. I feel safe with the security arrangements inside the Trust’s buildings.
3. I feel safe with the security arrangements outside the Trust’s buildings (e.g. grounds, car park, when visiting patients).
16. All health and safety issues are addressed promptly in my department.

Question Title

* 17. Thinking about the issues referred to above (e.g. the way you are supervised, your job content, your personal development, etc.), it would be helpful if you could briefly describe: those aspects which most positively affect your health and well-being:

Question Title

* 18. Those aspects which most adversely affect your health and well-being:

SECTION F
Staff Support Services

Question Title

* 19. The following statements seek your views about the way in which staff are kept informed and the way information flows around the Trust overall. Tick the box which best describes how much you agree or disagree with the statement.

  Strongly Agree Agree Disagree Strongly Disagree Don't Know
1. The Trust keeps me well informed about the things it is doing to improve the health of its staff.
2. I know who to contact if I need information about occupational health services.
3. The location of the occupational health department makes access to its services reasonably easy.
4. The hours that the occupational health department is open makes access to its services reasonably easy.
5. If I need help, the occupational health service will listen and advise me on personal health worries.
6. Opportunities for routine health screening in the Trust are adequate for my needs (e.g. blood pressure checks, well women/well men clinics).
7. Hepatitis B screening is available for all staff who are at risk.
8. I am reasonably satisfied with the range of services offered by occupational health.
9. The confidential staff counselling service is available to all staff in the Trust.
10. If I needed professional counselling I would use the Trust’s services.
11. I know who to contact within the Trust if I want professional counselling for personal or health-related problems.

Question Title

* 20. If there are any comments you would like to make regarding staff support services, please use the box below

T