Thames Valley Police Journal: Reflections on fatigue and well-being

Introduction

One of our organisational priority outcomes is to sustain a valued workforce. With increasing demands and fewer resources we need to explore how we can simultaneously drive productivity, efficiency, manage fatigue and maximise wellbeing.

As a middle manager for me it’s about turning this strategy into a tactical plan. I have a personal interest in how we manage fatigue and the rigours of night work. For the last 16 years I have failed to do so; engaging in unhealthy habits to keep myself going but ultimately damaging my long term health.

Recently, I have started to make positive changes to restore my health, but it took a real tragedy for me make these changes. On Boxing Day 2018 PC Dan Clayton-Drabble was killed in an road traffic collision (RTC) on his way home from his Christmas Day night shift. I used to work with Dan on Team 2 in Milton Keynes. He was a lovely lad and a fantastic officer. He was only 24 years-old. It is likely that through extreme fatigue Dan experienced a micro sleep and crashed his car on the way home. He was a friend and a colleague and I witnessed first-hand how much his death affected everyone at Milton Keynes, not to mention his family. Dan’s death is not an isolated incident:

• Between 2000-2009, more than 40 officers have died while driving to or from work[i]. This is just within the police. NHS staff face the same dangers.
• Road deaths such as these are often attributed to “micro sleeps”. Micro sleeps don’t last long; a few seconds. They are a consequence of heavy fatigue and no amount of caffeine, pre-workout or loud music can prevent them. Normal sleep is the primary way our body repairs and recovers itself. We are the only species on the planet who will deliberately deprive ourselves of sleep and we simply cannot function without it. Micro sleeps are often a consequence of sleep deprivation whether intentional or not [ii].
• Night shift workers are more likely to crash their cars than people who work during the day. Researchers found that drivers who did not work nights were four or five times less likely to crash their vehicles [iii]

Moreover:

• With a legal limit for alcohol use when driving as a standard, the results show that after 17–19 hours of wakefulness, subjects’ performance on many tests had dropped to that found at the legal limits for safe driving. You are potentially as impaired through lack of sleep as you might be had you been drinking alcohol at such a level that you would be regarded as unsafe to drive [iv].
• Researchers from Harvard found that 46% of police officers reported drowsy driving and even falling asleep. A quarter of these officers said that drowsy driving happened one to two times a month, and about 40% of the officers in the study screened positive for sleep disorders. That is nearly double the rate of the general population [v].
• It has been established that every extended work shift that was scheduled in a month increased the risk of an RTC by 9% and increased the monthly risk of a crash during the commute from work by 16.2%. We really need to consider the possible consequences of working that extra shift [vi].
• In the US in 2000, Vila found that police officers are the ones that suffer the consequences of poor resource management, especially when duties are changed at short notice. Many officers can relate to that. Whilst there are operational exigencies, the risk to the public will rarely warrant officers pushing themselves beyond their physical limits [vii].

Understanding the problem

Many of us struggle with night shifts. Personally, I have always struggled with insomnia and it got really bad when I turned 35. This is supported by scientific study (Mason et al 2000) who showed you will be more susceptible to fatigue and have reduced resilience for shift work as you approach your mid-thirties.

As we get older, we are likely to turn to sleep aids and stimulants to manage shift work. For example, the use of sleeping medication (over the counter or on prescription), alcohol, caffeine, pre-workouts and Night Nurse to manage short term problems will eventually lead to more serious health issues and a poorer quality of sleep.

I know this to be true as I am guilty of all of the above and I naively thought I was the only one going through these difficulties. But since I started this research and speaking with so many of you I have realised the scale of the problem. But we all need to understand these are temporary fixes – short term gains at the expense of your long term health. As we grow older, our bodies change. What we are capable of changes. I know we would all frown upon someone who used performance-enhancing drugs to replicate their ‘one-rep max’ bench press or their best 400m time from when they were twenty. So why do we refuse to accept that how we sleep and how we recover changes? But what can we do to mitigate these affects and maximise our health?

Your diet

The topic of ‘what constitutes a healthy diet’ would be an academic paper in itself. In summary, we all need to concentrate on being well hydrated, eating a balance diet, eating at the right times and avoiding binge eating and too much sugar. I’m not going to replicate this information. The Thames Valley Police (TVP) Wellbeing page has a lot of information on diets. It is vitally important that we ensure we get the right amount of sleep and have a decent diet to be effective at work as well as being healthy at home outside of work. You need to take responsibility for your diet and to ensure you have enough rest. If you are struggling for time, always prioritise your sleep and rest. Realise there is only so much time in the day to spend with your family, friends, be at work and even possibly manage another business interest.

Whilst personal responsibility is important, you need to be supported by the organisation. TVP has the responsibility to provide education and an environment for where you can flourish. Presently, you all have more time dedicated to how you use your smart phones than you do on how to manage the rigours of shift work. You have probably dedicated more time to POWDER checks on your vehicles than you have to your own wellbeing. This is going to change. Whilst these work responsibilities are important and need to be done, how do you expect to reach your full potential if you are fatigued or in ill health as a consequence of fatigue or lack of sleep? Remember, it’s not just you who suffers if you are in ill health, fatigued or stressed. Your family and friends will feel the strain too.

Dealing with the problem

My vision is to provide you with the knowledge and an environment in which you can flourish: mentally and physically. My obligation to you will be to provide you with the support and information you need to reach your potential. So for shift workers we will be providing awareness around personal responsibility, managing your time, hydration and nutrition, how to design your bedroom – we will provide you with an entire ‘toolkit’ of solutions. Your responsibility is to take this information on board and make changes where you need to. Those with other business interests will need to ensure they are getting enough rest to perform at work.

Together we will prioritise your wellbeing to ensure you are healthier in body and mind. In doing so, morale and productivity will increase. Your productivity per hour can be maximised by ensuring you are rested and your nutritional intake is good. The by-product of this is likely to be a reduction in absenteeism, complaints and fatigue related health and safety incidents.

These are just the benefits to you and the organisation. Your family and friends will also get to enjoy you at your best. It makes good business sense to invest in the wellbeing of our staff: you are our most important assets. Fatigue is a killer and it is strongly linked to mental health issues. My own anxiety and other issues stemmed from my insomnia. My constant fatigue led to my reliance on prescription sleeping tablets and way too much caffeine.

This is a serious morale, wellbeing and business issue and it is being debated all around the world. Many leading academics in this field recognise that there is a need for change. The airline industry has already embraced science and adopted new working practices to make positive changes. But the onus is on us as much as it is the organisation. We all have a role to play: it’s about both personal and organisational responsibility.

I have spoken to a great many different employers (public and private sector) and I have found
that, like the police, none of them really prepare their staff for the rigours of working nights. I know police work does mean at times we have to push ourselves but that should not happen all the time and is potentially destructive if it becomes the norm leading to burn out. This journey you are on is a marathon, not a sprint. Save some for the last 6 miles. The amount of support and knowledge leading companies offer their staff is unrecognisable to how it used to be. The younger generations entering the workforce have completely different expectations of what support they should receive, what they want from a career and organisations are having to adapt.

Managing wellbeing: an approach to understanding and developing positive practice

What can we do? A National Decision Model (NDM) assessment.

Gather information and intelligence:

I have liaised internally and externally to identify the main issues and find good practice. I have worked with the College of Policing, leading academics in the field of sleep deprivation and fatigue, and some private and public companies. I have liaised with the fire service and found contacts in Nuffield to provide you with the best nutritional information possible. I have been absolutely amazed about how much interest and support I have received. We are slowly starting to understand how important it is to invest in the wellbeing of our staff.

Assess threat and risk and develop a working strategy:

Research has shown that falling asleep whilst driving accounted for 20% of serious collisions under monotonous driving conditions. Sleep related collisions are more likely to result in death or serious injury as the driver is unable to take action prior to the collision. Many of these collisions are work related. Around half of these are caused by healthy men under 30 years old. Younger drivers tend to take more risks when driving sleepy. They believe they are ‘good drivers’ and don’t realise that sleep loss is more profound in its effects on their age. Drivers performing night-shift work and driving home are especially vulnerable. Especially on their first night shift [viii].

•  Stacey Pyke, 20, had been a police officer for just a week when she fell asleep at the
  wheel on the way home from her first-ever night shift [ix].

Older drivers are also more susceptible during mid-afternoon because of another dip in their body clock, which becomes more evident beyond about 60 years of age. The over-35’s find it harder to cope with night work specifically [x].

Given that most of us who have a few years’ service have already worked out how to manage [or not to manage] night work our priority is to provide education to those who are just joining the organisation, whether it be as an Officer, PCSO, Detention Staff, Specials [who normally work a day job and then come to us to do a shift], support staff and Contact Management Staff.

Consider powers and policy:

The Working Time Regulations put restrictions on the number of hours worked (although it is possible to opt out). However, even if the organisation still has a responsibility to ensure you are not put in a position where you are so fatigued you cannot operate. You also have a personal responsibility to live in such a way that you are fit for work and you must be open about how you are feeling in terms of whether this is actually the case.

As managers we need to monitor your fatigue and the hours that you are working. We need to be mindful how we utilise you and when. Produce Connection was fined £30,000 in April 2006 after one of its workers crashed and died while driving home after a third consecutive shift of nearly 20 hours.

The court heard that he was thought to be suffering from “chronic fatigue” and had fallen asleep at the wheel. The firm admitted two breaches of health and safety law in failing to ensure the health of workers and the public. The judge said the firm had failed to monitor the hours employees worked, and ordered it to pay £24,000 costs.

Mason et al details that the common law duty of care contained in the tort of negligence states that we all owe a duty of care to anyone whom we can reasonably foresee would be likely to be injured by the things we do or omit to do.

Clearly, in events of public disorder/ genuine unforeseeable major events we need to provide a service which can make this difficult – but for day-to-day policing this should be achievable. Legal ruling in Johnstone vs Bloomsbury Health authority suggests the employer should not expose the employee to a risk of injury to health if the employer knew or ought to have known that by requiring the employee to work the hours they did they were exposed to such risk.

Most importantly, Mason provided information on the case of R v Taylor (2006). PC Taylor of Tayside police was involved in a serious collision after working a series of very disruptive shifts. He was prosecuted for dangerous driving but his defence detailed that his duties were unreasonable and Tayside police should shoulder most of the blame. The case was dismissed.

Identifying options and contingencies:

I presented the evidence I had gathered to the Head of Learning and Development and Head of Employment and Wellbeing and I have had permission to turn my work into an hour-long training input. I am in the process of designing this with the Learning and Development department.

This will:

• Spread awareness of the dangers of fatigue both physically and mentally.
• Promote personal responsibility and provide staff with a practical tool kit of how to manage night work. This will cover:
• Nutrition: including the dangers of stimulants and a healthy diet.
• How to maximise opportunities for healthy sleep by designing your bedroom as a sanctuary for sleep: have a good Tuft And Needle Full Mattress, maintaining a temperature of 18-19C, using ear plugs, dark, black out blinds.
• How to manage working night shifts: rolling onto nights and off nights. When to go to bed. When to wake up. Finding a routine. Managing your commute; one of the most influential factors on you having an RTC on the way home can be the length/ monotonous nature of your commute.
• Speaking to your family so they can support you and understand how challenging nights can be.

Organisational responsibilities:

• Monitoring your hours and overtime.
• Creating a management culture where openness is key. Create a culture where managers have the discretion to manage or offer bespoke short term support.
• Ensure that learning is accessible and makes use of new technology platforms e.g. phone apps/ TED TALK style health talks.
• Spreading awareness that we can support you getting home or providing the facilities so you can rest before you drive home.
•  Ensure duty changes are minimised and we consequently have sufficient time to rest and recuperate.

The training will be easy. The challenge will be adopting new practices and driving cultural change. Managers need to exercise discretion to support officers who are struggling. We need to ensure we support our staff and the organisation by promoting a nurturing and open management culture. We can implement short term solutions where necessary and make the necessary referrals to support departments to secure long term wellbeing.

In terms of innovative solutions, what can we consider? Northamptonshire Fire Service manage nights totally differently. They have a different demand profile to work with but they allow their staff to sleep between certain time periods although it has complications. One issue the fire service need to contend with is that it takes about 20 minutes to be fully awake once your alarm goes off. It’s called sleep inertia. The Fire Service are normally out of the station in 90 seconds – so they may need to explore options to mitigate this risk.

What about permanent night shifts for those who can manage them? This allows your circadian rhythm to adjust and it also means you get paid more. That means for every officer who does that we can explore taking someone else off nights. This is not without its ‘lifestyle challenges’ as individuals will need to live their days off as if they were on a night shift. This maybe more of a challenge in rural areas where fewer amenities are available 24/7.

Take action and review what happened:

At every step of this journey I remind myself why I am doing this? I don’t want to lose any more friends and colleagues to fatigue. I want you all to be the best you can be. There will be times when we are shattered and exhausted, but the majority of the times we should be doing our SNACK checks:

S – Sleep [importance of healthy natural sleep]

N – Nutrition [and hydration]

A – Activity [importance of fitness and staying active]

C – Colleagues: listen to your colleagues/ colleague support

K – Knowledge – be aware of the dangers

S – Support [From your management/ Occupational Health/ Welfare]

Conclusion

My initial recommendation to turn my research into a training course for the most vulnerable has been approved. In the near future I will be looking to address the issues above and move to introduce learning for all other staff at every level and drive cultural change. I have just secured a partnership with Oxford University and Professor Russell Foster to produce a series of inspirational inputs to educate and to inspire us to embrace new working practices. For those of you not familiar with his work please take a look at his Ted talk: ‘Why we sleep.’ For Thames Valley to secure the services of this world renown Academic shows how committed we are to your wellbeing.

Nationally we are leading on this work and we are really hoping to make some significant changes to improve your wellbeing. This will in turn improve our efficiency and service to the public. The police have already adapted to new crimes trends and we have embraced digital policing to provide an improved service to the public. But have we ever changed how we manage our staff?

I have liaised with some of the Sunday Times Top 100 companies to work for. All of them have fully embraced Wellbeing and how the workforce has changed; understanding that investing in your staffs’ physical, mental health and working environment is the right thing to do and it also brings dividends in terms of productivity and morale. Do you know how many police forces were in the top 100 companies to work for? Not one! I think we should dream big. I think we should develop Thames Valley Police into a brand that attracts the best staff and most importantly retains the staff we have. Where does this dream start? It starts with each of you.

Make positive changes: simply pushing yourself passed your limits will ultimately prove fruitless. You put pressure on yourself and your family. Realise that your body is a machine and work smarter not harder. Concentrate on productivity as opposed to hours you’re at work. Your body needs the appropriate care and attention and pure adrenaline and a stubborn mind set to drive yourself onwards is only a temporary fix. Have you ever noticed that when you leave a problem and come back to it the next day the solution tends to present itself? This is science and other industries have already embraced these changes.

We are the only species on the planet that deliberately deprive ourselves of sleep. Sleep is the single most important method by which our body recovers from the rigours of the day. If you live until you are 90 years old, you would have spent 32 years asleep. That’s how important it is that you are rested. Until you start seeing the results of my work please remember: I am here for you. If you are struggling speak to your line managers, make the most of the fantastic support available: welfare, Occupational Health, EAP, FED – you can even just call or email me. Changing how we manage fatigue is just the start. Start looking after yourself and each other.

Stay safe.

About the Thames Valley Police Journal

This article appears in Volume 05, June 2020 of the Thames Valley Police Journal which showcases the academic research undertaken by officers and staff in Thames Valley Police. To access previous volumes of the Journal, please click on the images below.

Thames Valley Police Journal Volume 01, March 2018

Thames Valley Police Journal Volume 02, November 2018

Thames Valley Police Journal Volume 03, March 2019

Thames Valley Police Journal Volume 04, November 2019