In a new report endorsed by the NHS Chief Executive, the Royal College of Physicians (RCP) and Faculty of Occupational Medicine (FOM) call for a board level lead in every NHS trust to take proactive responsibility for staff health improvement and wellbeing.
The NHS employs 1.4 million people, accounting for 40% of the NHS budget. The NHS workforce is the main vehicle for healthcare delivery and a healthy workforce is crucial for providing high quality patient care.
The Staff Health Improvement project carried out by the Health and Work Development Unit (HWDU), a partnership between the RCP and the FOM, builds on the 2010 national audit. The audit found variation in trusts’ implementation of the NICE public health guidance for the workplace. For example, less than half of trusts (44%) had an overarching strategy or policy for staff health and wellbeing. Only 9% of trusts had a plan or policy to reduce obesity amongst staff approved by the board and only 37% of trust boards had approved a plan or policy to promote the mental wellbeing of staff.
Jude Williams, lead for the Staff Health Improvement project, RCP: ‘The Boorman review in 2009 told us that staff health improvement can have a positive impact on patient care. There is a series of NICE guidance which is evidence-based, with recommendations aimed at all employers, for improving staff health and wellbeing. All NHS trusts know they ought to be implementing the NICE guidance; but the 2011 NHS Staff survey found that less than half of the NHS workforce believes that their job is good for their health and 30% of staff report they have suffered work-related stress in the past 12 months.
‘This project report shows that the NICE guidance aimed at improving staff health can be complied with and explains how that can be achieved through sharing examples of the best practice taking place in acute and mental health trusts in England.’
The project looked at what selected[i] trusts have achieved since 2010 and how their successful implementation of the NICE workplace guidance can be replicated by every NHS trust across the country. Sharing of best practice will ensure that staff access to services is more consistent and the services are appropriate to staff needs, as well as helping NHS employers address the major public health challenges (smoking, obesity, physical activity and mental wellbeing) within their workforce.
Proactive board level leadership, strong organisational values that explicitly link to staff health and staff engagement are amongst the elements required for successful implementation of the guidance. Having a board lead with responsibility for staff health and wellbeing, drawing links between respect and engagement of staff, and articulating to staff the relationship between their own health and wellbeing and the quality of care they deliver were common themes in the best practice discovered. Actions that have been taken by organisations that are progressing well with the NICE guidance include:
Professor Mike Kelly, Director of the Centre for Public Health Excellence at NICE said: ‘I was pleased to be part of the group which helped to develop this report, which sets out how NHS organisations can use NICE public health guidance as a framework to address the major public health challenges, such as smoking, obesity, physical inactivity and mental wellbeing, within their workforce. I am sure it will be a useful aid to all healthcare organisations.’
Olivia Carlton, President of the Faculty of Occupational Medicine, said: ‘We strongly endorsed the findings of the Boorman Review which focused on NHS staff health and wellbeing. The HWDU’s work in systematic audit and sharing of good practice follows this through and is an excellent contribution to the work to improve staff health in the NHS.’
[i] Trusts that had progressed well with implementing the NICE guidance were selected for this project. These were trusts that performed in the top quartile when reviewing their audit summary score and reflected a broad cross section of trusts. The audit summary score was calculated by measuring implementation against 39 NICE recommendations across the five guidance areas (obesity, smoking, physical activity, mental wellbeing and long-term sickness absence) with weighted scores depending on the degree of implementation indicated ie ‘yes’, ‘no’ or ‘in development’ responses.
The range of NHS trusts involved included large and small urban and rural trusts, financially well performing trusts, and not so well performing trusts. This selection provided a good range of experience with the NICE guidance, highlighting the aspects that both challenged, and helped with, implementation.
The project was carried out by the HWDU team who conducted telephone and face to face interviews with the trusts involved to find out what the barriers are to implementing the NICE guidance, and what works.
HWDU’s remit is to contribute to improving the health of the workforce by supporting the implementation of evidence-based guidance. The unit carries out national clinical and organisational audit, facilitates change management work with participants and develops evidence-based guidance.