1 July 2011

Dr Richard PreeceProject Lead

Implementing NICE public health guidance for the workplace: a national audit

NICE guidance for the workplace

• Managing long-term sickness absence• Promoting physical activity in the workplace• Promoting mental wellbeing through productive and

healthy working conditions• Workplace interventions to promote smoking

cessation• Obesity: guidance on the prevention, identification,

assessment and management of overweight and obesity in adults and children

• Promoting and creating built or natural environments that encourage and support physical activity

National participation Trust type Participation

number %Acute 122/167 73%

Mental health 39/58 67%

Ambulance 10/11 91%

Primary care 110 /212 52%

Total 282/449 63%

North West participation Trust type Participants

Acute 22

Mental health 6

Ambulance 1

Primary care 18

Total 47

Board engagement

• 95% had a named board member with responsibility for staff health and wellbeing

• 44% had an over-arching strategy for staff health and wellbeing

• 66% had staff health and wellbeing as a regular board agenda item

• >90% had staff sickness absence as a regular board agenda item

HR/Workforce director 173Nursing director 15Chief Executive 10Operations director 9Medical director 2Finance director 1Other exec board member 38Non-exec board member 19

Board leadership

Engagement

Trusts more likely to have specific policies:• Where they have overarching strategy

Trusts more likely to take actions recommended:• Where health and wellbeing is regular board

agenda item; and,• Where staff are involved in planning and

designing approaches ; and, • Where they had done needs assessments

National (282 trusts)------------------------------------- Percentage (%)

North West

Does the trust have an organisation - wide plan or policy: Yes In

development No

To help reduce obesity amongst its staff 15 31 54 19%

to encourage and support employees to be more physically active 32 41 27 30%

To encourage and support employees to stop smoking 73 15 12 78%

To promote mental wellbeing amongst its staff 46 38 16 51%

Does the trust actively promote healthy food choices , for example using signs, pricing and positioning of products to encourage healthy choices in:

National (282 trusts)-------------------------------------Number

Staff restaurant 173 61

Regional average (range 31 – 72%) 63%

Vending machines 90 32

Regional average (range 6 – 50%) 40%

Shops for staff and clients 86 31

Regional average (range 8 – 50%) 40%

National (282 trusts)-------------------------------------Number

Does the trust offer overweight and obese staff multi-component interventions

86 31%

Regional average (range 15 – 53%) 30%

Physical activity infrastructure

• secure cycle parking nearly all

• all parts of site linked by walking three quarters and cycling routes, and new workplaces linked to existing walking and cycling networks

• most staircases clearly signposted about half and attractive to use

Does the trust provide: National (282 trusts)-------------------------------------Number %

On site gym 59 21

On site swimming pool 16 6

On site squash or tennis courts 28 10

Reduced membership fees for local leisure facilities 237 84

Bike purchase scheme 222 79

National (282 trusts)-------------------------------------Number

Does the trust policy allow staff to attend smoking cessation services during working hours without loss of pay?

179 63%

Regional average (range 38 – 89%) 60%

Absence data management

95% trusts monitor trends in LTSA and most report this to trust board

Does the trust record absence data in real time e.g. through ESR self-service

National (282 trusts)-------------------------------------Number %

Yes fully 94 33

Yes partially 77 27

No 111 39

National (282 trusts)-------------------------------------Number %

Does the policy require managers to contact staff whose sickness absence continues beyond a week or so

268 95

Does the policy give a trigger this?

No 40 15

Yes by 2 weeks 112 42

Yes by 3 weeks 15 6

Yes by 4 weeks 97 36

Occupational Health referral pathway

Routine monitoring of length of time from:• start of absence to referral 25%• receipt of referral to OH appointment 65%• appointment to issuing report 52%

Only 19% monitor all stages of the OH pathway

2010 case note audit of 7636 NHS staff showing number of weeks absent from work at time of audited appointment

• Median 8 weeks• 30% seen after 12 weeks absence • 5% seen after 6 months absence

Case management

64% have case managers who:• Co-ordinate any required assessments 98%• Timetable actions to eliminate delays 90%• Initiate formal interventions 97%• Prompt and track actions 95%• Provide periodic reports 89%• Monitor absence data in real time 80%

Providing specific interventions

74% education/training on coping strategies and resilience

76% physiotherapy for their staff 89% psychological therapies for their staff

Monitoring mental wellbeing

72% of trusts had systems for monitoring the mental wellbeing of employees

Manager training

Does the trust provide:

Training for line managers on how to promote and protect employee mental wellbeing 178 63%

Regional average (range 31 – 84%) 63%

Training to ensure line managers are able to identify and respond with sensitivity to employees’ emotional concerns, and symptoms of mental health problems

168 60%

Regional average (range 38 – 89%) 55%

Summary score

No. of trusts (out of 282 participants)

Needs of different staff addressed

Measure uptake by different groups

Adjust if uptake by groups differs

Obesity 21 12 10

Physical activity 53 27 25

Smoking cessation 115 47 32

Mental wellbeing 75 45 31

Inequality (national)

Key message: Engagement

Siân Williams, Director, HWDU, Royal College of PhysiciansSarah Jones, Project Manager, HWDU, Royal College of PhysiciansAngela Bartley, Public Health Lead, Royal Free NHS TrustKaren Charman, Head of Employment Services, NHS EmployersJane Huntley, Associate Director, NICEKaren Jennings, Head of Health, UNISONJanice Lowndes, Associate Director, Health Improvement, NHS SalfordConor McGarry, SpR in OM, Leeds Teaching Hospitals NHS TrustAlex Nestor, Deputy Director, Org Dev, Bristol NHS Foundation Trust Wendy Russell, Deputy Director, NHS Staff Health and Wellbeing, DHJulia Smedley, Consultant in OM, Southampton HospitalsPenny Peel, Manager, HWDU, Royal College of PhysiciansMichael Roughton, Statistician, Royal College of Physicians

… and many others

Acknowledgements