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Implementing NICE public health guidance for the workplace 2013 – round 2

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This second round audit report examines progress made with the implementation of six pieces of National Institute for Health and Clinical Excellence (NICE) public health guidance relevant to the workplace by NHS trusts in England.

Key recommendations

  • A simple scoring system was used to measure the extent of the implementation of NICE guidance. Although many trusts perform well and have improved since the first round, the range of scores was wide, indicating that there remains room for improvement.
  • All trusts have a sickness absence policy and three-quarters have one for smoking cessation, but only 57% have one for mental wellbeing, 44% for physical activity and only 28% have an obesity plan. Where plans are in place, staff were usually involved in their production and the board in sign-off. In 2010 many trusts said they had plans in development; some trusts now have these in place but a significant number do not.
  • Data on inequalities, contract workers and outsourced services are illuminating. Generally trusts do take some account of diversity when producing plans but fewer measure uptake of health promotion programmes by inequality characteristics. Very few use such data to adjust programmes.
  • Some striking findings:
    • 24% of trusts do not monitor the mental wellbeing of staff
    • only 31% of trusts monitor long-term sickness absence by age
    • trusts had difficulty estimating their complement of contract or outsourced staff. The 178 participating trusts estimated that they had 35,918 outsourced staff
    • outsourced staff have less access to trust health promoting initiatives than NHS employed colleagues.
    • staff working irregular or night shifts have poor healthy food choices
    • fewer than half of trusts monitor uptake of programmes to encourage physical activity by any inequality characteristics (eg age, gender, ethnicity)
    • 38% of trusts do not allow staff to attend smoking cessation services during working hours without loss of pay.
  • Many trusts gave us good examples of innovative practice, demonstrating that the NICE guidance can be successfully implemented. Trusts performing less well might learn from their peers by ‘buddying-up’ with neighbouring trusts, by coming to our free launch conference on 29 January 2014, and by following up the suggested checklists for action.