Mark Dooris, University of Central Lancashire

1. Healthy Universities: Overview and Update Mark Dooris, University of Central Lancashire With funding support from:

2. Presentation Outline • Background • Context and Underpinning Theory and Practice • National Research and Development Project • Conclusion

3. 1. Background • Why Healthy Universities? • Healthy Universities Timeline

4. Why Healthy Universities? Education is good for health… but universities can do much more, through: • protecting, maintaining and promoting health & well-being of students & staff • promoting economic, social & environmental well-being of wider community • developing, synthesising, transferring & applying knowledge/understanding • maximising their potential as a ‘generator’ of health & sustainability in society – CSR; ‘future shaping’ of decision-makers …and health can do much more for universities, helping them carry out their core business and achieve their goals more effectively!

5. (and, additionally)Why Healthy & Sustainable Universities? “The links between health and the environment have never been more clearly defined. Reinforcing the connections can lead to better and more effective public health policies and sustainable development strategies which in turn contribute to better environments. Whilst in England the health impacts of climate change are only just beginning to manifest, a syndemic approach which looks for common solutions to difficult social policy problems offers enormous potential to make a real difference.” Dr Fiona Adshead, Deputy Chief Medical Officer Sustaining a Healthy Future, 2008 and…Universities should be at the cutting-edge, not only in their research and teaching, but in their institutional practice and in knowledge exchange, leading change in society.

6. 1986 Ottawa Charter for Health Promotion Health Promoting University initiative established at UCLan 1st International (WHO) HPUs Conference 1998 WHO book ‘Health Promoting Universities’ published English Public Health Strategy: Choosing Health: “tosupport the initiatives being taken locally by some colleges and universities to develop a strategy for health that integrates health into the organisation’s structure to create healthy working, learning and living environments, increase the profile of health in teaching and research, and develop healthy alliances in the community.” 2006 English National Network of Healthy Universities established English Teaching Public Health Networks Initiative established – with one of its aims being “to create health promoting Universities and Colleges.” Funding secured for National Research and Development Project Healthy Universities: Timeline

7. 2. Healthy Universities: Overview • Why? • What? Principles and Aims/Action Areas • How? Processes in ‘Creative Tension’

8. Healthy Settings: Why? “Health is created & lived by people within the settings of their everyday life; where they learn, work, play & love” WHO (1986) Ottawa Charter for Health Promotion “many risk factors are interrelated and can be best tackled through comprehensive, integrated programmes in appropriate settings where people live, work and interact.” DHSSPS (2002) ‘Investing for Health’ (15.1)

9. Healthy Settings: Why? Illness Leisure & Recreation ‘Health’& Social Care Criminal Justice Ottawa Charter - strategies - - processes - Community Work/ Economy Education Health Source: adapted from Grossman and Scala, 1993

10. Healthy Settings: What? “The place or social context in which people engage in daily activities in which environmental, organizational & personal factors interact to affect health & wellbeing…where people actively use and shape the environment & thus create or solve problems relating to health.” Settings for Health – WHO (1998) Health Promotion Glossary “In the settings approach efforts are concentrated on working to make the setting itself a healthier place for people to live, work and play…The settings approach means combining healthy policies, in a healthy environment with complementary education programmes and initiatives.” Health Promotion Strategy for Ireland (DHC, 2000)

11. Create healthy and sustainable working, learning and living environments for students, staff and visitors Healthy University Healthy Universities: How? Principles and Aims/Action Areas Increase the profile of health and sustainable development in teaching, research and knowledge exchange. Evaluate their work, building evidence of effectiveness and sharing learning. Contribute to the health and sustainability of thewider community UNDERPINNING PRINCIPLES diversity and equity; participation and empowerment; internal and external partnership working; sustainability; holistic health and well-being; practice informed by evidence (and evidence informed by practice); learning and knowledge exchange

12. Healthy Universities: How? ‘whole university’ approach Leading Organisational and Cultural Change  Generating High Visibility Innovative Action Securing Senior Level Commitment and Corporate Responsibility  Enabling Wide-Ranging Participation Anticipating & Responding to Public Health Challenges  Helping to Deliver the Institutional Agenda Management and Co-ordination High Level Steering Group; Designated Co-ordination Role; Clearly Defined Stakeholder Roles Methods e.g. Policy Development, Social Marketing, Peer Education, Impact Assessment, Environmental Improvement Principles e.g. Diversity, Equity, Participation, Empowerment, Partnership, Sustainability

13. Healthy Universities: How? MappingConnections …between components of the setting, groups of people, issues “Systems thinking is a discipline for seeing wholes. It is a framework for seeing interrelationships rather than things, for seeing patterns of change rather than static ‘snapshots’”Senge (1990)

14. Healthy Universities: A System-Based Approach

15. 3. National Research & Development Project • Overview • Findings to date

16. National Healthy UniversitiesResearch & Development Project • Funded: by the Health Sciences and Practice Subject Centre (Higher Education Academy)and Department of Health • Steering Group: Peter Chell (DH); Judy Orme (UWE/SW TPHN); Sue Powell (NW TPHN); Mala Rao (DH) • Aim: “scope and report on the potential for a national programme on Healthy Universities.” • 4 Strands: • Rapid Literature Review: academic & policy-related. • Auditing/Mapping Healthy Universities Activity + Consultative Research: -- •  1st stage audit questionnaire (n=117; 64 [55%] returned) • 2nd stage mapping & research • - Sample 1: in-depth case study questionnaire (n=12; 6 [50%] returned) • - Sample 2: outline case study questionnaire (n=16; 9 [56%] returned) • - Sample 3: web-based questionnaire (n=60; 18 [ 30%] returned)

17. National Healthy UniversitiesResearch & Development Project • Consultative Research with and Engagement of National-Level Stakeholder Organisations: individual/small group interviews • AMOSSHE • DH • DIUS • HEA • HEFCE • LFHE • NUS • RSPH • UUK • 4. Action Planning and Reporting: stakeholder data validation workshop, development of protocol/framework & recommendations

18. 1st Stage Audit Questionnaire: Responses

19. 1st Stage Audit Questionnaire: Healthy University Activity and Interpretations • 28 (44%) of respondents stated that they have an established Healthy University initiative – but interpretation is variable, with aims including: “To be a healthy, ethical, environmentally-friendly and sustainable community which values well-being” “To raise the profile of health, well-being and sustainability within the culture, structures and processes of the university” “To promote a healthy and safe lifestyle among students” “To promote health and wellbeing in the workplace” “To hold a health week each year to promote healthy lifestyles to students and staff”

20. 1st Stage Audit Questionnaire:Where are Initiatives Led From? • In these 28 HEIs, the initiative was led by:

21. 1st Stage Audit Questionnaire: Interest in National Programme • 96% of respondents would be interested in a National Programme on Healthy Universities: “This fits with our values; we would be very interested in being involved.” “This would assist us in identifying key ways in which we could promote health matters within the University in a more structured way than at present.” “A national programme would help to pull together and lift the profile of the piecemeal activity currently going on.” “There is already much good work in progress which could be further supported and extended by participation in the National Healthy Universities programme.” • “It would be good to consider standardisation.”

22. 2nd Stage Mapping: Priority Topics

23. 2nd Stage Mapping and Stakeholder Interviews: Key Drivers and Motivations 1 • Staff • Valuing, recruiting and retaining staff • Enhancing staff experience • Reducing costs associated with sickness and absenteeism • Improving performance and increasing productivity • Students • Recruiting and retaining students • Widening participation (linked to inequalities) • Enhancing student experience and achievement • Providing access to young people as a target group

24. 2nd Stage Mapping and Stakeholder Interviews: Key Drivers and Motivations 2 • Positioning universities in a market-oriented context • Adding to distinctiveness and enhancing quality • Aligning with key agendas, e.g. sustainable development, corporate social responsibility, community engagement • Using topical issues (e.g. alcohol, obesity) as entry points • Contextual factors • Groundswell from committed/passionate individuals • New strategic appointments • Increased focus on workplace health and well-being • Increased recognition of impact of health on achievement

25. 2nd Stage Mapping and Stakeholder Interviews: Perceived Benefits of National Programme 1 In addition to the benefits that are also drivers: Universities • Encourage joined-up thinking, networking and sharing of good practice/case study support • Provide common base line – something to aim for that is recognised and measurable with agreed standards • Increase health-related work in universities, encourage more universities to be involved  long-term health benefits

26. 2nd Stage Mapping and Stakeholder Interviews: Perceived Benefits of National Programme 2 In addition to the benefits that are also drivers: Stakeholder Organisations • Secure visible commitment to health; develop critical mass; move from margins to mainstream • Provide coherent and systematic framework to harness and connect disparate initiatives • Ensure consistency and appropriate progression – from pre-school, through Healthy Schools, Healthy FE to Healthy Universities • Contribute to societal and economic productivity • Develop distinctiveness and reputation of UK HE sector

27. 2nd Stage Mapping and Stakeholder Interviews: Barriers and Challenges at Different Levels • Challenges faced by Healthy University Initiatives • Applying settings approach to large institutions • Embedding work in academic areas • Securing and sustaining buy-in with adequate resources • Ensuring clarity of role as ‘hub’ for health • Avoiding perception of overlap with other services • Balancing competing agendas and avoiding ‘initiative overload’ • Lack of national guidance, leadership and support for work Challenges to Securing National-Level Leadership • Independence and autonomy of universities • Perception of universities as éliteand privileged • Negotiating competing agendas and connecting to ‘core business’

28. Universities “A framework so HEIs could measure their current provision and identify what the gaps were.” “It would be difficult to set up an 'achievement' programme which has to be policed but good practice guidelines, examples of good practice, a communication strategy…” “Must be evidence based benchmarks created, and with a recognised accreditation system, like Investors in People.” “I like the idea of a ‘healthy university standard’ that you can achieve... I think this would need to be assessed in some way and time limited so that we have to show commitment to maintaining our work and building on it…Some element of central coordination will be needed and I think that the development of regional networks or clusters would also be useful to focus the work on local issues where appropriate.” 2nd Stage Mapping and Stakeholder Interviews: Potential Shape of National Programme

29. Stakeholder Organisations Light Touch: avoid being prescriptive and enable HEIs to respond to locally determined needs (AMOSSHE, DH, DIUS, HEFCE, LFHE, NUS, UUK) Flexible, dynamic & responsive framework: respect autonomy and acknowledge different emphases and capacities within sector; focus on processes and inputs relating to change management, rather than outputs and outcomes (AMOSSHE, DH, DIUS, NUS, UUK) Accreditation: kitemarking model akin to IIP, but would potentially conflict with ‘light touch’ approach and be thwarted by lack of holistic inspection/quality assurance framework (AMOSSHE, DIUS, HEA, RSPH) Branding: ensure marketed in relation to core business; profile/segment target audience; avoid being seen as Government-led (DIUS, LFHE, RSPH) Evidence-Based: importance of generating evidence and including research/evaluation dimension; value of measurable indicator set; value of case-study evidence (DH, HEFCE, LFHE, UUK) Exemplar/Best Practice Model: can encourage spread of approach through showcasing how HUs contributes to core agendas (HEA) 2nd Stage Mapping and Stakeholder Interviews: Potential Shape of National Programme

30. 2nd Stage Mapping: Benefits of the National Network Key role of national developments should be to build upon and strengthen the National Network:

31. 2nd Stage Mapping and Stakeholder Interviews: Potential Leadership and/or Championing of National Programme • Majority view that leadership must come from within sector with clear endorsement by and championing/involvement of a range of key stakeholder organisations • No clear consensus on which organisation would be most appropriate to lead • Recognition that leadership would influence and be influenced by shape of programme – i.e. whether it is based on regulation, externally or self-assessed standards, or the development and spread of good practice • Debate about whether the appropriate level of co-ordination is national and/or regional

32. 4. Moving Forward • Finalising report for submission to HEA HSPS & DH • HEA HSPS & DHcommitted to convening meeting of key stakeholder bodies to consider recommendations • Will be important to draw on the experience/learning of the Healthy FE programme (DIUS/DH)

33. Healthy Universities: Overview and Update Mark Dooris, University of Central Lancashire With funding support from: