Health and Work Development Unit 2011

1. Health and Work Development Unit 2011 Implementing NICE public health guidance for the workplace: Implementation and audit action planning toolkit

2. C. Local results benchmarked against the national average

3. The purpose of this section is to help you to: • review your performance in the national audit against the national benchmark • identify areas of success in implementation of the NICE recommendations audited • identify recommendations that are not fully met.

4. What was the aim of the audit? • To improve NHS staff health and wellbeing by measuring the extent and quality of the implementation of the relevant NICE workplace guidance by NHS trusts in England.

5. What did the audit cover? • This was a national organisational audit. The audit questions reflect evidence-based guidance from NICE covering: • Managing long-term sickness absence and incapacity for work (www.nice.org.uk/PH19) • Promoting physical activity in the workplace (www.nice.org.uk/PH13) • Promoting mental wellbeing through productive and healthy working conditions (www.nice.org.uk/PH22) • Workplace interventions to promote smoking cessation (www.nice.org.uk/PH5) • Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children (www.nice.org.uk/CG43). Note: section 4 addresses the workplace. • Promoting and creating built or natural environments that encourage and support physical activity (www.nice.org.uk/PH8).

6. The next set of slides presents your results against the national benchmark. You may choose not to use all of these slides if you already know which areas of the audit you need to focus on. • As you work through this section please identify the areas where you have done well and the areas where you think improvement can be made. Note these on the example tables that can be found on slides 72 and 73. • You will be asked to prioritise these areas before action planning.

7. Development of policies to promote staff health and wellbeing

9. Interventions to combat staff obesity NICE CG43: Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children: In their role as employers, NHS organisations should set an example in developing public health policies to prevent and manage obesity by following existing guidance and (in England) the local obesity strategy. Workplaces should provide opportunities for staff to eat a healthy diet…through active and continuous promotion of healthy choices in restaurants, hospitality, vending machines and shops for staff and clients, in line with existing Food Standards Agency guidance.

10. Interventions to combat staff obesity NICE CG43: Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children: Weight management programmes should include behaviour change strategies to increase people’s physical activity levels or decrease inactivity, improve eating behaviour and the quality of the person’s diet and reduce energy intake.

11. Interventions to promote physical activity among staff • NICE PH13: Promoting physical activity in the workplace • Encourage employees to walk, cycle or use another mode of transport involving physical activity to travel part or all of the way to and from work (for example, by developing a travel plan). • Help employees to be physically active during the working day by: • where possible, encouraging them to move around more at work (for example, by walking to external meetings) • putting up signs at strategic points and distributing written information to encourage them to use the stairs rather than lifts if they can • providing information about walking and cycling routes and encouraging them to take short walks during work breaks • encouraging them to set goals on how far they walk and cycle and to monitor the distances they cover.

12. Interventions to promote physical activity among staff

13. Interventions to promote & encourage smoking cessation among staff NICE PH5: Workplace interventions to promote smoking cessation Publicise the interventions identified in this guidance and make information on local stop smoking support services widely available at work. This information should include details on the type of help available, when and where, and how to access the services.

14. Interventions to promote & encourage smoking cessation among staff NICE PH5: Workplace interventions to promote smoking cessation Allow staff to attend smoking cessation services during working hours without loss of pay.

15. Sickness absence management • NICE PH19: Management of long-term sickness absence and incapacity for work • Within 12 weeks (ideally between 2 and 6 weeks) of a person starting sickness absence (or following recurring episodes of short- or long-term sickness absence) ensure that initial enquiries are undertaken in conjunction with the employee. The aim is to: • determine the reason for the sickness and their prognosis for returning to work (that is, how likely it is that they will return to work) and if they have any perceived (or actual) barriers to returning to work (including the need for workplace adjustments) • decide on the options for returning to work and jointly agree what, if any, action is required to prepare for this.

16. Sickness absence management

17. Sickness absence management • NICE PH19: Management of long-term sickness and incapacity for work • Within 12 weeks (ideally between 2 and 6 weeks) of a person starting sickness absence (or following recurring episodes of short- or long-term sickness absence) ensure that initial enquiries are undertaken in conjunction with the employee. The aim is to: • determine the reason for the sickness and their prognosis for returning to work (that is, how likely it is that they will return to work) and if they have any perceived (or actual) barriers to returning to work (including the need for workplace adjustments) • decide on the options for returning to work and jointly agree what, if any, action is required to prepare for this.

18. Sickness absence management

19. Return to work: long term sickness absence • NICE PH19: Management of long-term sickness absence and incapacity for work • If a return-to-work plan is needed it should determine the level, type and frequency of interventions and services needed, including any psychological support. A return-to-work plan could also identify if any of the following is required: • a gradual return to the original job using staged increases in hours and days worked (for example, starting with shorter hours and/or less days and gradually increasing them) • a return to partial duties of the original job or temporary/permanent redeployment to another job.

20. Return to work: long term sickness absence

21. Case management: long term sickness absence • NICE PH19: Management of long-term sickness absence and incapacity for work • There is evidence…that a case management approach (in which sick-listed employees are interviewed by a person or team who can direct health and occupational services to help the interviewee back to work) is effective at helping people return to work. A case manager will: • Keep everyone’s attention on the end point of a return to effective work • Monitor absence data in real time • Co-ordinate any required assessments • Prompt and track actions • Timetable actions to eliminate delays between milestones • Initiate formal interventions • Provide periodic reports to stakeholders

22. Case management: long term sickness absence

23. Sickness absence monitoring NICE PH19: Management of long-term sickness absence and incapacity for work Within 12 weeks (ideally between 2 and 6 weeks) of a person starting sickness absence (or following recurring episodes of short- or long-term sickness absence) ensure that initial enquiries are undertaken in conjunction with the employee.

24. Management of staff on long term sickness absence NICE PH19: Management of long-term sickness absence and incapacity for work Ensure psychological interventions and services are evidence-based. Also ensure they are delivered by suitably trained and experienced practitioners. These may be health professionals (such as physicians, nurses or others specialising in occupational health, rehabilitation or ergonomics); social workers; clinical or occupational psychologists; specialist counsellors or therapists.

25. Promoting mental wellbeing • NICE PH22: Promoting mental wellbeing through productive and healthy working conditions • Establish mechanisms for providing support and advice on developing and implementing organisation-wide approaches to promoting mental wellbeing. These could include tools and approaches for risk assessment, human resources management and management training and development. • Ensure that managers are able to identify and respond with sensitivity to employees’ emotional concerns, and symptoms of mental health problems. • Ensure that managers understand when it is necessary to refer an employee to occupational health services or other sources of help and support.

26. Promoting mental wellbeing

27. How were trusts scored? • HWDU created a summary score for each trust. This is derived from 39 standards divided into 6 domains. Five domains match a guidance topic and the sixth is an overarching board engagement domain. • Please note: not all questions were included in the score. The questions chosen for inclusion were those that related directly to the recommendations laid out in NICE guidance. You can see which questions were included from the appendix of your report.

28. How can you use the domain scores? • All trusts should be aiming to fully implement the guidance and reach 100% compliance. • The domain scores may help to guide and prioritise activities.

29. Domain scores

30. The national picture

31. What did we do well and how can we publicise this within our organisation?

32. What areas do we need to improve? The information will feed directly into your action plan.