1. 1 July 2011 Dr Richard Preece Project Lead Implementing NICE public health guidance for the workplace: a national audit

2. 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

3. National participation Trust typeParticipation number% Acute122/16773% Mental health39/5867% Ambulance10/1191% Primary care110 /21252% Total282/44963%

4. North West participation Trust typeParticipants Acute22 Mental health6 Ambulance1 Primary care18 Total47

5. 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

6. HR/Workforce director173 Nursing director 15 Chief Executive 10 Operations director 9 Medical director 2 Finance director 1 Other exec board member 38 Non-exec board member 19 Board leadership

7. 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

8. 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 15315419% to encourage and support employees to be more physically active 32412730% To encourage and support employees to stop smoking 73151278% To promote mental wellbeing amongst its staff 46381651%

10. 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 restaurant17361 Regional average (range 31 – 72%)63% Vending machines9032 Regional average (range 6 – 50%)40% Shops for staff and clients8631 Regional average (range 8 – 50%)40%

11. National (282 trusts) ------------------------------------- Number Does the trust offer overweight and obese staff multi-component interventions 8631% Regional average (range 15 – 53%)30%

13. 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

14. Does the trust provide: National (282 trusts) ------------------------------------- Number % On site gym5921 On site swimming pool166 On site squash or tennis courts2810 Reduced membership fees for local leisure facilities 23784 Bike purchase scheme22279

16. National (282 trusts) ------------------------------------- Number Does the trust policy allow staff to attend smoking cessation services during working hours without loss of pay? 17963% Regional average (range 38 – 89%)60%

18. Absence data management 95% trusts monitor trends in LTSA and most report this to trust board

19. Does the trust record absence data in real time e.g. through ESR self-service National (282 trusts) ------------------------------------- Number % Yes fully9433 Yes partially7727 No11139

20. National (282 trusts) ------------------------------------- Number % Does the policy require managers to contact staff whose sickness absence continues beyond a week or so 26895 Does the policy give a trigger this? No4015 Yes by 2 weeks11242 Yes by 3 weeks156 Yes by 4 weeks9736

21. 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

22. 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

23. 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%

24. Providing specific interventions 74% education/training on coping strategies and resilience 76% physiotherapy for their staff 89% psychological therapies for their staff

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

27. Manager training Does the trust provide: Training for line managers on how to promote and protect employee mental wellbeing 17863% 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 16860% Regional average (range 38 – 89%)55%

28. Summary score

29. No. of trusts (out of 282 participants) Needs of different staff addressed Measure uptake by different groups Adjust if uptake by groups differs Obesity211210 Physical activity532725 Smoking cessation1154732 Mental wellbeing754531 Inequality (national)

30. Key message: Engagement

31. Siân Williams, Director, HWDU, Royal College of Physicians Sarah Jones, Project Manager, HWDU, Royal College of Physicians Angela Bartley, Public Health Lead, Royal Free NHS Trust Karen Charman, Head of Employment Services, NHS Employers Jane Huntley, Associate Director, NICE Karen Jennings, Head of Health, UNISON Janice Lowndes, Associate Director, Health Improvement, NHS Salford Conor McGarry, SpR in OM, Leeds Teaching Hospitals NHS Trust Alex Nestor, Deputy Director, Org Dev, Bristol NHS Foundation Trust Wendy Russell, Deputy Director, NHS Staff Health and Wellbeing, DH Julia Smedley, Consultant in OM, Southampton Hospitals Penny Peel, Manager, HWDU, Royal College of Physicians Michael Roughton, Statistician, Royal College of Physicians … and many others Acknowledgements