What if NHS Staff are the greatest Public Health Campaign we could have?
And, what if NHS Staff’s health and wellbeing not only enabled a healthy happy workforce it also offered a productivity edge to the delivery of services?
Health is a population issue, you could say it is the bottom line in any society, and we know that in the UK today our population has many growing health issues. For instance in one common health condition, there are rising implications for our populations, healthcare systems, and society at large:
‘Obesity is responsible for about one in ten deaths in Britain and costs the NHS £5.1 billion a year’. (Rowley and Kirk 2016)
In recent reports the media and press portray that the NHS finds it tougher to make ends meet, and to meet all the demands it faces from the population:
‘Such are the levels of obesity in the UK – two thirds of the adult population are at least over-weight - The NHS is struggling to cope with associated health problems such as diabetes and heart disease.’ (Johnston 2016)
In recent years studies highlight the link between our lifestyles, and our health for example:
‘There is increasing research evidence about the causal role of alcohol in cancer’ (Connor 2016)
‘Drinking alcohol has been shown to increase the risk (or chance) of getting some types of cancer’ (Committee on Carcinogenicity statement 2015/S2)
‘Being overweight or obese could cause around 700,000 new cancers by 2035’ (Cancer Research UK 2016)
Self-Management and Self-Care have been initiatives offered to the public in the last 10 years e.g. via the Expert Patients Programme, or Self Management UK, though it could be said that these initiatives haven’t gained as much traction as they might have. Recently Kevin Fenton re-emphasised the importance of self-care, and self-management by stating “It is estimated that if the public were fully involved in managing their health and engaged in prevention activities £30 billion could be saved” (Fenton, 2016).
If this is so, where do we start? What could enable the population to be more involved in their health?
What if what was needed is right under our very nose?
What if the NHS workforce could be the greatest public health intervention for the health of our nation?
What if NHS staff naturally became Health and Wellbeing Champions, as ‘sign posts’ towards resources and support for self-care, and as points of inspiration through their own levels of self-care and wellbeing? As lifestyle is a factor in health, then who better to be more actively engaged in their own lifestyle than NHS Staff?
‘Because of the role that the NHS occupies in national life, all of us working in the NHS have a responsibility not just to support those who look after patients but also to draw attention to and make the case for some of the wider changes that will actually improve the health of this country’ (Stevens 2016)
The NHS in England alone deals with over 1 million patients every 36 hours. That means that 1 million patients have the potential to be inspired by the NHS workforce every 36 hours. What if, with a population of around 65 million in the UK that means over a period of time a large number of people the NHS serves could be inspired to take a more active role in their health?
What if this in itself could be a substantial intervention in the future of the health of our population, as well as in the sustainability of the NHS, and in valuing and supporting the NHS workforce?
The NHS has 1.4 million employees in the UK (West 2016 a). If we look at the wellbeing of NHS workforce specifically we can see e.g:
‘Work-related stress is widespread among staff in the NHS; last year according to the NHS Staff Survey, nearly 40% of staff reported feeling unwell as a result of stress.’ (West 2016 b)
‘One in four (25%) NHS employees reported experience musculoskeletal problems due to their work’ (NHS England)
Added to which, it is reported that 700,000 of NHS staff are overweight or obese (Donnelly 2016).
The NHS has been working on NHS staff health and wellbeing – e.g. NHS Staff Survey 2016 – ‘89% agree that their organisation takes positive action on employee health and wellbeing’ (NHS England 2016) (300,000 staff responded).
And we know that health and wellbeing for employees not only supports the staff, but also supports patient care quality:
‘The best employers know that staff wellbeing and high quality patient care are two sides of the same coin’ (Simon Stevens in NHS England 2016).
with other added benefits such as:
“If truly embraced the precepts and benefits of good self-care can be conveyed to the next generation of physicians’ (Shanchez-Reilly et al 2013).
‘Self-confidence can deepen as can a deeper sense of self worth. Equally, developing self-care at work made a difference to the quality of services practitioners offered.’ (Keep 2013)
“Happy well staff are less likely to need time off sick, to leave for alternative employment, or become disinterested and disengaged in their work. All of these factors related to productivity which the NHS cant afford to ignore” (NHS England 2016)
So where could we go from here?
Simon Stevens (2014) suggested ‘amid mounting frustration within the medical profession and NHS over the failure of successive governments to invest sufficiently in public health campaigns’... that ‘The National Health Service is to put its own 1.35 million staff at the head of a new fight against obesity by encouraging them to join weight-watching groups and take out gym memberships’ with NHS staff leading by example’.
What if it were simpler (and less costly) than that?
What if in the first instance we focused on a healthier NHS workforce e.g:
Every board member, and NHS leaders had their part to play as role models for health and wellbeing? Not lip service, and no perfection but playing an active part in their own health and wellbeing? (How many truly vital and healthy leaders do we currently have in the NHS?)
The simplest of daily living activities were consistently encouraged and supported – the physiological aspects of our body is the foundation to good health – e.g. hydration, posture, peeing on time, regular breaks.
Every job description had a sentence in it that asked the employee to take care to the best they could of their health and wellbeing at work?
Each NHS organisation in their values or a charter, or statement of intent supported the Health and Wellbeing of their staff, and that this was ‘counted’ (as it is in CQUINs), in CQC inspections etc?
All team meetings had employee wellbeing regularly on their agenda as a ‘check-in’.
The NHS started the biggest online employee library, blogs and resources for its own staff to be inspired by one another’s wellbeing stories, recipes and tips?
And from this without perfection, what if staff started to feel more empowered to take care of their health and wellbeing?
And if this were so, what if the NHS workforce then naturally became health and wellbeing champions, having experienced their own health and wellbeing changes?
And the NHS offered them further support to be health and wellbeing champions, to share their own learning, stories with those they serve?
Wouldn't that be the largest public health campaign to date in any country?
Awford, J. (2014) NHS boss tells his staff to slim down and set an example: Nurses and doctors urged to join diet classes and hospitals ordered to make their canteens healthy. Daily Mail. 20th October. http://www.dailymail.co.uk/health/article-2799084/nhs-chief-urges-1-3million-hospital-staff-join-gyms-weight-watching-groups-battle-against-obesity.html#ixzz3NeWNrKOT
Black, C. (2008) Working for a healthier tomorrow. UK Government.
Cancer Research UK (2016) Being overweight or obese could cause around 700,000 new UK cancers by 2035. Cancer Research UK. January. www.cancerresearchuk.org/about-us/cancer-news/press-release/2016-01-07-being-overweight-or-obese-could-cause-around-700000-new-uk-cancers-by-2035.
CIPD (2016) Growing the Health and Wellbeing Agenda: From first steps to full potential. Policy Report. January.
Committee on Carcinogenicity (2015) Statement on consumption of alcoholic beverages and risk of cancer. statement CC/2015/S2
Connor, J. (2016) Alcohol consumption as a cause of cancer. Addiction. 21st July.
Donnelly, L. (2016) Overweight doctors and nurses will be offered Zumba classes and sports clubs. Telegraph. 5th March.
Fenton, K (2016 a) Making an Impact on the Public’s Health and Wellbeing. Public Health England. April.
Johnston, I (2016) NHS Hospitals to set example for the rest of the country with their own ‘sugar tax’. Independent Monday 18th January
Keep, J. A. (2013) Developing self-care at work. PhD, University of the West of England. http://eprints.uwe.ac.uk/21799
NHS England (2016) Staff Survey Results 23rd February. www.england.nhs.uk/2016/02/staff-survey-results/
NHS England – About The NHS. https://www.gov.uk/government/organisations/public-health-england/about
Rowley T, and Kirk, Al., (2016) How did Britain get so fat? Telegraph. Friday 26th February.
Sanchez-Reilly, S, Morrison, L.J., Carey, E, Bernacki, R,. O’Neill, L., Kapo, J., Periyakoil, V.S., deLima Thomas, J. (2013) Caring for oneself to care for others: physicians and their self-care. J Support Oncol. June; 11 (2) 75-81.
Stevens, S (2016) NHS Hospitals to set example for the rest of the country with their own ‘sugar tax’. As quoted in Johnson, I. in the Independent Monday 18th January
West, M. (2016 a) Engagement is up according to the NHS Staff Survey, but at what cost? Kings Fund. 2nd March.
West, M. (2016 b) Creating a workplace where NHS staff can flourish. Kings Fund Blog www.kingsfund.org.uk/blog/2016/01/creating-workplace-where-staff-can-flourish.