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Simon Stevens announces major drive to improve health in NHS workplace

NHS England Chief Executive Simon Stevens will today (Wednesday 2 September) kick-start a major drive to improve the health and wellbeing of 1.3m health service staff, in a bid to benefit both staff and taxpayers.

Speaking at the NHS Innovation Expo conference, Mr Stevens will set out how NHS organisations will be supported to help their staff to stay well, including serving healthier food, promoting physical activity, reducing stress, and providing health checks covering mental health and musculoskeletal problems – the two biggest causes of sickness absence across the NHS.

Estimates from Public Health England put the cost to the NHS of staff absence due to poor health at £2.4bn a year – accounting for around £1 in every £40 of the total budget. This figure is before the cost of agency staff to fill in gaps, as well as the cost of treatment, is taken into account.

Today’s new £5 million initiative has three pillars:

  • First, a major drive for improved NHS staff health, spearheaded by a group of leading NHS hospital, mental health, ambulance, community and clinical commissioning group employers, in partnership with NHS Employers and Public Health England;
  • Second, a new nationally-specified occupational health service for GPs suffering from burnout and stress, in partnership with the Royal College of GPs and BMA General Practitioners Committee;
  • Third, national action by NHS England working with Public Health England and other agencies to challenge and support catering contractors and PFI providers to raise the standards of food and nutrition.

Simon Stevens said: “NHS staff have some of the most critical but demanding jobs in the country. When it comes to supporting the health of our own workforce, frankly the NHS needs to put its own house in order.

“At a time when arguably the biggest operational challenge facing hospitals is converting overspends on temporary agency staff into attractive flexible permanent posts, creating healthy and supportive workplaces is no longer a nice to have, it’s a must-do.

“And at a time when the pressures on GPs have never been greater, we need to extend the local practitioner health programmes that have been shown to help GPs stay healthy and get back to work when sick.

“Equally, it’s time for PFI contractors and catering firms to ‘smell the coffee’ – ditch junk food from hospitals and serve up affordable and healthy options instead. Staff, patients and visitors alike will all benefit.”

Pillar One

Leading NHS employers to spearhead comprehensive initiative to boost NHS staff health at work

Ten local NHS organisations and NHS England itself, collectively employing around 55,000 staff, have agreed to lead implementation of this new programme. All participating organisations will commit to six key actions:

  • providing the NHS health check at work for NHS staff aged 40 or over – so that staff are able to access it more easily, and receive local signposting and support, while testing new models of health assessments and health-related incentives;
  • providing specific capacity for staff to access physiotherapy and mental health talking therapies, as well as smoking cessation and weight management services;
  • ensuring patients and staff are always offered healthy options in restaurants, cafes and vending machines on site, and actively promoting healthier options through targeted promotions;
  • establishing and promoting a local physical activity ‘offer’ to staff, such as running yoga classes, Zumba classes, or competitive sports teams, and promoting healthy travel to work by offering the Cycle to Work scheme;
  • fully implementing Public Health England’s Workplace Wellbeing Charter assessment and accreditation process, fully implementing the NICE guidelines on workplace health; and
  • identifying a Board level director lead and senior clinician to champion this work, while providing training to all line managers to help them support their staff’s health and wellbeing.

This new initiative is designed to put into practice the commitment made in the NHS Five Year Forward View ‘to ensure the NHS as an employer sets a national example in the support it offers its own staff to stay healthy’.

Stevens will cite a review by Dr Steve Boorman, which found that staff ill-health and related absence is linked to an increased risk of unsafe care, worse experiences of care for patients and poorer outcomes. The annual NHS staff survey also reveals big differences between individual NHS organisations in how their employees say they are supported at work. This includes creating a positive working environment that listens to frontline staff, tackles bullying and discrimination, reduces stress and promotes health and positive mental wellbeing.

It is intended to extend the programme to all NHS employers over the coming five years, targeting those with the highest rates of sickness absence and recruitment and retention pressures in 2016/17.

The initiative draws on the important work done by Dame Carol Black, Chair of the Nuffield Trust and a government advisor on health and work, in this area. Dame Carol will also play a role in helping drive progress together with national bodies and the leading network of local NHS employers.

Danny Mortimer, Chief Executive of NHS Employers, said: “Supporting our staff to stay healthy is a key priority for employers. A healthy workplace helps to improve outcomes for patients and we have been pleased to work with Simon Stevens and Dame Carol Black and our exemplar organisations in building on the work across the NHS to date.  We look forward to continuing to support the ambitious programme being launched today.”

Christina McAnea, UNISON Head of Health and chair of the NHS Social Partnership Forum, said: “The health and well-being of NHS staff at work has a direct impact on patients and this initiative rightly starts recognising that. Addressing physical and mental health issues is important and a step in the right direction as it will help tackle some of the major causes of stress at work.

“NHS staff experience some of the highest levels of stress and violence in the country and this can no longer be tolerated. Health unions will be working with employers and NHS England on these issues.”

Pillar Two

New nationally-specified occupational health service for GPs suffering from burnout and stress

Increasing pressures in general practice are one of the reasons why GPs leave the profession. Occupational health services are available across the whole of England but with varying levels of follow-up services depending on local commissioning arrangements by CCGs.

NHS England will therefore develop a national service specification for procurement regionally from 1st April 2016. It will be supported by specialist services for doctors building on those which have been successfully developed in areas such as:

  • The London Practitioner Health Programme, funded by CCGs in and around London;
  • House Concern, a specialist service in the Northern region;
  • Somerset Clinician Support Service, and;
  • MedNet, a service provided by South London and Maudsley NHS Trust and the Tavistock.

Pillar Three

National action to challenge and support catering contractors and PFI providers to raise the standards of food and nutrition.

NHS England will meet the major hospital catering vendors and PFI contractors to discuss how to ensure that the NHS leads the way in offering healthy food to its staff and patients.

There is much that can be done within existing contracts to provide healthier choices for staff, and some Trusts have already shown what is possible by promoting healthy options (e.g. including fruit rather than confectionary in discounted meal deals) and working to reshape their overall offer.

NHS England will stress Stevens’ view that it is unacceptable for health sector organisations to be contracting with caterers who mainly sell foods which don’t meet nutritional standards, or actively promote unhealthy eating. Officials will also push for organisations to ensure that they are providing easily understandable nutritional information and appropriate portion sizes, building on the Government Food Buying Standards to ensure a healthy and sustainable food and drink offer. Food and drink offered in vending machines should meet existing nutritional standards, so that staff have a choice of healthy options, including when working at evenings and weekends.

Duncan Selbie, Chief Executive of Public Health England, said: “The public sector should be the standard bearer for workforce health. The positive steps the NHS is taking to systematically improve the health and wellbeing of its workforce, including better access to occupational health, encouraging more physical activity and healthier food options, will have trickle down benefits for the health and wellbeing of the wider population. The money saved on reducing staff sickness can be spent on services for the public and the healthier habits picked up by public sector employees can be passed on to the people they serve.”

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31 comments

  1. Anonymous says:

    I am currently off with depression and burn out almost near suicidal, why? I have spent the past 3 years trying to fight against work place bullying and management of mental health issues. The main problem is you have a lot of broken people trying to fix people. With this comes many complex personalities and personality clashes.

    The main problem I have encountered is actually the management of staff within the NHS. I recently started a new post thinking things would change, but sadly there are managers that have been in the job so long and so set in their ways, they are scared of change, and any talented staff that might pass offer ideas for the better, get bullied or pushed out.

    Personally I think for change firstly you need to look at the management hierarchy, look at how long people have been in their roles/ or within the organisation. Its those that have been in the job too long that seem to ruin an organisation. Don’t get me wrong some staff become wise, but a majority are just comfortable waiting to get a pension and don’t care about people.

    All my experiences of poor management or bullying are from those staff that feel threatened. Sadly the reality is the younger generation are more wise and widely exposed to information which means this situation will keep happening. I did go gym everyday, eat like a vegetable and come across presentable (prior to being off sick)- for this I have been ridiculed and bullied and told I am just annoying? I have had some people use me as a role model but as stated, some feel threatened and so feel the need to make me feel like an outsider to the point I don’t know who I am any more.

    I remember once my line manager actually changed my hours to ruin my routine, knowing gym was a huge part of my life- I walk into work and was told I had to work set hours the next day which in turn led me to not do my usual work out. Some sad people out there. And the policy states this is not allowed but it still happened?

    I have decided to leave the NHS based on the fact its an ego building platform rather than a nourishing caring environment. .

    Its been a hard lesson to learn- I just got my dream job to, but leaving because what the job was advertised as, has now suddenly changed since going into post? and I might have the fancy title but actually the job is far from it because work is being pulled away from me or done for me? (and this is a very senior manager), how this is normal I have no idea. And saddest part, I was so close to making a change that cost me my dads life, but hey who cares right?! Makes me sick that people just don’t have that compassion.

    If you are looking for someone to help with anti bullying and well-being please get in touch. It is something I am very passionate about to the point I’m off sick.

  2. Jenn says:

    My arm was damaged after being assaulted, casualtly did nothing because it wasn’t broken and I had to wait over two months for physiotherapy. Now my job in the NHS is in the balance.
    I tried to return to work twice and each time ended up in casualty passing out from the pain. I couldn’t have stronger pain killers because it’s a fair drive to work and I can’t get there by public transport. The two months of waiting for treatment from the NHS, is now going to cost me my job in the NHS because of time off sick.
    It was bad enough to be assaulted, the emotional and physical trauma were bad enough, managing the pain and family while waiting for treatment were very hard, but then I was dragged into a meeting and not informed of the process or what it was about and be told i was being put in front of panel for dismissal, so coldly after all i have been through, it simply beggared belief.
    The changes are too small and too late. I used to think there was a lot of integrity in working for the NHS, work to help people and not for money or rewards – of which there are none in the NHS – I gave my heart and soul to the job and took great care in all I did, to me it was all about the patients.
    The changes are too little too late, a lot of NHS staff suffer from policy and uncaring managerial approaches. The NHS needs to care for the people who care for the patients, people behind the scenes and people at the forefront.

  3. Frank says:

    My name is Frank.
    I have been calling south Hampton And the Royal Sussex Brigthon Hospital but,
    Nobody seem to have heard of the 5 Million NHS Staff health Scheme set by Simon Stevens.
    Am a Personal trainer and would like to set up Classes at Brighton Hospital.
    I would like please some help to make people aware of this scheme at the hospital.
    Can you please help?
    Thank you very much in advance.
    Frank GB

  4. christine jefferies says:

    This is too little to late !
    Nursing staff are leaving the NHS in droves and we have virtually 0 attendance for replacement job interviews. I also have recently been informed that my hospital has ceased to offer physiotherapy sessions for staff in -house ( saving money from the budget). I know of two people directly affected by this in my department alone. The suggestions are great and would improve moral but how do we police this in a atmosphere of pariah management who are only interested in their own prestige and rarely even are seen on the shop floor. So to conclude the dam is leaking and sticking blue tack in the hole will not stop the torrent.
    C Jefferies Staff Nurse

  5. Zara chamberlain says:

    How refreshing to hear that someone is actually addressing the stress that all NHS workers face day in and day out.
    How about offering all NHS staff a cheaper membership at their local gyms. Exercise is vitally important and there are many gyms around for people to choose from. I feel it would be difficult to fit in team approaches, although that would be beneficial I am sure, due to everyone’s work commitments outside of the work environment.
    My local gym offers a reduction of £1.00 a week- nit much of an accentive!
    If we are worth it and I believe all staff at whatever grade are, then I think it’s about time it was shown.
    In the ‘old days’ many hospitals had their own gyms for all staff- all gone now sadly.

    • Anonymous says:

      I heartily agree that NHS staff should be empowered and enabled to exercise through reduced gym/swim membership. As a student nurse, I have been shocked at the number of unhealthy nurses I have met. It is a challenge to stay healthy and working long shifts and feeling tired and stressed can lead to making unhealthy lifestyle choices. Making a) food choices more healthy and b) the exercise options more available and affordable is surely a step in the right direction. Of course, this is a wider public health issue too, the “obesogenic” environment we live in is the cause of many of the health problems we battle with today. However, the NHS leading by example and ‘getting its house in order’ by looking after its workforce is a good start.

  6. Peter says:

    This seems more about treating the unwell, secondary prevention, not about addressing the transactional management culture and poor working conditions, excess bureacracy and red tape and lack of authority despite being accountable.

    It does not address the basic of a safe place of work, systems of work and safe and effective colleagues in the Francis report and Health & Safety @work Act.
    Occupational health professionals are experts in health in the workplace and they do not appear to be having a central role. Why would you refer stressed GPs to stressed GPs ? PHE may have a population health perspective on this but they do not have the skills to risk assess, evaluate workers health and functional capacity or define the legislative drivers fror this in conjunction with disability law, employment law and EU Directives, EU Occupational Safety and Health (OSH) Strategic Framework 2014-2020.

    This needs to be provided by or co-ordinated in occupational health not multiple external providers with no continuing relationship with the management structure of the NHS organisations

    • Anonymous says:

      Totally agree Occupational health should be higher up the priority in this report – for GPs and all NHS staff

  7. Alan Moore says:

    Fine to have healthy GPs with Occupational Health access but when they are sitting alone in their surgeries because all their staff have fallen off the perch with burn-out the system will still grind to a halt. The mean-spirited withdrawal of Occupational Health for practice staff – both nurses and non-clinical support -when NHSE took over from PCTs was and still is a national disgrace.

    • Stella Sawyer says:

      Agree that OH services should be available for all primary care staff (preferably before burnout ensues…). Around 10 years ago funding WAS made available for GPs and Primary Care staff to access local NHS Occupational Health services – however this funding seemed to disappear when CCGs took over from PCTs….

  8. Helen Bean says:

    I , like many nurse get back pain and the best treatment for this and the way to avoid having to be absent from work is visiting my chiropractor. I think if this service could be provided through occupational health the amount of nurse’s off sick with back pain would reduce, therefore saving the NHS money and increasing standards of patient care as we would have better staffing levels.
    Helen Bean Staff Nurse Cumbria

  9. COHPA welcomes the announcement by NHS Chief Executive Simon Stevens at the NHS Innovation Expo conference on 2nd September of a £5 million initiative to improve NHS Staff health, provide a nationally specified OH Service for GP’s and implement action to raise the standard of food and nutrition for staff in NHS establishments.

  10. Anonymous says:

    You talk of health checks for the over 40s. What will be done when issues are identified?

    You talk about work related stress. What will be done to overcome the lack of staff, and replaceing staff who leave with those on a lower grade, people who dont have the knowledge to carry out the work carried out by the previous person

  11. James Milne says:

    I understand there are 168 NHS Hospitals in England. It would interest me to know if the percentage of Absenteeism is consistent throughout all, unlikely, or if there are factors influencing those with a higher percentage i.e. a poor performing Hospital?

    I am firmly of the opinion that stress related illness is a major factor in Absenteeism and can identify areas which cause problems. To me, there are more people than we know who have this condition but, because of the stigma, report sick for a different reason i.e. migraine, cold, stomach upset etc.

    It is also my considered opinion there is a worrying lack of ‘mutual respect’ within the ranks of the NHS but is definitely not unique to them. This is clearly evident to me in many forms. Subordinate Staff feel undervalued, it’s not about money even if they are underpaid, unappreciated, they feel it is not their place to have a point of view and don’t give it. More importantly, if they have a concern this will not be reported because they fear the consequences of doing so. I’m afraid there is a price to be paid for raising a concern, even if it’s just. Morale is therefore low, standards can fall and this definitely has a negative effect on the whole Hospital.

    What the NHS England should realise is that none of the £5m would be needed if they tackled the problem of a lack in ‘mutual respect’ and therefore this money could be utilised in the other ways of Pillars One, Two and Three.

  12. Rob says:

    Adequate staffing levels and decent rotas would help stress levels dramatically. The service is haemorrhaging staff and I fear that it will take more than Zumba to stop it. One can see by the Governments funding and insulting 1% pay rise for the next four years, how they really value those at the sharp end.

  13. Farhat Hamid says:

    Not new but a very welcome and much needed initiative.
    Easier to roll out in hospitals, efforts must be there to ensure implementation across NHS Organisation include community services please.
    I agree with many of the comments relating to the stretched working conditions for staff, whilst this needs to be tackled systematically I do believe that fair and supportive leadership can be the catalyst for change/improvements for many of the issues raised.

  14. George says:

    Our Trust has just struck a lucrative deal with Costa Coffee. The result? Staff and patients wandering about with delicious but high calorie drinks and snacks, corridors accumulating dark red coffee cups and fatter staff who are paying premium prices. .

  15. Karen says:

    I do not feel providing exercise classes and healthy meals is tackling the root of the problem at all. While it might seem like a friendly gesture NHS staff really need improved working conditions. The hours are long and combined with a chaotic shift pattern this has got to be detrimental to peoples health. Staff miss breaks within their shifts which are often a minimum of 12hours, or may not be offered a break until near the end of their shift. They are constantly under pressure from ridiculous targets. Quite simply they need to be treated a bit better and allowed more flexibility regarding their working hours. Then you may see a difference.

    • andrea says:

      The constant inability to obtain a meal break however short, results in the staff grabbing a biscuit or similar item. Long shifts, quick turn around from nights to days, no breaks, higher patient activity all impact on the staff’s health. Lets get the basics right before investing in other schemes.

  16. Katie Puplett says:

    In the York Directorate of the LYPFT we have recognised the need for improving the physical health of our staff. We are curently piloting, with great success, a physical activity programme for staff run by our Healthy Living Advisors. We have made links with the occupational health physiotherapy team who refer staff with a history of neck and back dysfunctions into our core stability classes. We also run a legs, bums & tums class, gym sessions, circuit training, aerobics and body sculpting classes.

  17. Paul Cook says:

    I agree that the NHS is under staffed so staff are over worked but it is important this is recognised as being in all areas, not just doctors and nurses. We need to work on improving public health and reducing immigration to reduce the NHS workload, reducing stress and pressure on the staff.

    • Anonymous says:

      Reducing immigration isn’t the answer to your argument because the majority of people working for the NHS are immigrants and the majority of people using it are not.

  18. Graham Boniface says:

    First of all, I welcome the comments above. It is about time! Sickness absence is creeping up. £1.7 billion in 2012/13 and now over £2 billion.

    I would like to see research into staff wellbeing being the 4th pillar. All too often well meaning ideas are launched without quality research to underpin organisational change that is all too often rushed into to meet the agenda of the moment.

    Please don’t botch this

  19. Carol Hartman-Andersen says:

    GP Choices support and Occupational Health Service has been providing OH services to GPs and Dentists within County Durham and Darlington for approximately 17 years. Our service was a NHS Beacon site and we are currently funded by the 3 local CCGs (Darlington, North Durham and DDES. Not only do we offer OH services we provide support to GPs experiencing burn out , drug and alcohol addiction, mental health, a mentoring scheme for all GPs , educational evenings for Sessional GPs, Needlestick injuries advice and follow up, counselling , and signposting to other specialist services. Our GP Advisors have achieved accreditation with the RCGP Health for Health Practitioners and provide specialist support to GPs and Dentists. I would be delighted to discuss our service further

    • Dougal says:

      You do nothing to tackle the sources of stress. Please leave the forum for open discussion rather than selling services for personal gain.

  20. Anonymous says:

    Having been a nurse in the nhs for nearly forty years. I have seen the deterioration of shift work pattens and increase of working hours (twelve and a half hr shifts) to be the most important factor in the increase of sickness. Staff are expected to work both days and nights in a seven day period and the turn around of these shifts are totally unacceptable, it is no wonder staff are dropping like flies.If you are serious about putting your own house in order, please look at making working pattens more friendly.

    • Anonymous says:

      Totally agree. working within clinical environment for 12 1/2 hrs is unaccepatble and detrimental to nurses life.

  21. Interesting to hear todays renewed commitment to increasing physical activity take up among NHS staff. Here in Bolton the Public Health Team have been running the NHS Fun Tri with great results. The event is focused on staff who would not normally undertake any physical activity and is open only to NHS Staff. The emphasis is supporting and encouraging individuals to get involved as part of a relay team. The event is self funded through entry fees which are kept as low as possible. Distances are kept short to encourage novices. Over the past 4 years we have had over 1000 people take part from across the North West. The vast majority of these participant are complete novices, many of whom have not done any physical activity for a number of years, The evidence tells us that once a commitment to be part of a team has been made the participants maker sustainable changes in their Physical Activity.
    There is great potential to upscale this across different areas across England.

  22. mike says:

    simon stevens is avoiding the truth, and the truth is the nhs is massively under staffed, the population is growing, thanks to immigration the nhs is struggling to cope, only more doctors and nurses can help, this can help the stressed out front line staff, not yoga classes and different diets.

  23. sheena Moffat says:

    Cut the generous sickness benefits and your sickness levels will half in an instant

    • Graham Boniface says:

      Sheena

      I get your point but I don’t agree with you. Staff work bloody hard and often put others before their own wellbeing. There will always be people that abuse the system, but that is a small percentage. All too often the blame is on the staff, but gross change in culture at organisational level must happen if sickness is to reduce.