NHS adopts the carrot approach to staff wellbeing – but will it pay off?

NHS England is to offer trusts financial incentives to boost their employees’ wellbeing.

Hospitals and other providers will be funded to provide physiotherapy, occupational therapy and counselling for staff who need them. They will be encouraged to organise physical activities such as fitness classes or running clubs, and to improve the quality of food available to staff, day and night.

Public Health England says staff sickness absence is costing the NHS £2.4 billion a year, which amounts to £1 in every £40 of the total NHS budget.

The healthy way to work

Nursing Standard’s campaign to improve workplace meals

Department of Health figures suggest that of the 1.3 million staff working in the NHS in England, 300,000 are obese and a further 400,000 are overweight.

An NHS England spokesperson described the financial incentives – trusts can apply for a share of a £600 million fund – as a ‘bonus’ on top of the work they already do to promote workforce wellbeing.

One way to qualify for a grant is to show an increase in staff influenza vaccination rates. One of the initiatives is to increase the overall vaccine uptake rate in the NHS from about 50% to 75%.

NHS England will use the annual staff survey to help it decide which trusts receive funding. It will look for examples of staff stating that their employer is addressing problems such as work-related stress and back injuries.

Nurse Sue Bedford, founder of Pulse Health Screening, which provides occupational health checks for individuals and corporate clients, is ‘very much in favour’ of the NHS England proposals.

She says: ‘We are seeing staff turn into patients because of the demands and stress they are under, coupled with poor eating habits and the lifestyles they are forced to adopt.’

She adds that staffing levels and stress are much worse now compared to when she qualified in 1980. ‘The pressure to take on extra shifts and work long hours is horrendous,’ she says.

This impression is backed up by results from the 2015 NHS staff survey which revealed that almost half the 70,000 nurses questioned have experienced work-related stress, while 60% felt under pressure to work even when sick.

Unison’s head of health Christina McAnea cautions that the NHS initiatives ‘won’t help staff at all if staff don’t have time to use these new services’.

The trust where you can call a 24-hour health helpline

Nottingham University Hospitals NHS Foundation Trust was one of the organisations to pilot the incentive scheme.

The trust employs 14,000 staff, 6,860 are aged over 40. It provides regular health check roadshows across its two main sites and plans to increase their frequency and follow-up to ensure progress is made.

A free, confidential 24/7 employee assistance programme called HELP provides telephone support. A website has a range of health and support information and eligible staff can have up to six weeks of counselling.

The organisation wants to develop a weight-management strategy comprising healthy eating promotions, tailored physical activity, long-term individual support for staff with a body mass index of 35 or more, and referrals for staff requiring medical intervention.

Health and wellbeing co-ordinator Steph Knowles says: ‘You can never eliminate all problems in hospitals, especially stress, but our staff find the holistic approach we take to their health and wellbeing makes this one of the top 20 trusts to work for.’

She says that if they receive support early enough, staff with physical or mental health problems should be able to remain in work.

In November 2009 the DH published a review led by occupational health physician Steve Boorman looking into the health and wellbeing of NHS staff.

It found organisations that prioritised staff health enjoyed benefits including enhanced performance, better patient care, higher retention and lower sickness absence rates.

Slow progress

Seven years on, it ‘appears things have not improved enough if incentive schemes like this are necessary’, says RCN senior employment relations adviser Kim Sunley.

She adds: ‘Carrots are all well and good, but if they are not working then you have to look at using sticks.

‘Our members are telling us the root causes of problems are not being tackled. They are not getting the breaks they need.’

Ms Sunley said the RCN knows of cases where nurses have complained they do not have enough time to get a glass of water.

‘Schemes like this are not something you do to staff, they are something you do with staff.’

To qualify for the scheme, hospitals will be required to remove advertisements, price promotions and checkout displays that promote sugary drinks and foods that are high in fat, sugar or salt from their buildings.

They will have to submit information about their fast food franchises, vending machines and shops ahead of the ‘sugar tax’, expected to be levied on NHS food outlets from April 2017.

Nursing Standard identified the problems nurses face in the workplace when we launched our Eat Well Nurse Well campaign in 2014. We called on employers to sign our charter that committed them to providing healthier meals and snacks for their staff.

Among the first organisations to sign up to Eat Well Nurse Well was the Hospital Caterers Association.

Its national chair Phil Shelley, facilities manager at Musgrove Park Hospital in Taunton, says: ‘I completely endorse the Nursing Standard campaign; nurses should be aware of what they are eating and what is and isn’t healthy.’

Mr Shelley reveals his association has regularly met NHS England chief executive Simon Stevens and his advisers ‘in an effort to be much more proactive’ about staff eating habits across the health service.

Mr Shelley is inspired by the example set by NHS providers in Scotland. Health boards there have adopted a programme called the healthy living award scheme.

This has given boards control over what is sold over the counter and from vending machines on their premises.

NHS organisations can set a maximum size for chocolate bars or minimise the proportion of items on sale that are considered unhealthy. Mr Shelley wants to see this replicated in England.

He adds: ‘Members of the Hospital Caterers Association have got to help staff to make these choices because if the NHS can’t get health and wellbeing right then that is very worrying’.

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