Providers of acute NHS health care services have the potential to play a much broader role than is often recognised in improving and maintaining the health of populations. At Oxford University Hospitals NHS Trust, we have committed to not just treat disease, but to improve health in the entire community we serve.
With more than 11,000 staff and around a million ‘patient contacts’ every year, plus many more visitors, we are ideally placed to promote healthy lifestyles and behaviours, and improve health in a holistic way at the population level. Our population health strategy, ‘Here for Health’, jointly agreed last year with Oxfordshire County Council, sets out how we are doing this. It has three overarching aims: to promote healthy lifestyles to our patients, visitors and staff at all opportunities; to develop our hospital environment to support healthy behaviours; and to ensure that population health approaches are integral to the work of the Trust.
In taking this approach, we are perfectly aligned with the spirit of NHS England’s Five Year Forward View, which sets out the need for ‘a radical upgrade in prevention and public health’ and better support to NHS staff to stay healthy and act as ‘health ambassadors’. Below are a few examples of how we are doing this…
Supporting our staff to improve and maintain their health
We believe staff who are happy, healthy and safe will consistently deliver high-quality patient care. Our Centre for Occupational Health and Wellbeing delivers a full and diverse programme of work to improve the physical and mental health of our staff. Priorities are developed and agreed by a group of representatives drawn from across the organization, informed by staff surveys, sickness absence data, NICE guidance, and national initiatives. Co-ordinated and driven by the Health and Wellbeing promotion specialist, the agenda actively encourages staff to make changes, no matter how small, to their lifestyles which can then make a difference to how they think, feel, behave and perform.
Current priorities for improving the physical and mental health of our staff include:
- training health champions and developing a network of staff promoting healthier lifestyles and encouraging change;
- increasing physical activity opportunities through lunchtime walks, signed stair walking, pedometer challenges, walk to work routes, cycle to work schemes and discounted gym memberships;
- becoming a mentally healthy workplace through training staff to manage stress, build resilience, and promote mental wellbeing;
- promoting and encouraging healthier eating by working with staff and catering/retail providers;
- raising awareness of all aspects of health and wellbeing through opportunistic health promotion activities such as our annual Healthy Hospital Days at all our hospital sites.
Providing health improvement advice in the hospital setting
The ‘Here for Health Centre’, an innovative drop-in health improvement advice centre, was opened at one of our hospital sites in August 2014. This service provides brief health improvement advice and information to our patients, visitors and staff. All are able to drop-in at a convenient time to access support to improve their physical and mental health. The Centre has also become embedded in some of our care pathways, with clinicians referring patients and/or carers that they feel could benefit .
The Here for Health Centre
At the centre, individuals can browse information on healthy living and local community services, and can have an assessment of their lifestyle and chronic disease risk. The individual is then supported to identify an area of their lifestyle they would like to change, for example, their diet or smoking . Using motivational interviewing and other behavior change methods, staff help individuals to write a specific action plan for themselves, setting out exactly WHAT they want to do, WHY they want to do it, and specifically outlining HOW they will do this. This might include accessing local community services for further support, and the centre has developed close links with many Oxfordshire services for signposting or referring people to.
In the six months since opening, the centre has been accessed around 1000 times, and has become a valued service among clinicians who refer their patients. As it is such a novel approach in this setting, we are evaluating its implementation, and early qualitative evidence is highly positive.
We firmly agree with NHS England’s view that a preventive, population approach is needed for the sustainability of the NHS, and that this requires coordinated action across sectors. Collaborative relationships built across our organisation and with local partners in the course of this work are key to its success. These relationships are resulting in much wider opportunities and synergism than we had imagined – this part of the ‘process’ is an important outcome in improving the health of a population.
Aine Lyng is a Health Promotion Specialist at Oxford University Hospitals NHS Trust