Workplace Nutrition and Public Health Context Jade Clark, RD BDA Work Ready Accredited Dietitian
Workplace Health NHS 5 Year Forward View (2014) NICE Guidance: Mental wellbeing at work (PH22) 2009 Physical activity in the workplace (PH13) 2008 Smoking: workplace interventions (PH5) 2007 Workplace health: long-term sickness absence and incapacity to work (PH19) 2009 Workplace health: management practices (NG13) 2015
White Paper- Key points Absenteeism costs UK workplaces estimated 8bn / year Presenteeism estimated 15bn per year Employees with musculoskeletal and other (chronic) health conditions report higher rates of absenteeism and presenteeism Obesity is strongly associated with sickness absence in the workplace. Employees that are obese take an average of four extra days sick per year Maintaining a normal weight gives the lowest risk for sickness absence Shift workers are at increased risk of obesity, diabetes and metabolic syndrome Workplace health interventions may improve productivity by 1-2%
London Workplace Health Charter & Workplace Wellbeing Charter Needs assessment and planning Attendance management Health and Safety Mental Health Smoking/tobacco Physical Activity Healthy Eating Alcohol and Substance misuse
Award Levels Commitment Achievement Excellence
England Workplace Wellbeing Charter Commitment Healthy Eating A healthy eating statement is in place and employees are aware of it. Appropriate, acceptable and accessible information on healthy eating is provided. Any kitchen facilities or beverage areas are in good condition and conform to the highest possible standards and requirements of food hygiene. Wherever possible, eating facilities that are clean and user friendly are provided away from work areas. Use of these facilities is promoted to enable regular breaks away from the work area. All workplaces have access to fresh drinking water. Achievement Any on-site catering facilities provide healthier options that are actively promoted.
England Workplace Wellbeing Charter Healthy Eating cont. Excellence A corporate healthy eating food plan, guidelines or similar has been produced in consultation with staff that covers: Corporate hospitality Catering provision Local sourcing of food using local providers Vending/in-house catering pricing strategy to promote healthy options Local healthy food availability for staff considered as part of facilities management. Tailored programmes to improve understanding and take-up of healthier diets are offered. Internal or external support is on offer for those who wish to lose weight. Rolling schedule of planned events to promote the importance of healthy eating are in place.
BDA Work Ready National Programme launched in June 2015: drives demand for DTs in workplace health raises awareness of the benefits of nutritional health in the workplace supports businesses implementing nutritional wellbeing programmes designed to support delivery of national award schemes:
Programme design Uses evidence & principles of good practice in workplace wellness programmes Delivery through BDA members qualified in workplace nutritional health (Work Ready Accredited Dietitians)
Workplace Nutrition what works Multi-component interventions are likely to be more successful in achieving weight loss Schröer S, Haupt J, Pieper C (2014) Evidence-based lifestyle interventions in the workplace an overview. Occup Med (Lond); 64(1): 8-12 Dehydration can cause fatigue, headaches, tiredness, loss of concentration and negative impact on mental and physical performance. El- Sharkawy et al (2016) Hydration amongst nurses and doctors on-call (the HANDS on prospective cohort study) Clinical Nutrition 35:935-942 Watson et al ( 2015) Mild hypohydration increases the frequency of driver errors during a prolonged, monotonous driving task Physiology & Behaviour 147: 313-8 Organisational behaviour change Vending machines Fruit and veg schemes Alinia et al (2011) A workplace feasibility study of the effect of a minimal fruit intervention on fruit intake. Public Health Nutr; 14(8):1382-7 Gorton et al (2010) Healthier vending machines in workplaces: both possible and effective. N Z Med J; 123(1311):43-52.
Tools Linked to our concept Available Soon
Work Ready CASE STUDY South London NHS Hospital Emergency Department (ED) Brief: To conduct a Nutritional Needs Assessment The overall aim: to support the staff to start considering and looking after their own health and wellbeing, including their nutritional wellbeing, in addition to their responsibilities to the patients
CASE STUDY: Key meetings with Stakeholders ED management team Occupational Health and Wellbeing Catering and Facilities Dietetics ED staff, including those from clinical, administration and receptionist roles
CASE STUDY: Site Tour On site restaurant and coffee shops Vending Machines Staff kitchens and staffrooms Wider hospital environment and external local food provision
CASE STUDY Key partnerships Human Resources Food and Nutrition Steering Group Health and Wellbeing Steering Group (not yet established) Internal Communications Team Catering and Facilities Management and team Nutrition and Dietetics Department Local Public Health Team
CASE STUDY Key potential enablers: Good opportunities to eat healthy food across the site during daytime hours Good facilities for making drinks and easy availability of water for staff. An imminent staff health and wellbeing strategy Clear communication channels: email, intranet and ED staff newsletters Key potential barriers : Variety of working patterns and long shifts for the majority of ED staff The traditional healthy eating training/workshops offer is not a suitable option for ED staff due to the nature of the shifts and staff rotas. Communication channels for staff who do not access email or the intranet at work
NHS CQUIN: NHS staff health and wellbeing Commissioning for Quality and Innovation (CQUIN) Mandatory Allocated proportion of income is conditional based on demonstrating/achieving quality improvement and innovation goals.
Indicator 1b Healthy Food for NHS staff, visitors and patients The banning of price promotions on sugary drinks and foods high in fat, sugar and salt The banning of advertisements of sugary drinks and foods high in fat, sugar and salt on NHS premises The banning of sugary drinks and foods high in fat, sugar and salt from checkouts Ensuring that healthy options are available at any point including for those staff working night shifts
By 2018/19 80% of drinks lines stocked must be sugar free (less than 5 grams of sugar per 100ml). In addition to the usual definition of SSBs it also includes energy drinks, fruit juices (with added sugar content of over 5g) and milk based drinks (with sugar content of over 10grams per 100ml). 80% of confectionery and sweets do not exceed 250 kcal. At least 75% of pre-packed sandwiches and other savoury pre-packed meals (wraps, salads, pasta salads) available contain 400kcal (1680 kj) or less per serving and do not exceed 5.0g saturated fat per 100g
Rationale for NHS CQUIN: NHS staff health and wellbeing SACN, 2015: intake of sugar should not exceed 5% of total dietary energy PHE commenced a broad sugar reduction programme Includes price promotions, reviewing nutrient profiling model, reformulation, sugary drink tax, provision of healthier food and drink across public sector outlets (inc NHS), awareness raising
CASE STUDY - Findings Observed evidence that the hospital was achieving the first 3 of the indicators. Vending machines included Good provision of healthy food available across the site during the day Evidence of nutritional labelling at POS, but lacking consistency across site Poor provision of healthy food for staff working nightshifts
CASE STUDY- Findings ED staff specific Limited staff knowledge of availability Poor ED staffroom facilities Culture of grazing, snacking and consuming unhealthy foods during shifts
Staff Quotes sometimes when you re on nights you just eat crap- sweets, popcorn. You re not sure when you re going to get a meal There have been plates of fruit around the department recently- they all got eaten
What information would be helpful for you? Quick and easy meals Healthy snacks What not to eat What s good for you
CASE STUDY: Objectives 1. To improve ED Staff Room equipment and environment 2. To raise awareness and support a culture of healthier eating amongst staff 3. To further improve and implement consistent nutritional colour coded guidance and labelling at point of sale/ on menu boards to support healthy choice 4. To ensure healthy, hot food options are available to staff at all times 5. To improve awareness of healthier food, snacks and menu options for sale on the hospital site 6. To improve awareness of staff weight management options and wider wellbeing services
Reflections Capturing staff views Engaging with key stakeholders CQUIN: Opportunity to review, support and uphold indicators objectively Uptake and implementation of recommendations benefits beyond ED staff Health promotion engagement/education?
BDA Work Ready Your route to accreditation Next training date: 11 October 2017, Central London https://www.bda.uk.com/calendar/event/view?id=522
BDA Work Ready Training for BDA members: Get up to date on latest evidence on workplace health Understand how BDA Work Ready works Build your network Find out about the tools and how to implement them Cost 175 per person (includes post-training accreditation)