Website of the Department of Health

Taking opportunities for health: the role of NHS staff

Evidence shows that:

13. It will be NHS staff who put these plans into action and, to make a real, sustained impact, the whole of the NHS must join in. Across the NHS, there are one million interactions every 36 hours with people who are looking for some kind of help with their health. This offers enormous potential to get the right messages across. Every member of NHS staff has the potential to increase their role in raising people's awareness of the benefits of healthy living - as par t of the wider NHS responsibility to patients to improve health, not just provide healthcare for the sick.

14. We will exploit this potential wherever we spot it. As part of improving access and availability of tailored help to smokers wanting to quit we will, from 2006, offer NHS Stop Smoking Services on the new 'choose and book system'. Choose and book is an electronic appointments service, initially for use by GPs in booking first outpatient appointments. From 2006, smokers will be free to choose available appointment slots for local NHS Stop Smoking Services, and book them through their GP practice. We are also working towards embedding an offer of stop smoking advice as part of clinical assessment in surgical care pathways from 2006.

15. NHS staff are among the most respected and valued people in England. People trust them and listen to them. This strategy will begin to provide  NHS staff with the support they need to make the most of that opportunity. This strategy marks the start of an important and fundamental cultural change in the way that the NHS relates to patients, with staff providing professional counsel and encouragement to patients on health, as well as high-quality treatment.

16. To support this change, we will develop a National Health Competency Framework, which will include new programmes to give NHS staff the training and support they need to develop their understanding and skills in promoting health. Through induction training for all new staff, undergraduate courses and continuing professional development we will equip all frontline staff to recognise the opportunities for health promotion and improvement, and use skills in health psychology to help people change their lifestyles. Elements of this training may also be helpful for workers outside the NHS, including in the voluntary and community sectors(i). 

Footnote: (i) Annex B describes what we are doing to improve the evidence base, develop and disseminate information and best practice and improve training opportunities, learning from international best practice.

Transforming health and prevention services

17. Health improvement and preventive services are patchy in quality and variable in coverage across the country. There is a geographical lottery in the support available. For a new approach to health policy in the 21st century, these services need to benefit from the same systematic drive for improvement and modernisation that is already transforming access to primary care, surgery and emergency care in the NHS. To meet increasing demand for health in the NHS, England needs fast, effective and universal access to high quality, people-centred health improvement and prevention services which have capacity to deliver.

18. We also need to tackle health inequalities head on, ensuring that the NHS provides people in disadvantaged areas and groups with services designed around their needs so that they want to use them. Developing new, innovative models of care and pursuing opportunities for sustained action as well as quick wins will be particularly important in tackling inequalities. We will need to ensure that service improvements do not increase health inequalities.

19. We will act on the best available evidence or develop new models of care to be evaluated in real time to determine what works ahead of wider rollout. Health trainers will provide a key part of that infrastructure. Cultural change in the way that the NHS relates to patients, equipping itself to advise on health as well as treatment, will provide another. The rest of this chapter sets out how health and prevention services will be modernised over time, using the new health trainers as the foundation for an NHS where it is increasingly easy to get information and advice or access to services. It describes what NHS organisations will do, and how they can work in partnership with local government and the independent sector.

20. In improving these services, we will initially concentrate on:

a. building a new local infrastructure for improving health, within the new arrangements for primary care services;

b. addressing the needs of people who face specific challenges:

c. tackling the big lifestyle issues:

Case study

The Sheffield CIRC (citywide initiative for reducing cardiovascular disease) Programme aims to reduce inequalities in cardiovascular premature mortality. It delivers high-quality, secondary prevention programmes to an estimated 14,000 individuals with cardiovascular disease in the areas of highest need.

Fifty-one Sheffield GP practices received a tailored programme of support that included: training of nurses and doctors; additional nursing time; IT support; dietetics; physical activity and psychological specialist input. A citywide programme of user support and community engagement with ethnic minority communities also linked into the practice-based activities. Additional funding of £1 million has enabled the programme to be incorporated into the mainstream services of the four Sheffield Primary Care Trusts. By 2003, Sheffield had seen a 23% decline in the under ­75 cardiovascular mortality rate in the most deprived fifth of its population since 2000, compared to a 16% decline in the Sheffield population as a whole.