Transcript Document

NICE Work - the NICE guidelines
for the workplace
Trent Occupational Medicine Symposium, Nottingham, 6th
October 2011
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Professor Mike Kelly, PhD, FFPH, Hon FRCP.
The Centre for Public Health Excellence, NICE, London, UK
NICE
The National Institute for Health and
Clinical Excellence (NICE) is the
independent organisation in the UK
responsible for providing national
guidance to the NHS and the wider
public health community on the
promotion of good health and the
prevention and treatment of ill health.
Has had a public health role since
2005.
Audiences for public health
guidance
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The NHS
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Local government
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The workplace
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Education
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The utilities
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Industry
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Retailers
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DH and other government
departments
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The public
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National policy makers
The pillars of our work
• Comprehensive evidence base
• Expert input
• Patient and carer involvement
• Independent advisory
committees
• Genuine consultation
• Regular review
• Open and transparent process.
Methodological principles governing
all NICE’s work
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Base recommendations on the
best available evidence.
To determine cost effectiveness
using the QALY.
To be clear about scientific and
other values
To allow contestability.
To be seen to be and to be
independent of government, the
pharmaceutical industry and
other vested interests.
NICE methods for public health
Second edition
(April 2009)
Third edition
(April 2012)
The NICE public
health guidance
development process
An overview for
stakeholders, including
public health practitioners,
policy makers and the
public
The workplace guidance
Workplace physical activity
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Focuses on activities either based in the workplace or
outside the workplace but initiated or endorsed by
employers.
Small, medium and large organisations
Public, private and voluntary sector organisations
Benefits to employers:
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- Better staff retention
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- Increased staff loyalty
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- Reduced sickness absence
Recommendations
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Policy and planning
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Physical activity
programme
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Supporting employers
Policy and planning
Develop a physical activity plan or policy that:
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maximises the opportunity for all employees
to participate
involves staff in planning and development
has dedicated resources
sets organisational goals
links to relevant national and local policies
The physical activity programme (1)
• The programme could include:
– flexible working policies
– policies to encourage walking, cycling or the use
of other transport involving physical activity
– dissemination of information, for example, on
local opportunities to be physically active
– ongoing advice and support
– confidential, independent health checks
The physical activity programme (2)
The programme should:
– encourage employees to walk, cycle or use
other forms of transport involving physical
activity to travel to and from work
– help employees to be physically active during
their working day
– Encourage employees to set physical activity
goals
– take account of the nature of the work and any
health and safety issues
Supporting employers
• Organisations with responsibility for increasing
physical activity or for occupational health should
provide support to employers who are implementing
this guidance. This should ideally be in the workplace
and include:
–advice and other information on local resources
–resources, for example, the services of physical
activity experts
• If initial demand exceeds resources a targeted
approach is suggested.
Smoke free workplaces
Benefits for employers
• Reduced sickness
absence
• Increased productivity
• Improved employee
health
• Increased compliance with
smokefree legislation
Effective interventions
• Nicotine replacement
• Self-help materials
therapy (NRT) and
• Brief advice
bupropion
• Telephone counselling
• Individual behavioural
and quitlines
counselling
• Group behaviour therapy
programmes
Effective interventions
• Pharmacotherapies: NRT and bupropion
• Individual behavioural counselling with a
trained smoking cessation counsellor
• Group behaviour therapy: at least two group
meetings offering information and support
plus a behavioural intervention
Effective interventions
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Brief interventions: opportunistic
advice and support offered in 510 minutes
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Self-help materials
Telephone counselling and
quitlines
What should employers do?
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Make information on local stop smoking
support widely available
Offer to help employees who smoke to quit.
Be responsive to individual needs and
preferences
Where possible, provide on-site stop
smoking support
Work with staff and their representatives to
develop a smoking cessation policy
What can employees do?
• Contact local stop smoking
services for information,
advice and support
• Encourage employers to
provide advice, guidance and
support to help employees
who want to stop smoking
The business case
• 72% of smokers want to quit
• A non-smoking working environment
encourages people to quit
• Loss of productivity of 33 hours per
year per smoker
• Use the NICE business case and
other costing tools to help identify
costs and savings
Long term sickness absence
Background
• Being in employment, either paid or unpaid, can be good
for people’s health and wellbeing
• In 2006, an estimated 175 million working days were lost
due to sickness absence in Britain
• Sickness absence and ‘worklessness’ in Britain are
estimated to cost over £100 billion a year
• About 2.7 million people receive incapacity benefit
Scope of guidance
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Help employees return to work following
long-term sickness absence
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Reduce the re-occurrence of short- and
long-term sickness absence
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Prevent or reduce the number of employees
moving from short- to long-term sickness
absence
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Help those on incapacity benefit to return to
paid or unpaid full- or part-time employment
Pre-requisites and considerations
– Employer and employee should jointly agree any
plans to help the employee return to work
– The employee should have someone they trust to
liaise with at every stage
– The person liaising with them should be a good
communicator and aware of discrimination law and
relevant health and safety practices
Recommendations
• Three recommendations are relevant to employers
and relate to long-term (or recurring bouts of longor short-term) sickness absence
• Recommendation four is relevant to commissioners of
services for unemployed people in receipt of
incapacity or similar benefits
Initial enquiries
• Employers should identify someone who is impartial to
undertake initial enquiries with the employee, to:
o identify reasons for sickness and barriers to
returning to work
o discuss the options for returning to work and
jointly agree what action, if any, needs to be
taken
• If necessary, employers should appoint a case
worker/s
Detailed assessment
• Only if needed, arrange for a relevant specialist/s to
carry out a detailed assessment. This could include:
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specialist advice on diagnosis and treatment
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use of a screening tool
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a combined interview and work assessment
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development of a return-to-work plan, including if
needed, interventions or services
Interventions (if needed)
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Ensure the employee is consulted and jointly agrees
to all planned interventions, services and the returnto-work plan
Coordinate and support delivery of planned
interventions and services
Level of interventions
(if needed)
• In addition to usual treatment and care consider:
• ‘light’ interventions for those who are likely to return to
work
• An ‘intensive’ programme of interventions for those
who are unlikely to return to work
Incapacity for work
• Commissioners of services for unemployed people in
receipt of incapacity or similar benefit, such as the
Department for Work and Pensions to:
– commission an integrated programme to help
claimants return to work (paid or unpaid)
– evaluate the programme (including any specific
components).
Cost savings
• This guidance is likely to lead to cost savings for
employers by reducing the annual number of sick
days taken
• The business case template produced to support
this guidance helps organisations to estimate the
local cost impact
Find out more
• Visit www.nice.org.uk/PH19 for the:
– guidance
– quick reference guide
– business case template and costing report
– checklist for employers and employees
– guide to resources
Conclusion
The future topics for the workplace
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Working with DWP
Working with employers and trades unions.
Occupational health and public health.
Future updates
• GABBAY, M., TAYLOR, L., SHEPPARD, L., HILLAGE,
J., BAMBRA, C., FORD, F., PREECE, R., TASKE, N.,
KELLY, M.P.(2011) NICE’s Guidance on long term
sickness and incapacity, British Journal of General
Practice, 61: 206-7. British Journal of General Practice
2011; DOI: 10.3399/bjgp11X561221.