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Views And Reviews Acute Perspective

David Oliver: Doughnut deliveries, hospital staff, and the pandemic

BMJ 2020; 369 doi: (Published 27 May 2020) Cite this as: BMJ 2020;369:m2042

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Rapid Response:

NHS staff: in the future we need to promote their health

Dear Editor
We are pleased that during this pandemic NHS staff are being appreciated by members of the public, local shops and food companies.(1) Oliver mentions clapping and gifts including food that are being provided as indications of support.(1) However when this pandemic is over we would like to see a more structured and long term approach to supporting staff.

We recommend that there is a paradigm shift in our thinking about hospitals so that health promoting hospitals are created.(2-6) They would have as one of their key aims to maintain and promote the health of staff. This is particularly relevant now as many staff do not have the time or supportive environment to make their own health and well-being a high priority. Many are currently working under considerable pressure, very long hours and stressful conditions.

Although in general it is nurses and doctors that are mainly covered in the media, we feel that there are others including catering, cleaning and administration staff who deserve far more appreciation many of whom are on relatively low incomes. These skilled and dedicated staff are essential to the smooth running of the NHS and positive patient experiences. A health promoting hospital should be a healthy place to work for all.

Throughout the country there are examples of public health interventions in some hospitals to maintain and promote the health of staff, however most of these are small-scale. We would like to see far more opportunities for low cost healthy food options available to staff so that the environment certainly would not be described as obesogenic.(7) There should also be exercise and relaxation facilities on site. Linked to this is the need for greater support and encouragement for active travel particularly in relation to cycling. A crucial issue is, however, that staff need time to participate in some of these initiatives.

Local authority public health personnel have the knowledge and skills to be able to support the creation of health promoting hospitals. Resources will be needed to enable them to undertake this work in a comprehensive and systematic way.(8-11) Adequate long-term funding is a pivotal issue and strong government support will be needed if this is to be a success. In the long-term health promoting hospitals will have benefits for staff, patients and the local community.

1) Oliver D. ACUTE PERSPECTIVE. David Oliver: Doughnut deliveries, hospital staff, and the pandemic BMJ 2020;369:m2042

2) Poland B, Green L and Rootman I (eds) Settings for Health Promotion. London: Sage Publications, 2000.

3) Tones K and Tilford S. Health promotion: effectiveness, efficiency and equity. Cheltenham: Nelson Thornes, 2001.

4) Watson, M. Going for gold: the health promoting general practice. Quality in Primary Care. 2008; 16:177-185.

5)Yaghoubi M, Karamali M, Bahadori M, Effective factors in implementation and development of health promoting hospitals: a systematic review, Health Promotion International. 2019, 34(4): 811–823.

6) Watson M C and Lloyd J. Health promoting hospitals – back to the future! British Medical Journal rapid response, 12th March 2020.

7) Watson M and Lloyd J, 2013 It’s time to ban junk food on hospital premises. BMJ Rapid Response 1st July 2013.

8) Watson M C and Lloyd J, 2016. Need for increased investment in public health BMJ 2016;352:i761.

9) BMA. Funding for ill-health prevention and public health in the UK. May 2017.

10) House of Commons Health Committee. Public health post-2013: second report of session 2016-17. House of Commons Paper No 140, 2016-17.

11) Watson M C and Thompson S, 2018. Government must get serious about prevention. BMJ 2018;360:k1279.

Competing interests: No competing interests

30 May 2020
Michael Craig Watson
Trustee, Institute of Health Promotion and Education.
Dr John Lloyd, Honorary Vice President, Institute of Health Promotion and Education.
Institute of Health Promotion and Education, PO Box 7409, Lichfield WS14 4LS, UK.