Public health guidelines - promoting healthier places

NICE public health guidance can be used to help prevent the spread of disease, tackle health inequalities and improve population health.

This year we published guidance to help the NHS, local government, the public, voluntary and private sector improve health and wellbeing in the communities people live, work and enjoy their free time in.

Improving health and wellbeing in the workplace

Our June 2015 guideline on workplace health called on managers and employers to address the effect of poor working environments on people’s lives. Each year more than a million working people in the UK experience a work-related illness. This leads to around 27 million lost working days costing the economy an estimated £13.4 billion.

The guidance provides advice on creating positive working environments that respect work life balance and encourage creativity. It emphasises the role senior leaders can play in challenging behaviour and actions that are harmful to the health and wellbeing of staff. Positive and flexible styles of management are also recommended to give people control over working patterns and freedom to explore opportunities that may come their way.

Supporting the guidance, NHS England Chief Executive, Simon Stevens, who has recently launched a £5 million plan to improve the health of NHS staff, said:

“Health-promoting workplaces are obviously good for millions of employees and ultimately for taxpayers too, so the time is right for all employers – including the NHS – to raise our game.”

Professor Dame Carol Black, the Department of Health’s Expert Advisor on Health and Work, said the guidance could have a positive, long lasting effect on the workplace.

“When its influence eventually comes to be measured – in terms of the quality of service and product, workplace efficiency and productivity, and staff morale – this new guidance from NICE might well prove to be the most significant ever.”

Bringing communities together to reduce health inequalities

More recently, our March 2016 guideline on community engagement sets out ways local authorities and health bodies can meet statutory obligations to deliver effective community engagement.

Good public health needs to be rooted in strong, well connected communities that feel a part of improving their health and wellbeing.

The NICE guidance highlights how local government and the NHS can work with other partners to enable more joined up communities; making it as easy as possible for people to get involved and, crucially, ensuring that local needs are understood and represented.

This way the public can feel confident that health and care priorities are reflected in any plans to tackle health inequalities.

The guideline was welcomed by Public Health England and seeks to complement the work already being done to build resilient communities that give people the space to develop public health solutions and have a greater say over their health and wellbeing.

Enjoying the sun safely

In February 2016 published guidance on the risks and benefits of sunlight exposure. Skin cancer incidence rates have increased rapidly in England in the past 30 years and studies show that people need to be frequently reminded to protect themselves from over exposure to the sun.

High risk groups such as people with lighter skin, those who work and enjoy leisure time outdoors and those who holiday in sunny countries need advice on the dangers of skin damage and overexposure. On the other hand people who cover up for cultural reasons, are housebound or are otherwise indoors for long periods of time are all at higher risk of low vitamin D levels, which can cause problems with bone and muscle health such as rickets.

The guideline focuses on the need to weigh up these risks and benefits and highlights the challenge in communicating this to the public. It features recommendations for healthcare professionals to offer tailored advice that takes into account an individual’s level of risk.

It also recommends national and local campaigns to emphasise how the risks and benefits of sunlight can depend on individual behaviour, geographical location, time and day of the year, weather conditions and natural skin colour. It suggests that the messages could be part of existing national and local health promotion campaigns.

Professor Gillian Leng said:

“Our recommendations will help tailor public health activities focused on those groups most at risk from over or under exposure to sunlight. They will ensure that all activities and campaigns take a balanced, consistent and effective approach, and ultimately make the sun more friend than foe.”

A city wide strategy to tackle health inequality

In March 2016, Coventry City Council won the NICE Public Health category at the Local Government Chronicle (LGC) awards for its work to reduce health inequalities across the city.

The city was one of seven in the UK to become a ‘Marmot City’ in 2013. Across the city, all relevant organisations, including the council, the Clinical Commissioning Group (CCG), the voluntary and community sector, the fire and police services have made a commitment to implementing the six policy objectives of Professor Michael Marmot’s report on health inequalities, ‘Fair Society, Healthy Lives’.

Since 2013, the life expectancy gap in Coventry between the most affluent and most deprived has narrowed and there have been improvements in educational development, health outcomes, life satisfaction and employment, and reductions in crime in priority locations. Evidence based solutions lie at the heart of the council’s strategy to deliver on the six Marmot policies.

Commenting on the award work, the NICE judges said: “Coventry showed clear and straightforward connections between the strategic priorities of the Council, the focus of their Health and Wellbeing Strategy and the development and delivery of community initiatives to promote real improvement in the public’s health and the socio-economic climate of the city.

Councillor Karmran Caan, Cabinet Member for Health and Adult Services said, “We are committed to improving the life chances of every person in our city and we want to raise the profile of Coventry as an exemplar city for reducing health inequalities.

“We have an excellent team working hard to deliver this programme and we are thrilled and honoured to receive this award”.