Let me start this piece by saying that I love the NHS, I currently work for it and my family have for many decades now. The constant media attacks and political dismantling sadden me greatly, the NHS is still one of the premier health care systems in the world and we should all remember this. We only need to look at America to see the dangers of the alternative route. Many people come up with their visions for the NHS, how to ‘save’ it, well here is mine.
Top down changes (read meddling) and political posturing hasn’t worked for the NHS, the answer, I believe, lies in investing in it’s staff. The strikes of last week show that all is not well within the hospitals and it is not just pay where staff are struggling. Obesity rates are higher within the NHS workforce than in the general population. This is a frankly shocking statistic yet shouldn’t be surprising when you look at the lifestyle of the average NHS worker: long hours, high job stress, no availability of healthy food and poor education around what constitutes healthy in the first place has led to wards full of nurses who would easily qualify for the NHS’s own obesity services.
This isn’t me pointing the finger of blame at such staff, far from it. They are the product of a broken system and in fact I applaud their efforts to continue to deliver a high standard of care despite the situation they find themselves in. Obesity is far from just a visual problem; try to imagine the difficulty of looking after a very sick patient, in a stressful environment with an expectant family relying on your expertise, whilst you are personally battling hunger, lethargy and brain fog. When we look at the situation from this angle do we think the answer to improved outcomes and patient care is changed protocols at a management level or by improving the health of individual staff. Regardless of weight we can improve attentiveness and cognitive performance through very simple dietary changes yet this factor is never considered. If you went to watch your favourite sports team and saw them snacking on a mars bar and a can of coke pre game you'd find that odd, yet you see it on a hospital ward and don't blink. Both the athlete and the nurse need to be able to perform at their best yet in only one of those situations lives are on the line...
Having worked in a hospital setting for some years now I witness many problems which would be so easy to fix yet no one else sees them. I attended a staff training session at the hospital’s development centre. The hub for staff training in the area. I was on the course with mainly nurses, all of which were visibly tired and drained having rushed there after a long shift with no lunch. During the tea break from training these hungry nurses visited the vending machine outside which was stocked entirely with crisps, chocolate bars and fizzy drinks. There wasn’t even water available. I took a photo of this and, as some may remember, tweeted it. Thankfully some water appeared there a few days later but it is still so far from an ideal. Imagine the performance levels of those nurses when they returned to the wards.
This is a complex issue spanning the entire NHS from staff training through to frontline service delivery. It is easy to poke holes but this is of little practical use. So what follows are my answers to these problems:
1. Revise the NHS standpoint on what constitutes healthy eating. This is, without doubt, the biggest stumbling block to progress. If the NHS doesn’t abandon the outdated and disproven dietary doctrine it still preaches then how does it expect to make meaningful change. Look at anyone that is objectively healthy and I will guarantee that they aren’t eating the diet that the NHS supports. Low fat, high carb is dead. Even a basic understanding of biology will allow you to see how a low carb approach works. It is time to adopt this. Fat is our friend!
2. Train staff to understand that their health will be compromised in their role and give them practical tools and knowledge to overcome this. In nurse training and such like there should be the acceptance that it will be difficult to remain a healthy weight and that eating conventionally is likely to land them in difficulty. There should be no hiding from this and this training can be given post qualification. It would be simple to provide workshops teaching practical solutions that could be implemented immediately and would give a discernible effect on staff performance. Coffee with coconut oil and cream mid shift could literally save lives! Hell I’ll offer trial workshops for free…
3. Realise that nutrition provided to staff on site is a priority. We are past the point now where food is just seen as ‘sustenance’ and a bit of stodge is ok to keep people running. It is abundantly clear that what goes into staff effects the quality of their work. Catering should not be delivered with cost in mind, quality has to be a priority, the savings will come from well nourished, productive staff. Healthy doesn’t mean boring salads, the lunchtime meal should be enjoyable and set you up for a productive afternoon.
4. Remove processed food from sites. It is human nature to look for the easiest source of calories when time is tight and energy is low. It is not good enough to make meek comments about providing ‘choice’ for staff when defending vending machines filled with rubbish. It is important that staff have an opportunity to pick up something on the go and it isn’t difficult to provide healthy options here. A vending machine filled with water, bags of nuts and bags of beef jerky is not a difficult thing to achieve yet could make a huge difference. Thankfully in my locality vending machines are the greatest source of this. Where hospitals have McDonalds on site the problem is of a far greater scale yet the answer is the same.
5. Make it a priority, see it as an opportunity. An issue like this needs buy in on all levels and in the world of social media it is much easier to spread the message that everyone is involved. The message needs to be framed as an opportunity for staff not as another policy to be implemented. It is a real opportunity for services now to become trail blazers and make a difference nationally as well as locally.
To my mind the above action points (number 1 aside) are not difficult to implement and should not be costly to do so either. The recommendations from Simon Stevens will not make a difference. Exercise isn’t the issue; I’ve had clients easily lose a stone and improve their functioning without any change in activity. Asking overworked and poorly nourished NHS staff to attend gym classes is only going to exacerbate the problem. As for slimming classes, you are asking staff to find an extra hour in their day to attend a service where no one benefits but the service’s shareholders. This idea is wholly typical of the government’s desire to jump into bed with private companies rather than tackle the real issues. The health of NHS staff can only be improved by looking at their working day and tweaking from there. It isn’t possible to bolt on a solution without tackling the problem.
I will be sharing this piece with NHS staff from all levels to get their opinions. If you have a theory on how to change this issue then please comment. If you work in an organisation and think that you could benefit from looking at some of these problems then please get in touch, as you can see I am passionate about this area and would love to help.