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Publication: Promoting physical activity in the workplace

Source: Excerpts from the publication “Promoting physical activity in the workplace”
NICE guidelines [PH13] Published date: May 2008
The publication in its entirety can be viewed at http://pathways.nice.org.uk/pathways/physical-activity
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This document constitutes the Institute's formal guidance on how to encourage employees to be physically active.

Many employers recognise that they have an obligation to the health and wellbeing of their workforce. Investing in the health of employees can also bring business benefits such as reduced sickness absence, increased loyalty and better staff retention.

These recommendations aim to help employers and workplace health professionals prevent the diseases associated with a lack of physical activity. The recommendations alone will not reverse the current obesity epidemic or other health trends associated with a sedentary lifestyle. However, efforts made in the workplace, alongside wider strategies to increase physical activity levels, could help improve people's health significantly.

Recommendation 1: policy and planning

Who should take action?

  • Employers in organisations of all sizes (in larger organisations this might include their representatives, for example, human resources [HR] directors and senior managers).
  • Public health professionals, occupational health professionals, workplace health promoters.
  • Trades unions, other employee representatives, employees.

What action should they take?

Develop an organisation-wide plan or policy to encourage and support employees to be more physically active.

This should:

  • include measures to maximise the opportunity for all employees to participate
  • be based on consultation with staff and should ensure they are involved in planning and design, as well as monitoring activities, on an ongoing basis
  • be supported by management and have dedicated resources
  • set organisational goals and be linked to other relevant internal policies (for example, on alcohol, smoking, occupational health and safety, flexible working or travel)
  • link to relevant national and local policies (for example, on health or transport).

Recommendation 2: implementing a physical activity programme

Who should take action?

Employers in organisations of all sizes (in larger organisations this might include their representatives, for example, HR directors and senior managers).

Public health professionals, occupational health professionals, workplace health promoters.

Trades unions, other employee representatives, employees.
What action should they take?
Introduce and monitor an organisation-wide, multi-component programme to encourage and support employees to be physically active. This could be part of a broader programme to improve health. It could include:

  • flexible working policies and incentive schemes
  • policies to encourage employees to walk, cycle or use other modes of transport involving physical activity (to travel to and from work and as part of their working day)
  • the dissemination of information (including written information) on how to be more physically active and on the health benefits of such activity. This could include information on local opportunities to be physically active (both within and outside the workplace) tailored to meet specific needs, for example, the needs of shift workers
  • ongoing advice and support to help people plan how they are going to increase their levels of physical activity
  • the offer of a confidential, independent health check administered by a suitably qualified practitioner and focused on physical activity.

Recommendation 3: components of the physical activity programme

Who should take action?

Employers in organisations of all sizes (in larger organisations this might include their representatives, for example, HR directors and senior managers).

People responsible for buildings and facilities.

Public health professionals, occupational health professionals, workplace health promoters.

Trades unions, other employee representatives, employees.

What action should they take?

Encourage employees to walk, cycle or use another mode of transport involving physical activity to travel part or all of the way to and from work (for example, by developing a travel plan).

Help employees to be physically active during the working day by:

  • where possible, encouraging them to move around more at work (for example, by walking to external meetings)
  • putting up signs at strategic points and distributing written information to encourage them to use the stairs rather than lifts if they can
  • providing information about walking and cycling routes and encouraging them to take short walks during work breaks
  • encouraging them to set goals on how far they walk and cycle and to monitor the distances they cover.
  • Take account of the nature of the work and any health and safety issues. For example, many people already walk long distances during the working day, while those involved in shift work may be vulnerable if walking home alone at night.

Recommendation 4: supporting employers

Who should take action?

Directors of public health, public health practitioners in the statutory and voluntary sectors.

Local strategic partnerships.

Private, statutory and voluntary organisations with responsibility for increasing physical activity levels or for occupational health.

Trades unions, business federations, chambers of commerce.

What action should they take?

Offer support to employers who want to implement this guidance to encourage their employees to be more physically active. Where appropriate and feasible, this should be provided on the employer's premises. It could involve providing information on, or links to, local resources. It could also involve providing advice and other information or resources (for example, the services of physical activity experts).

2. Public health need and practice

There is increasing recognition of the need to encourage healthier lifestyles and the government has set specific targets to increase physical activity levels (Department of Culture, Media and Sport 2002; DH 2004; Health Development Agency 2004; House of Commons Health Committee 2004; Wanless 2004).
Physical activity is essential for good health (DH 2004). Increasing activity levels will help prevent and manage over 20 conditions and diseases including cancer, coronary heart disease, diabetes and obesity. It can also help to promote mental wellbeing (DH 2004; Pate et al. 1995). Physically active employees are less likely to suffer from major health problems, less likely to take sickness leave and less likely to have an accident at work (Dishman et al. 1998).

Around 65% of men and 76% of women aged over 16 are not physically active enough to meet the current national recommendations (that is, they spend less than 30 minutes on 5 or more days a week involved in at least moderately intense activities). Physical activity levels vary according to age and gender. Women tend to be less physically active than men, and older people tend to be less physically active than younger people. Levels also vary according to socioeconomic class and ethnicity, although these relationships appear to be complex (Joint Health Surveys Unit 2004).

Trends highlighted by health surveys undertaken in England in 1997, 1998, 2003 and 2004 found a small increase in physical activity levels between 1997 and 2004. However, national travel surveys show that the average distance people walk and cycle has declined significantly in the last three decades (National Statistics 2004).

The cost of physical inactivity in England, including the direct costs of treatment for major lifestyle-related diseases and the indirect costs caused through sickness absence, has been estimated at £8.2 billion a year (DH 2004).

Sickness absence

In the fiscal year 2005–2006, an estimated 30.5 million working days were lost as a result of work-related illnesses and injuries. On average, each sick person took 16 days off work in that 12-month period. Mental health problems (stress, depression or anxiety) and musculoskeletal disorders accounted for the majority of working days lost, leading to an estimated 10.5 million and 9.5 million days off work (full-day equivalent) respectively (Health and Safety Executive 2007). (The incidence of stress, depression or anxiety and musculoskeletal disorders can be reduced by physical activity.)

Government policy

The government aims to promote health at work by 'improving working conditions to reduce the causes of ill health related to work, and promoting the work environment as a source of better health' (DH 2004). In addition, by 2010, its 'Government setting an example' programme aims to reduce by 30% the number of working days lost through accidents and cases of ill health in the civil service and the rest of the public sector (Health and Safety Executive 2005).

In the wider context, 'Revitalising health and safety strategy' (Department for Environment, Transport and the Regions 2000) sets national targets to be achieved by 2010. These are to reduce:

  • by 10% the rate of fatal and major injury accidents
  • by 20% cases of work-related ill health
  • by 30% the number of working days lost per worker as a result of work-related injury and ill health.
    Increasing national physical activity levels is also central to:
  • national service frameworks (NSFs) on coronary heart disease, diabetes, mental health, older people and long-term conditions

It is also relevant to Healthcare Commission targets, local area agreements and local delivery plans.

The guidance

This guidance considers workplace-based policies and initiatives that aim to increase employees' physical activity levels and are applicable in England. It also considers similar initiatives outside the workplace that are initiated or endorsed by employers. It covers all employed adults including volunteers, subcontractors and temporary staff. It is not aimed at people who are self-employed.

3. Considerations

PHIAC took account of a number of factors and issues in making the recommendations.

General

3.1 Physical activity is influenced by a range of factors associated with individuals, workplaces and the wider environment. This guidance can only be one element of a broader strategy to increase physical activity.

3.2 The guidance needs to be considered within the context of a range of public health issues, including the high and increasing levels of overweight and obesity. It was noted that physical activity is an important way of helping maintain weight loss over several months or years. The Chief Medical Officer's report on physical activity (DH 2004) noted that: 'all substantial movement of body weight – such as steps walked per day, or stair climbing – contributes to energy expenditure and may help with weight management. People who need to avoid weight gain should reduce the amount of time they spend inactive'.

3.3 It is unrealistic to assume that a one-off intervention can be 'life changing', so PHIAC considers it important to provide ongoing interventions, support and encouragement.

3.4 PHIAC also considered whether some interventions may cause some individuals harm by reinforcing their determination to avoid being physically active.

3.5 Small and medium-sized organisations may have different needs from those of large organisations. PHIAC has tried to ensure the recommendations can be tailored to make them relevant to all business practices.

3.6 PHIAC recognised the importance of workplace ethos and the need for employers to lead efforts to promote and support initiatives to increase physical activity levels in the workplace.

3.7 There are particularly close links between this guidance and the guidance on 'Promoting and creating built or natural environments that encourage and support physical activity' (NICE public health guidance 8).

3.8 If an intervention is not included in the recommendations it does not necessarily mean it should be stopped. These recommendations are based on the available evidence and not all interventions may have been evaluated.

Benefits to employers and the NHS

3.9 Increasing employee's physical activity levels may help reduce some illnesses and conditions that are important causes of sickness absence, resulting in improved productivity and reduced costs for employers.
3.10 The economic modelling used on the evidence is conservative and does not consider the long-term benefits of physical activity (such as the prevention of some cancers and other conditions), or the short-term benefits for people's mental wellbeing. The modelling is made difficult because many studies treat physical activity-related outcomes as permanent. However, assuming even modest uptake, the interventions in this guidance could be considered cost effective from an NHS perspective, and cost saving from an employer perspective, because they reduce absenteeism.

Equality issues

3.11 PHIAC considered the extent to which the recommendations could generally widen health inequalities, for example, by improving the health of the better off in society without improving the health of those who are worst off.

3.12 Increasing levels of physical activity in the workplace could have an impact on equality in the workplace, since not all employees may be able to participate in all the activities on offer (for example, shift workers or people with disabilities may be excluded from some activities). PHIAC emphasised the need to implement plans that give everyone an equal chance to improve their physical activity levels at work.




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