title: Implementing NICE obesity guidance for staff: an NHS trust audit.
abstract: BACKGROUND
  The UK National Institute of Health and Clinical Excellence (NICE) has produced guidelines (CG43) on preventing and managing overweight and obesity, which apply to the National Health Service (NHS) as an employer.
  
  
  OBJECTIVE
  To record in an NHS trust baseline assessment and management of obesity by its occupational health (OH) service staff, with reference to the standards in CG43, enabling deficiencies to be identified and improvements to be recommended as a benchmark for future measurement.
  
  
  METHODS
  Criteria relevant to OH in CG43 were identified and data were collected from trust policies, interviews with managers, questionnaires to OH staff, examination of OH resources and case notes of staff attending OH. Results were checked for compliance with CG43 standards.
  
  
  RESULTS
  Although the trust met NICE standards as an employer, significant lack of compliance was found in its OH service. Only 53% of staff attending medical examinations had weight recorded, OH resources were inadequate and 75% of its staff had received no training. Problems identified included lack of written guidance, time and care pathways. The resulting action plan included a consultant-led working party liaising with the trust's health and well-being committee, training, enhanced OH resources, an obesity protocol, a database and weight management clinics.
  
  
  CONCLUSIONS
  We found not only a lack of OH policy guidance but apparent inertia in dealing with obesity. The action plan demonstrated how OH clinical practice can draw upon CG43 to combat obesity in an NHS workforce.
authors.affiliation: Department of Occupational Health, University Hospitals of Morecambe Bay NHS Foundation Trust, Furness General Hospital, Dalton Lane, Barrow in Furness, Cumbria LA14 4LF, UK. mbdalton49@gmail.com.
authors.forename: M B
authors.initials: MB
authors.lastname: Dalton
mesh_terms: D006291:Health Policy / Q000639:trends*; D006801:Humans; D008485:Medical Audit; D009765:Obesity / Q000628:therapy*; D016272:Occupational Health; D013222:State Medicine / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Audit; NHS occupational health department; NICE; guidelines; obesity.