Prevention and health improvement are core business for the organisation (this section builds on the World Health Organisation’s (WHO) health promoting hospitals standards).


Area Core Principle Components
Strategic approach The organisation’s strategic and policy documents recognise prevention and health improvement as part of its core business. Prevention and health improvement principles and actions are embedded within its operational plan, strategies and policies.
  • The organisation identifies responsibilities for leadership, planning and implementation of prevention and health improvement activity
  • The organisation’s information systems allow information on needs, activity and outcomes related to prevention and health improvement to be recorded and collated
  • The organisation has clear monitoring and reporting arrangements for its prevention and health improvement work, with board-level accountability
and health
for patients
The organisation ensures that health professionals, in partnership with patients, systematically assess needs for prevention and health improvement activities as part of all patient pathways. Health professionals provide patients with information, advice and onward referral as appropriate and available, based on the findings of the assessment.
  • The organisation ensures that all patients have opportunities to assess their need for prevention and health improvement
  • The patient’s needs assessment reflects information available from others, including other professionals and the patient’s family/carer, and ensures sensitivity to social and cultural background
  • Prevention and health improvement work with patients is embedded in patient pathways through approaches such as MECC, and identifies and makes use of 'teachable moments' during a patient's ongoing care
  • Frontline staff have access to training and resources to enable them to assess and provide support to patients around prevention and health improvement
  • The organisation works with partners to identify needs for and promote access to health improvement interventions for patients who need them
Workforce health The organisation actively promotes the mental and physical health and wellbeing of its staff.
  • The organisation provides staff with information about healthy lifestyles
  • Staff have access to opportunities to support a healthier lifestyle which enables them to act as positive role models for patients
  • The organisation systematically identifies and tackles workplace stress and any staff concerns about mental health
  • Staff views are taken into account in developing all workforce health activities
  • The organisation’s occupational health service provides accessible support and advice on work-related health for staff, and also supports the organisation’s work on promoting staff health and protecting staff from work-related injury, infection and ill health
Promoting a healthy environment  The organisation promotes a healthy and safe working and service delivery environment.
  • Healthy food and drink options are available for patients and staff, including out-of-hours
  • The organisation promotes a smoke-free environment, linked to support to stop smoking for patients and staff who need it
  • The organisation ensures a safe workplace and protects staff from potential hazards and risks to their health
  • The organisation’s HR and employment policies promote staff health and wellbeing
Working with partners The organisation collaborates with partners on the planning and implementation of prevention and health improvement activities, based on a shared understanding of the needs of the local population.
  • The organisation develops approaches to prevention and health improvement jointly with partners, referring to national and local policy and priorities and contributing to the strategic objectives of the STP/ICS
  • The organisation shares information on health needs with partners to support the development of prevention and health improvement strategies, plans and interventions
  • The organisation draws on information from the wider health and care system such as JSNAs to inform its own work on prevention and health improvement
Specialist expertise in prevention
and health
The organisation has an identified source of specialist expertise and advice on prevention and health improvement.
  • There is at least one professional with appropriate specialist public health training and experience who provides the organisation with advice and when necessary leadership on prevention and health improvement
  • The professional is either directly employed by the organisation or has defined responsibility to work with the organisation while employed by another organisation such as PHE or the local authority


Case studies


Training and supporting hospital staff to intervene with patients with multiple unhealthy risk behaviours

Traditionally interventions to help people tackle unhealthy behaviours focus on single issues such as smoking, alcohol use or weight problems. However, many people have multiple risk behaviours and tackling one in isolation may increase other risks; for example when people stop smoking they may put on weight. In addition, it is often difficult to allocate staff time for training in separate lifestyle topics. Clinical and public health staff at Bolton NHS Foundation Trust designed a multiple unhealthy risk factors assessment form, covering up to six modifiable risk factors. A single-day training session was designed and delivered to equip staff with the knowledge and confidence to assess patients and complete a brief intervention for several modifiable behaviours in one go.


Training staff to deliver MECC enables them to have conversations about health behaviours

Making every contact count (MECC) enables staff to have conversations with service users and colleagues about their health-related behaviours. As a trust-wide initiative, MECC promotes an organisational culture of health improvement. Lancashire Health NHS Foundation Trust has been implementing MECC since 2015. An e-learning programme is available to all staff. It covers four key health-related behaviours (being tobacco free, low risk alcohol consumption, healthy diet and physical activity) giving staff the skills and knowledge to initiate health chats. Evaluation of the training indicated not all staff saw MECC conversations as being relevant to their role. It also demonstrated significant gains in staff’s knowledge, confidence and skills as well as awareness of their own health related behaviours. There are now around 17,000 MECC conversations taking place across the trust each month.