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12. Assessment of staff

Matter for discussion submitted by the RCN Cambridgeshire Branch

That RCN Congress discusses the introduction of an annual physical and psychological assessment for all staff

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Progress reports

Submitted by: Cambridgeshire Branch
Council lead and committee assigned: Cecilia Anim, Nursing Practice and Policy Committee
Committee decision: No work required
Members involved: None

Final summary update at May 2012

This Congress debate looked at the health and wellbeing of nursing staff and whether health assessments should be introduced.

As this was a matter for discussion it did not call for any specific action by the RCN. However, the RCN is already supporting work on this issue.

The RCN continues to support the work of RCN Fellow Dame Carol Black to implement the recommendations of the Boorman Review. The review examined the health and wellbeing of NHS staff and called for easier access to occupational health, better health-promoting activities and better line management.

The RCN supports the NHS health check which is available for NHS staff between the ages of 40 and 75, and the NHS online self-assessment health tools. The RCN continues to lobby for the NHS to be an exemplary employer in terms of working environment, healthy food/lifestyle choices, management systems and work-life balance.

Update at November 2012

For the reasons outlined below, no work is required going forward with this item.

There is a government Health Check already in place for those between 40-75  plus online self assessment health check tools available.

The RCN continues to support the work of Dame Carol Black FRCN, in implementing the recommendations of the Boorman Review ‘The Health and Wellbeing of NHS Staff’ for health of NHS workforce, calling for easier access to occupational health, better health promoting opportunities and better line management.

We also continue to support the call for better working environments, food choices and access to recreation along with a work life balance approach to health improvement, and to lobby for and promote the NHS as an exemplary employer.

This encompasses the provision of adequate and effective occupational health services, but also takes account of the wider determinants of health of staff, such as the working environment, healthy food / lifestyle choices, and taking account of management systems and work life balance. There is also a wide debate as to the efficacy of random health screening on healthy populations.

The above reasoning was communicated to the proposer, along with the following suggestion:

There is a wide debate as to the efficacy of random health screening on healthy populations, and so you may want to consider proposing at 2012 Congress, that RCN undertakes a literature review to determine the validity of offering annual health checks to all NHS staff.


Debate report

Claire Topham-Brown from the RCN Cambridgeshire branch asked Congress to discuss the proposal of an introduction of an annual physical and psychological assessment for staff. She said that currently health equipment is looked after more than staff and referenced Dr Steve Boorman’s review of NHS health and wellbeing which highlighted the need to protect the health of workers.

She said that stress is a growing issue, as she asked delegates to consider if and how this could be implemented, by whom and where the information would be stored. Claire reminded delegates of the importance of staff to employers: “Without us, they are nothing but a building and equipment.”

Delegates responding to this matter for discussion urged caution. An assessment could be used as a ‘stick to beat staff with’ under the sickness and absence policy, warned Douglas Lockhart. Bethann Siviter said it was difficult enough for disabled nurses to remain in employment and an assessment may cause concern for nursing staff.

Lesley Pallett, who works in the field of staff health and wellbeing, asked where the funding would come from. She advised that staff are already reluctant to approach occupational health departments which she said were underfunded and understaffed.  This view was echoed by Maura Buchanan who recommended that we should instead concentrate on ensuring the Boorman Review was implemented.

Sarah Briggs proposed that NHS staff should have their own appointments prioritised to ensure that employees were able to get back to work as soon as possible.


Providing generic health screening in the workplace is not a legal requirement, but there are obvious benefits to the early detection of potential problems and ‘at risk’ employees. Prevention of illness and early treatment is much less costly to employers in comparison to dealing with the issue once an employee is already on long term sick leave. The interim report of the Boorman Review (2008) identified clear links between staff health and wellbeing and the three dimensions of service quality - patient safety, patient experience, and the effectiveness of patient care.

Mental health and musculoskeletal disorders are primary causes of ill health and absence in the NHS workforce; a Department of Health report (2010) found higher rates for depression, anxiety and substance misuse in health professionals than any other groups of workers. Presenteeism – attending work when not well enough to do so – has also been identified as an issue within the nursing workforce (Boorman, 2009).

In its 2010 public health white paper, Health lives, healthy people, the new Coalition Government confirmed its support of the previous government’s scheme for free regular health checks for people aged 40 and over, and stated that employers can improve health outcomes for employees by recognising and responding to workforce health needs. The Government believes NHS organisations should lead by example – recommending the introduction of local health and wellbeing strategies in 2010/11 and the proactive improvement of the quality of, and access to, occupational health services.

The Department of Health has accepted the recommendations contained in the NHS health and wellbeing report (Boorman, 2009) – namely that NHS organisations should provide staff with health and wellbeing services centred on prevention of both work-related and lifestyle-influenced ill health, that are also fully aligned with wider public health policies and initiatives. It has also accepted the recommendation that trusts should institute arrangements to identify mental health issues affecting staff, ensuring these are tackled at an early stage before they become debilitating.

In Northern Ireland the Department of Health, Social Services and Public Safety (DHSSPS) Confidence in care programme is looking to modernise occupational health services for health and social care workers and implement Boorman’s recommendations. It is currently preparing a human resources strategy that will highlight how maintaining staff health, wellbeing, and safety is essential to improving organisational behaviours and performance.

The introduction of annual health checks for all NHS staff would improve the health and wellbeing of trust staff by increasing access to occupational services, delivering early detection of preventable disease and the more effective management of long term conditions. However, in its 2007 report the Disability Rights Commission identified health requirements for registration as being a barrier to people with impairments and long term conditions pursuing careers in a number of regulated professions. If used as a condition of continued employment, an annual ‘fitness test’ could impact negatively on disabled nurses or those with long-term conditions.

References and further reading

Boorman S (2009) NHS health and wellbeing: final report, Leeds: NHS Health and Wellbeing Review. Available at: www.nhshealthandwellbeing.org
(Accessed 3/2/11) (Web)
Department of Health (2010) Invisible patients:  report of the working group on the health of health professionals, London: DH. Available at: www.dh.gov.uk
(Accessed 3/2/11) (Web)

Disability Rights Commission (2007) Maintaining standards: promoting equality: professional regulation within nursing, teaching and social work and disabled people’s access to these professions, Stratford upon Avon: DRC. Available at: www.maintainingstandards.org (Accessed 3/2/11) (Web)