Published: 01/04/2004, Volume II4, No. 5899 Page 9

New NHS employees could be subject to a series of health and fitness tests before they are given permanent employment contracts, according to draft Department of Health proposals under discussion by ministers.

A paper leaked to HSJ says that new employees should be subject to tests and given 'enforced support' on initiatives such as smoking cessation and weight loss in order to 'maximise the role of Europe's largest employer in improving public health'.

If the plan goes ahead, potential NHS staff and those moving post could be tested on their use of drugs and alcohol, and would be assessed against standards of nutrition and sexual health. Those failing to meet DoH 'core health improvement standards' - including a body mass index (BMI) of 25 or less - would have to sign up to dietary and smoking-cessation programmes before permanent contracts could be signed.

The working party was set up to consider how best to engage the public in reducing health inequalities ahead of the white paper on public health, expected this summer. And the document, which is with ministers, admits 'we have gone beyond our remit to tackle not just the challenge of public engagement, but how best to use the NHS's role as an employer to influence health trends'.

An HSJ source said public health minister Melanie Johnson was understood to be 'seriously considering the idea in some form'.

Under the proposals, staff progress against key health targets on BMI and weekly alcohol consumption would be assessed as part of the annual staff appraisal process.

Acknowledging the sensitive nature of the proposals, working party chair Dr Palif Loor recommends that the scheme should be 'piloted and its introduction phased'.

In particular, he suggests the new consultant contract and Agenda for Change system should be given time to bed down before any proposals on employee health assessments are publicly mooted.

Acknowledging that the prospect of testing would 'undoubtedly concern' some NHS staff and unions, the paper says the 'communications role will be central to the delivery of the initiative'.

It suggests that senior NHS managers should take a 'leadership role in endorsing and championing the scheme' by 'going public' on their own progress against personal health challenges in areas such as obesity, and alcohol consumption.

Unlike the Commission for Health Improvement, the Heatlthcare Commission is responsible for public health, and could include staff-wide health improvements in future ratings.

UK Public Health Association chair Dr Geof Rayer, said: 'I would be delighted if this was introduced. If people are going to give advice, then It is a case of first of all physician health thyself.'