PUBLIC HEALTH

Published: 24/03/2005, Volume II5, No. 5947 Page 29

Answers to health problems look simple - eat less, exercise more, have safe sex, do not smoke, drink sensibly. But knowing is not doing.

Hospitals should be leading with strategies to tackle these problems, but have neglected their role.

In 2004, Bradford Teaching Hospitals foundation trust developed the UK's first public health strategy for an acute trust.

It covers three areas: creating a healthy place to work and visit, reducing inequalities, and partnerships and regeneration.

There are some simple steps trusts can take to improve health:

. Encourage staff to offer advice to all patients on smoking, healthy weight and physical exercise.

. Replace daytime television programmes in outpatient waiting areas with health promotion videos.

. Carry out an annual health survey to monitor lifestyle factors.

There are also specific actions on smoking, obesity and exercise.

Smoking: ban it on hospital grounds. Get staff to encourage patients (and colleagues) to seek help. Offer staff and patients free nicotine replacement therapy.

Obesity: provide nutritional meals and snacks to patients and staff.

Limit the sale of sugary drinks and make water free and accessible. Get UNICEF UK Baby Friendly accredited, and adopt best-practice baby milk standards, which should increase breastfeeding rates and reduce obesity in later life.

Exercise: create a path around the hospital with measures showing the distance covered and calories burned. Promote cycling and walking and penalise car parking to promote healthier transport.

Offer free pedometers to staff and patients.

In reducing inequalities, hospitals can play an important role through employment opportunities, promotion and training and development as well as through access to services. Measure your progress with health equality audits.

Support regeneration by buying locally. Target recruitment and training in areas of unemployment and adopt environmentally friendly purchasing, waste reduction and recycling policies.

John Wright is operations medical director for Bradford Teaching Hospitals Foundation trust and Jane West is a specialist trainee in public health at the trust John. wright@bradfordhospitals. nhs. uk