Published: 11/11/2004, Volume II4, No. 5931 Page 3

All NHS frontline staff will be instructed to undergo training to ensure every contact with a patient is used to promote healthy living, the public health white paper will announce.

HSJ understands that one chapter of the public health white paper, due out next week, will focus on the responsibilities of the NHS both in improving the health of the nation and as a 'model employer' of 1.3 million staff.

All staff will be told to take part in a newly devised 'health improvement curriculum' which will train them in how to use every contact with patients to push public health messages and make interventions.

The NHS workforce strategy, due to be published next year by the Department of Health and NHS Confederation's employers' organisation, will set out the responsibilities of the health service, as Europe's largest employer, to improve the health of its own staff.

The white paper, which is likely to emerge on Tuesday, will also call on the NHS's nine national clinical directors to re-evaluate all the current national service frameworks in the light of the new policy direction.

The 'czars' will be asked to redraft the NSFs by spring 2005 to ensure they 'provide comprehensive integrated health promotion' in their clinical areas.

The white paper will stress that the public has called for the NHS to take a lead in public health.

It will say there are three key ways the health service can demonstrate this: by using the million contacts with patients each year as 'opportunities for improving health promotion'; by ensuring primary care trusts serve the particular needs of disadvantaged groups; and by adopting a 'systematic and determined' approach to public health interventions, via improved staff training.

As HSJ went to press, discussions were understood to be continuing within government about the most controversial elements of the white paper: action to restrict smoking in enclosed places, food labelling and advertising of junk food.

Yesterday, Scottish first minister Jack McConnell was due to announce a ban on smoking in all workplaces, enforceable with fines of up to£3,600 for publicans and restaurant owners who repeatedly flout restrictions.

In England, health secretary John Reid has made clear his opposition to such a ban. The main compromise option under discussion is changes to licensing laws so that pubs and restaurants would need to prove staff and vulnerable groups - such as children - were not being put at risk.

On advertising, the government looks likely to withdraw lucrative government contracts with agencies that also produce junk-food advertisements heavily targeted at children. A traffic-light labelling scheme to categorise the health value of different foods has also been mooted.

For full coverage of the public health white paper, see next week's HSJ.