The results demonstrated that food supply interventions to promote nutrition across all domains of the school environment can be implemented successfully.

Objective: The present paper reports on a quality improvement activity examining implementation of A Better Choice Healthy Food and Drink Supply Strategy for Queensland Health Facilities (A Better Choice). A Better Choice is a policy to increase supply and promotion of healthy foods and drinks and decrease supply and promotion of energy-dense, nutrient-poor choices in all food supply areas including food outlets, staff dining rooms, vending machines, tea trolleys, coffee carts, leased premises, catering, fundraising, promotion and advertising. Design: An online survey targeted 278 facility managers to collect self-reported quantitative and qualitative data. Telephone interviews were sought concurrently with the twenty-five A Better Choice district contact officers to gather qualitative information. Setting: Public sector-owned and -operated health facilities in Queensland, Australia. Subjects: One hundred and thirty-four facility managers and twenty-four district contact officers participated with response rates of 48?2 % and 96?0 %, respectively. Results: Of facility managers, 78?4 % reported implementation of more than half of the A Better Choice requirements including 24?6 % who reported full strategy implementation. Reported implementation was highest in food outlets, staff dining rooms, tea trolleys, coffee carts, internal catering and drink vending machines. Reported implementation was more problematic in snack vending machines, external catering, leased premises and fundraising. Conclusions: Despite methodological challenges, the study suggests that policy approaches to improve the food and drink supply can be implemented successfully in public-sector health facilities, although results can be limited in some areas. A Better Choice may provide a model for improving food supply in other health and workplace settings. Keywords Food supply Hospitals Health centres Health facilities Obesity AustraliaAt the time of the present study (2009), Queensland Health provided a range of services for 4?33 million people through fifteen Health Service Districts across the state (1,2) . Queensland has an area of 1?73 million square kilometres, which makes it the second largest state in Australia and approximately seven times the size of Great Britain (3) . More than 50 % of Queensland's population lives in regional and remote areas outside the greater metropolitan area of Brisbane; it is the most decentralised state in Australia (3) . There were 67 947 full-time equivalent employees in Queensland Health, which represented approximately one-third of the Queensland public-sector workforce (4) .Queensland Health has a clear leadership role in promoting healthy lifestyles throughout the state and this is increasingly important with the rising prevalence of lifestyle-related chronic disease (5) . The most recent data in Queensland indicate that at least 16 % of the total disease burden is due to measurable risk factors with dietary determinants (high blood pressure, high cholesterol, overweight and obesity, and low fru...

BackgroundIt is recognised within palliative care (PC) that Band 6 Clinical Nurse Specialists (CNS) are working in a time of organisational change with increasing complexity around their specialist role (NHS Education for Scotland 2006). CNSs, in particular newly appointed staff, have reported feeling more vulnerable and stressed and struggling to cope to deliver the same quality of care to patients and their families. To support the above scenario an NHSGGC PC Leadership Steering Group was established in partnership with NES Leadership Unit.Aims• Provide a safe space for participants to share and learn from each other• Provide a training programme which embeds the values, behaviours and attitudes of leadership skills• Provide a foundation to support greater successional planning throughout palliative care (Scottish Government, 2013; Scottish Government, 2015)• Increase participants’ knowledge and understanding of quality improvement (QI) methodology supporting individual QI action plans.MethodsThe development of a 12 month leadership programme based on needs of the participants, open to all Band 6 PC CNSs working within NHSGGC acute and hospice care settings, was established. The programme includes a leadership resource folder, ongoing staff support, feedback to participants utilising 360 degree review and Myers Briggs, provision of mentoring and action learning sets and evaluation process.ResultsInterim feedback to date 10 CNSs signed up. To date participants have attended a launch day and two masterclasses held on: Understanding Myers Briggs and working with differences; Understanding Quality Improvement methodology.All participants have received ‘360 review process’ feedback based on the NHS Scotland Leadership Qualities Framework helping to inform their PDP. All have participated in an action learning set. Three further masterclasses are built around learning needs of the cohort.ConclusionFeedback to date has highlighted the importance of this programme in addressing a need, focusing on developing leadership skills for a capable, sustainable workforce. Further evaluation is embedded within this programme.