4 Implementation

This section highlights 3 areas of the guideline that were identified as a focus for implementation. It outlines possible activities and also gives information on resources or practical examples that could support implementation.

Approaches in different settings

All messages conveyed should be in line with 'supporting information for practitioners' (see section 2).

Managers and practitioners with a duty of care

Managers and health, public health and social care practitioners who have a duty of care for others (for example, in the workplace, education, or residential or day care settings) could develop a policy to address the risks and benefits of sunlight exposure. This could:

  • Outline the benefits of such a policy. For example, in the case of employers this could be fewer days absence because of sunburn or other adverse effects (Sun protection: advice for employers of outdoor workers Health and Safety Executive).

  • Cover the needs of all at‑risk groups (see recommendation 1.1.1).

  • Tailor advice according to skin type and age.

  • Tailor advice according to needs and circumstances. This includes people for whom English is not a first language, from lower socioeconomic groups, with specific cultural needs, or with a disability.

  • Encourage people to manage their own risk, for example, by covering up with suitable clothing or seeking shade.

The policy could also state that sun‑awareness information should:

  • Help people and their carers identify their own potential risks and benefits from sunlight exposure and the protective measures they should take.

  • Adopt a balanced approach and avoid scaremongering.

  • Be conveyed using a range of approaches, for example, one‑to‑one as well as in groups.

  • Be clearly displayed in communal locations including pharmacies, airports, schools, travel vaccination clinics and appropriate leisure and sporting events.

  • Be available in a variety of formats, including formats that are suitable for people with a disability.

  • Use skin‑type charts. A range of charts are available, such as those produced by Cancer Research UK and the British Association of Dermatologists.

Early years, education and leisure

Managers and staff in early years, education and leisure environments could develop a policy on how to protect children and young people's skin when they are outside for more than a brief period in strong sunlight. This includes those working in preschool settings, primary and secondary schools.

A comprehensive policy would:

  • Encourage children and young people to cover up with suitable clothing (including a wide‑brimmed hat), to spend time in the shade and to wear sunscreen to protect themselves when the sun is strong.

  • Encourage parents and carers to provide children and young people with suitable clothing, as well as sunscreen. Make it clear that spending time in the shade and wearing suitable clothing are as important as using sunscreen.

  • Be consistent with child protection and safeguarding policies, for example, by specifying who should help children and young people cover up with suitable clothing or apply sunscreen, and when.

  • Outline the need to take children and young people's individual characteristics, for example, their skin type, into account. A range of charts are available, such as those produced by Cancer Research UK or and the British Association of Dermatologists.

  • Raise awareness of the risks and benefits of sunlight exposure among children and young people, their parents and carers. For example, by making it clear that children and young people should never be allowed to burn and should be made aware of how important it is to protect their skin.

  • Provide children and young people, their parents and carers with timely information (for example, during the spring and summer holiday season) on the risks and benefits of sunlight exposure in play and leisure environments. For detail on how the information should be displayed see recommendations 1.1.8 to 1.1.13.

Managers and staff might also want to think about using practical, classroom‑based activities, for example, in personal, social, health and education lessons covering health or diversity. A range of organisations provide information for schools, such as Cancer Research UK and the PSHE Association.

Workplaces

Employers, managers and relevant practitioners in the public, private, voluntary and community sectors could:

  • Implement a policy on sunlight exposure to help meet their responsibilities under the Health and Safety at Work Act. Note: sunlight exposure is an occupational hazard for people working outdoors.

  • Incorporate information on sunlight exposure into routine practice and health and safety training.

  • Provide advice according to people's occupation and role.

  • Train employees to understand the risks and benefits of sunlight exposure and encourage basic self‑checks for mole or skin changes.

  • Use existing resources for the target audience where available. For example, the Institution of Occupational Safety and Health has developed a sun‑safety film for construction workers.

Residential and day care services

Managers and practitioners who work in residential or day care settings could:

  • Develop, implement and monitor activities to address the risks and benefits of sunlight exposure.

  • Provide advice to children, young people, adults and their carers on protecting their skin and enjoying the sun safely.

  • Provide advice on vitamin D supplements as necessary (see NICE's guideline on vitamin D: increasing supplement use among at-risk groups.)

Training

Health Education England, Public Health England, clinical commissioning groups and local authorities could work together to consider the training needs of health, public health and social care practitioners in relation to sun exposure. This could be part of their registration and post‑registration training and continuing professional development. Training could cover:

  • The health risks and benefits of sunlight exposure. This includes the impact of a range of variables including environmental, biological and behavioural factors (see section 2).

  • The importance of conveying consistent, tailored messages to the public (see section 2).

Evaluation

Public Health England and directors of public health could:

  • Evaluate policies, strategies and media campaigns (local and national) to protect the public from over‑ or underexposure to sunlight. This includes the effect of both one‑to‑one and group‑based prevention activities. This could be done by working with commissioners and senior managers in local authorities and the NHS, council leaders, elected members, public health teams, local businesses and voluntary and community organisations.

  • Use a range of measures of knowledge, attitudes, awareness and behaviour (see NICE's guideline on behaviour change: general approaches).

Need more help?

Further resources are available from NICE that may help to support implementation:

Other guidance and policies

The guideline should be implemented alongside other guidance and regulations:

  • National Institute for Health and Care Excellence (NICE)