Making Every Contact CountUsing Every Opportunity to Deliver Brief Adviceto Improve Health and WellbeingImplementation Gui...
Welcome and IntroductionsProfessor David WalkerDirector of Public Health, NHS Midlands and EastExecutive Lead for Making E...
Our AmbitionsSir Neil McKayChief Executive, NHS Midlands and East
Why Make Every Contact Count?Dr Rashmi ShuklaRegional Director of Public Health, West MidlandsChair of MECC Steering Group
Case for MECC• Growing evidence base• Potential scale for impact• NHS as an exemplar for health
Risk Factors   80% of heart disease, stroke,   and type 2 diabetes cases and   33% of cancers could be   prevented by elim...
Global Economic Burden of NCDs:Lost output 2011-2025
Healthy Lifestyle Profile• Smoking: 19 to 22% of population smoke• Alcohol: 14.6 to 17.9 % drinking at increasing risk  wi...
Life Years gained from stopping smokingLifeyearsgained              Age smoking stopped (yrs)
Alcohol Harm reduction • Alcohol brief advice changes drinking behaviour of 1 in 8   people • For a PCT of 310,000 cost = ...
Health Benefits of Weight Lossof 10kg in 100kg subject Death:      20-25% decrease in premature mortality Diabetes:   50% ...
Survival in 20,244 healthy adultsaged 45-79 by health behaviours   Health Behaviours:                                     ...
Further Supporting Publications•   Securing Good Health for the Whole Population 2004, Sir Derek Wanless     •   Fully eng...
What do we mean by evidence basedpractice?   “the conscientious, explicit and judicious     use of current best evidence i...
Potential Scale of Impact across SHA Cluster• Over 280,000 staff• Millions of patient contacts a year in primary and  seco...
Who can Make Every Contact Count?Ashok SoniNHS Future Forum
What do Staff and Patients think aboutMaking Every Contact Count?Dr Simon HowProject Manager for Making Every Contact Count
Insight was gathered from nine organisationsacross the West Midlands, East Midlands andEast of England
Methodology 1Gathering insight• Researchers spent a day in each of the nine organisations interviewing 49 staff and 54  pa...
Methodology 2Patient interviews:• attitudes to healthy lifestyles advice• which staff groups• what would aid the conversat...
Key Themes•   Time•   Clinical vs. Non clinical•   Environment•   Effectiveness•   Staff behaviour•   Training
Appointments take 10-15 minutes      The NHS should give advicein which to diagnose, treat and      if they have time – bu...
I’d give advice if patients knewIf a porter gave me advice, I’d want   to expect it. They would need  a second opinion fro...
It would need to be               Yes and we have a Gregg’sdelivered one-to-one in a         onsite which doesnt doprivate...
If I was already thinking           It could work,about doing or changing             with the rightsomething, it might be...
Staff’s own lifestyles are Overweight people                 key. Enthusiastic ex-understand –‘I’ve tried          smokers...
We’d all need to            We know basic guidance but I’d be    have some formal              worried about saying the wr...
SUMMARY• MECC received positively by staff and patients• Need to create an environment in which it is  OK to ask for and g...
How to deliver Making Every Contact Count:The Implementation Guide and ToolkitDr Lola AbuduPublic Health ConsultantNHS Mid...
Introducing the ImplementationGuide and Toolkit
Background to Implementation Guide and ToolkitBuilding Blocks for „wider‟ public health workforce development    • 2005 - ...
The Power of MECC                    MECC is about encouraging people to                    make healthier choices to achi...
What does the Guidance Say?• Much more than training staff• Organisational development and  culture change• Led by staff w...
A Closer Look at The ToolkitContents• Foreword• Introduction• Section 1: What is MECC• Section 2: An overview of the evide...
The Implementation Process Not one size fits all but promotes key principles: •   Get Senior Managers on board and Champio...
Tools and Resources•   Implementation checklist•   Behaviour change pathway and competence mapping•   Example data capture...
What Next?• Supported implementation• TEST, LEARN & ADAPT the guidance and expand the  toolkit• Contribute to evidence base.
For further information contact: Elaine.varley@derbyshirecountypct.nhs.uk 07881837059 maureen.murfin@derbyshirecountypct.n...
Questions?
Refreshment Break
Making Every Contact Count In PracticeCase Study Examples
Making Every Contact Count atCambridge University HospitalNHS Foundation TrustBarbara Brafman-Price, Smoking Cessation Cli...
Addenbrooke‟s
Background• Cambridgeshire has a relatively healthy population,  smoking prevalence around 20%• How to increase Stop Smoki...
Making it happen: Early Critical Factors• Substantial organisational change is required to create a culture and  environme...
Making it happen!•   Developing a workforce to deliver and support behavioural change    -    Flexible, adaptable tailored...
Training• Flexible (delivered on the wards, mdt‟s, lunchtime  seminars, audit mornings)• Adaptable (time negotiable to fit...
What does it mean to be a Stop Smoking              Champion?
Developing the Infrastructure• An easy to use electronic referral system (less than a  minute to place a referral)• Assess...
Referral Process
Creating a supportive    environment
Corporate support is keyGareth Goodier and Pat Reid visit the team
Health Promotion events
What have we achieved?• Start date January 2010 (dedicated project coordinator  June ‟10)• 635 stop smoking referrals to d...
Challenges•   Competing priorities within the organisation•   Need for more robust data (Out of area patients)•   Resistan...
There is still work to be done
For further information contact: Val Thomas, Public Health Consultant ( NHS Cambridgeshire Val.Thomas@cambridgeshire.nhs.u...
Derbyshire Community HealthServices NHS Trust (DCHS)The DerbyshireHealth Promoting Workforce ProjectLinda SaxeWorkforce He...
The Derbyshire Health Promoting Workforce Project• Jointly funded collaboration with NHS Derbyshire County, Public  Health...
Over 5000 opportunities every day to do or say something that may help to improve someones             health and wellbein...
How do we start to            promote healthy lifestyle choices?1.   Getting staff to recognise those moments of engagemen...
Project Development• Steering Group• Developed with staff and patient engagement• Evaluated from the start with support fr...
Information Gained from Workshops• Lack of confidence, knowledge and training• Some services reported that they were promo...
Patient Public Involvement•   Seamless approach•   Consistency•   Attitude and expectation•   Proactive approach and follo...
Training•   Unique approach•   Working with two services•   Meeting with managers & team Leader•   Meet with team•   Facil...
Key outcomes•   Increased confidence and motivation•   Part of staff role•   Interest and understanding of Public Health/H...
The Way Forward•   Organisational vision•   Embedded into values and culture•   Users perspective•   Ongoing evaluation•  ...
For further information contact:   Linda Saxe   Workforce Health and Wellbeing Project Manager   linda.saxe@dchs.nhs.uk   ...
Public Health at BCH: Makingevery Contact CountSarah-Jane Marsh, Chief Executive
Context•Three years ago our staff told us they wanted to dothings differently•They wanted to create the conditions where t...
What did we do to prepare tomeet this objective?                       Commissioned a                       MBA student to...
We began to understand we’re ina unique position to create avirtuous circle                               Children come in...
So we started a journey…             Yesterday                             Today                                 Tomorrow•...
Integrating our work withMECC has created extra pull…Training•We have used MECC for ourstaff training, preferring face tof...
Conclusion•We’ve come an enormously long way inthe three years we’ve been doing publichealth campaigns at BCH•There’s a re...
Piloting the MECC Toolkit within a Mental               Health SettingDerbyshire Healthcare NHS Foundation TrustJulieann T...
Why we Chose to become a Pilot Site• The Mental Health Strategy “No Health without Mental  Health” (DoH, 2011), has a spec...
Killer Facts !• People experiencing severe mental health problems  face a greater risk developing physical ill health• 2 -...
The Pilot - What we were asked to do• Organisational readiness  (organisational assessment tool)• Staff readiness  (workfo...
Delivering the Pilot• The pilot ran from August -- December 2011• Settings:•    Morton Ward (acute in patient ward, Hartin...
How we delivered it 2 Step team approach:• Orientation session• Implementation session
Lessons Learned• Health Lifestyle behaviour change is a value based topic which  cannot simply be taught through a trainin...
Recommendations for taking MECC Forwards              • Delivering the Concept             • Embedding the Concept        ...
Delivering the ConceptRecognise the need to tailor the MECC message to address the needsof the team and consider the setti...
Embedding the ConceptRecognise that it is necessary to embed the principles withincurrent practices, using existing system...
Supporting the EmbeddingRecognise that resources will be needed & shared indelivering and embedding the philosophyFor exam...
Supporting Drivers• CQUIN L6b (From April 2012 - to develop an implementation  plan for MECC)• 4E committee addressing Hea...
Longer Term Developments• Service user empowerment - Peer advocacy• Developing a co-ordinated & well communicated network ...
For further information contact:Karen.wheeler@derbyshcft.nhs.ukJulieann.trembling@derbyshcft.nhs.uk
Moving ForwardMake Every Contact Count in your OrganisationProfessor David WalkerDirector of Public Health, NHS Midlands a...
• Training and Guidance   •   Implementation support coordination centre -   •   E- learning module – Every Contact Counts...
Questions?
MECC Guide and Toolkit Website:http://nhs.lc/makingeverycontactcountContacts:Simon How,MECC Project Managersimon.how@dh.gs...
Mecc launch 18 05 12
Mecc launch 18 05 12
Mecc launch 18 05 12
Mecc launch 18 05 12
Mecc launch 18 05 12
Mecc launch 18 05 12
Mecc launch 18 05 12
Mecc launch 18 05 12
Mecc launch 18 05 12
Upcoming SlideShare
Loading in …5
×

Mecc launch 18 05 12

1,219 views

Published on

Slides used by the presenters at the Making Every Contact Count Guide and Toolkit Launch event which took place on 18th May 2012

Published in: Sports, Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,219
On SlideShare
0
From Embeds
0
Number of Embeds
14
Actions
Shares
0
Downloads
8
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Mecc launch 18 05 12

  1. 1. Making Every Contact CountUsing Every Opportunity to Deliver Brief Adviceto Improve Health and WellbeingImplementation Guide and ToolkitLaunch Event18th May 2012Leicester Marriott Hotel
  2. 2. Welcome and IntroductionsProfessor David WalkerDirector of Public Health, NHS Midlands and EastExecutive Lead for Making Every Contact Count
  3. 3. Our AmbitionsSir Neil McKayChief Executive, NHS Midlands and East
  4. 4. Why Make Every Contact Count?Dr Rashmi ShuklaRegional Director of Public Health, West MidlandsChair of MECC Steering Group
  5. 5. Case for MECC• Growing evidence base• Potential scale for impact• NHS as an exemplar for health
  6. 6. Risk Factors 80% of heart disease, stroke, and type 2 diabetes cases and 33% of cancers could be prevented by eliminating tobacco and excessive alcohol, maintaining a healthy diet, physical activity WHO declared these as the main shared risk factors in the development of Long Term Conditions (LTCs) WHO. 2008. 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases
  7. 7. Global Economic Burden of NCDs:Lost output 2011-2025
  8. 8. Healthy Lifestyle Profile• Smoking: 19 to 22% of population smoke• Alcohol: 14.6 to 17.9 % drinking at increasing risk with 4.0% to 6.1% drinking at high risk levels• Physical activity: 61 % of men and 71% women do not meet recommended levels• Obesity: men 22% to 26%, women 24% to 28%• Healthy eating: 75% of men and 71% of women do not eat 5 pieces of fruit/veg a day
  9. 9. Life Years gained from stopping smokingLifeyearsgained Age smoking stopped (yrs)
  10. 10. Alcohol Harm reduction • Alcohol brief advice changes drinking behaviour of 1 in 8 people • For a PCT of 310,000 cost = £48,000 to deliver IBA to 10,000 increasing risk drinkers • 1,250 will change drinking behaviour • Resulting in reduced, acute admissions and A&E attendances • Estimated benefits to NHS = £126,000* • ROI = £2.60 back for every £1 spent * Based on DH ready reckoner v5.2
  11. 11. Health Benefits of Weight Lossof 10kg in 100kg subject Death: 20-25% decrease in premature mortality Diabetes: 50% decrease in risk of Type 2 DM 30-50% decrease in blood glucose Lipids: 10% decrease in total cholesterol 30% decrease in triglycerides Blood 10mmHg decrease in systolic BP pressure: 20mmHg decrease in diastolic BP
  12. 12. Survival in 20,244 healthy adultsaged 45-79 by health behaviours Health Behaviours: Number of • Non smoker Healthy 100 • Alcohol <14 units/wk behaviours • Not inactive • Blood vitamin C 90 % still alive >50 mol/l 4 (5 servings fruit and 3 vegetables daily) 80 2 Overall impact: 1 14 year difference in 70 0 life expectancy -2 0 2 4 6 8 10 12 Year of study Survival Function According to Number of Health Behaviours in Men and Women Aged 45–79 Years without Known Cardiovascular Disease or Cancer, Adjusted for Age, Sex, Body Mass Index and Social Class, EPIC-Norfolk 1993–2006 Khaw et al. PLoS Med 2008 Jan 8: 5 (1): e12 (EPIC-Norfolk prospective study
  13. 13. Further Supporting Publications• Securing Good Health for the Whole Population 2004, Sir Derek Wanless • Fully engaged scenario• High Quality Care for all: NHS Next Stage Review 2008, Lord Ara Darzi • Need to put prevention first• Fair Society, Healthy Lives: Strategic Report of Health Inequalities in England 2010, Sir Michael Marmot • Strengthen the role and impact of ill-health prevention• NHS Future Forum Report• NICE – Behaviour Change Guidance 2007• NICE – Smoking Cessation Services Guidance• SIPs (Institute of Psychiatry, Kings College, London) – alcohol brief advice
  14. 14. What do we mean by evidence basedpractice? “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” David Sackett et al…, BMJ 1996
  15. 15. Potential Scale of Impact across SHA Cluster• Over 280,000 staff• Millions of patient contacts a year in primary and secondary care• Very brief advice given 10 times a year by every member of staff = 2.88 million opportunities to change lifestyle behaviour• Less than an hours time a year for each member of NHS staff• A healthier workforce
  16. 16. Who can Make Every Contact Count?Ashok SoniNHS Future Forum
  17. 17. What do Staff and Patients think aboutMaking Every Contact Count?Dr Simon HowProject Manager for Making Every Contact Count
  18. 18. Insight was gathered from nine organisationsacross the West Midlands, East Midlands andEast of England
  19. 19. Methodology 1Gathering insight• Researchers spent a day in each of the nine organisations interviewing 49 staff and 54 patients.• The interviews were carried out on site to provide context to the insight gathered and maximise the numbers of the target audience • Cardiology • Respiratory • Gastroenterology • Mental health • General practice • Stroke • Community Practice • Clinical assessment unit
  20. 20. Methodology 2Patient interviews:• attitudes to healthy lifestyles advice• which staff groups• what would aid the conversationStaff interviews:• attitudes to delivering lifestyle advice• situations and settings• confidence levels• influence of their own lifestyle• what would help them in initiating and delivering brief adviceRole playing scenarios:• This provided valuable insight into the factors that will play a role in delivering/receiving health lifestyle advice
  21. 21. Key Themes• Time• Clinical vs. Non clinical• Environment• Effectiveness• Staff behaviour• Training
  22. 22. Appointments take 10-15 minutes The NHS should give advicein which to diagnose, treat and if they have time – butrefer. Offering health promotion they’re too busy. (Patient)advice on top of that takes timeaway. (Staff ) It’s a good idea but how would it work? We don’t have much time with Time patients (staff)• MECC is about delivering very brief lifestyle advice (30 seconds to 3 minutes) when appropriate• MECC is not about giving advice upon every encounter with a patient/ colleague with an unhealthy lifestyle. It is about recognising when advice is appropriate and when it will be effective• Prevention of illness will, in the long run, save the NHS time and money• Brief advice does not always have to be delivered during clinical time.)
  23. 23. I’d give advice if patients knewIf a porter gave me advice, I’d want to expect it. They would need a second opinion from the doctor to know – otherwise some (patient) would say ‘what do you know? (staff) It would be ok if he was a bit jokey, like ‘you should lay off the fags mate Clinical and non- clinical staff (patient) • Patients say that the relationship with a staff member and the manner in which the advice is delivered is equally as important as how authoritative that staff members role is perceived to be. • Patients value the opinions of staff who had been through a lifestyle change themselves. This trumped whether they were clinical or not.
  24. 24. It would need to be Yes and we have a Gregg’sdelivered one-to-one in a onsite which doesnt doprivate area, not out in the much to support us inopen (patient) promoting healthy lifestyles (staff) In the pharmacy, patients will discuss anything and have no objections – they are open and welcoming of Environment advice (patient)• The training packages for MECC highlight the importance of understanding and respecting a patient/colleagues‟ feelings towards discussing their lifestyle behaviours• Staff feel that different health settings present different challenges and opportunities• MECC is about using opportunities as they arise to help people make healthy lifestyle changes, signposting or providing information leaflets are seen as useful by patients
  25. 25. If I was already thinking It could work,about doing or changing with the rightsomething, it might be a people (staff)good final push. (patient) Fine, give it to me. I Effectiveness won’t necessarily take it though (patient) Research shows that brief advice is effective, for example: • 1 in 8 people respond to brief advice about alcohol intake by reducing their drinking behaviour by one level e.g. from increasing risk to lower risk • 1 in 20 people go on to quit smoking following brief advice The communications campaign supporting MECC will promote this fact to help both staff and patients understand the impact MECC can have
  26. 26. Staff’s own lifestyles are Overweight people key. Enthusiastic ex-understand –‘I’ve tried smokers have knowledge this and that might and passion (staff) work (patient) Patients have said to me, ‘well you’re not exactly thin’. But when you’re in a Staff Behaviour healthcare setting it’s easier to raise (staff)• Patients are receptive to staff who have made a lifestyle change themselves and feel they are better equipped to provide advice on these issues• Staff feel their lifestyle does not hinder their ability to give advice, however patients do feel that staff appearance and lifestyle are important to patients‟ receptivity to advice• Staff lifestyle and appearance are superseded by the development of a relationship between patient and staff member and their communication skills and interpersonal skills• MECC is also about improving staff health and wellbeing
  27. 27. We’d all need to We know basic guidance but I’d be have some formal worried about saying the wrong training around thing (staff) delivery (staff) Manner and Training communications skills are crucial (patient)• MECC toolkit signposts to a range of training options from e-learning modules to face to face training.• Training will help staff members become more comfortable with giving alcohol and weight management advice• Prompts (e.g. a card asking about lifestyle behaviours) may MECC help staff members to begin a conversation• Patients expect to be asked about their lifestyle behaviours• Effective communications help create an environment where staff feel more comfortable giving advice
  28. 28. SUMMARY• MECC received positively by staff and patients• Need to create an environment in which it is OK to ask for and give lifestyle advice• Staff are willing, but need training to build confidence and capability• Communication of consistent MECC message is key
  29. 29. How to deliver Making Every Contact Count:The Implementation Guide and ToolkitDr Lola AbuduPublic Health ConsultantNHS Midlands and EastMaureen MurfinPublic Health Workforce Development ManagerNHS Derbyshire County
  30. 30. Introducing the ImplementationGuide and Toolkit
  31. 31. Background to Implementation Guide and ToolkitBuilding Blocks for „wider‟ public health workforce development • 2005 - Health Trainer Early Adopter • 2006 - Hosting the Regional Health Trainer Hub • 2007 - Introduction of Health Champions, volunteers trained in health improvement • 2008 - Commissioned Report: Developing a Health Promoting Workforce • 2009 - Workforce Transformation Project partnership with DCHS • 2011 – Behaviour Change Guidance Development & Pilot testing • 2012 – Implementation Guide and Toolkit
  32. 32. The Power of MECC MECC is about encouraging people to make healthier choices to achieve positive long-term behaviour change for better health and wellbeing among patients / service users and staff themselves MECC involves: Systematically promoting the benefits of healthy living across the organisation Asking an individual about their lifestyle and if they want to make a change Responding appropriately to the lifestyle issue/s once raised Taking the appropriate action to either give information, signpost or refer service users to the support they need
  33. 33. What does the Guidance Say?• Much more than training staff• Organisational development and culture change• Led by staff within the context of their service and role• A collective responsibility – staff and organisation TOGETHER!• Grown from the needs of the public and what they need, want and expect• A path to delivering system and scale
  34. 34. A Closer Look at The ToolkitContents• Foreword• Introduction• Section 1: What is MECC• Section 2: An overview of the evidence and policy for MECC• Section 3:How organisations can achieve systematic and sustainable change through MECC• Section 4: Who benefits from MECC?• Section 5:The responsibilities of strategic and operational roles within an organisation• Section 6: What is the implementation process for MECC• Section 7: What tools and resources are available?• References and supporting documentation
  35. 35. The Implementation Process Not one size fits all but promotes key principles: • Get Senior Managers on board and Champions in place • Assess the organisations current position as a health promoting organisation (culture and structure) • Take a systematic approach to service and workforce development that supports and empowers service users to improve their own health and wellbeing • Take a team approach to implementation and training • Have systems and processes to capture progress • Support service users to engage with healthy lifestyle messages • Consider the role of staff health and wellbeing
  36. 36. Tools and Resources• Implementation checklist• Behaviour change pathway and competence mapping• Example data capture forms• Example CQUIN, NHS Midlands and East metrics• Examples from practice• Individual and team assessment tool• Making the case presentation• Links to policy drivers and initiatives• Organisational assessment tool• Prompt card and health benefit cards• Orientation workshop slides• Training options – MECC workshop slides and E learning
  37. 37. What Next?• Supported implementation• TEST, LEARN & ADAPT the guidance and expand the toolkit• Contribute to evidence base.
  38. 38. For further information contact: Elaine.varley@derbyshirecountypct.nhs.uk 07881837059 maureen.murfin@derbyshirecountypct.nhs.uk 07785714543 http://nhs.lc/makingeverycontactcount
  39. 39. Questions?
  40. 40. Refreshment Break
  41. 41. Making Every Contact Count In PracticeCase Study Examples
  42. 42. Making Every Contact Count atCambridge University HospitalNHS Foundation TrustBarbara Brafman-Price, Smoking Cessation Clinical LeadVal Thomas, Public Health Consultant, NHS CambridgeshireMr John Latimer, Consultant and Lead Gynaecological Oncologist
  43. 43. Addenbrooke‟s
  44. 44. Background• Cambridgeshire has a relatively healthy population, smoking prevalence around 20%• How to increase Stop Smoking Services throughput ?• High level of patient throughput in Addenbrookes and The Rosie though its size and complexity presents many challenges• Commissioning an evidence based model
  45. 45. Making it happen: Early Critical Factors• Substantial organisational change is required to create a culture and environment that is supportive of smoking messages.• Opportunistic, Timing – Co-Creating Health – COPD – Partnership culture• Behavioural change methodologies were increasingly visible• Leadership - Identified a senior champion – Operations Director, key clinicians, Co-creating Health Co-ordinator• Target one or a small number of areas• Sustaining and developing - demands everyday determined, tenacious and committed leadership• On going commissioner support
  46. 46. Making it happen!• Developing a workforce to deliver and support behavioural change - Flexible, adaptable tailored training programme - Network of “champions” created across the trust• Developing the Infrastructure - An easy to use electronic referral pathway - Routine processes adapted - On-site drop in clinic• Creating a supportive environment - Securing high level support and endorsement - Lanyards - Newsletters coverage - Regular health promotion events
  47. 47. Training• Flexible (delivered on the wards, mdt‟s, lunchtime seminars, audit mornings)• Adaptable (time negotiable to fit in to organizational pressures)• Tailored (What does it mean to each staff group? Why is it important to their patients?)
  48. 48. What does it mean to be a Stop Smoking Champion?
  49. 49. Developing the Infrastructure• An easy to use electronic referral system (less than a minute to place a referral)• Assessment booklets adapted to prompt staff to make a brief advice (changing the processes is vital)• A drop in clinic for staff and patients• Ongoing communication activities is paramount• Champion network – extremely valuable
  50. 50. Referral Process
  51. 51. Creating a supportive environment
  52. 52. Corporate support is keyGareth Goodier and Pat Reid visit the team
  53. 53. Health Promotion events
  54. 54. What have we achieved?• Start date January 2010 (dedicated project coordinator June ‟10)• 635 stop smoking referrals to date• 1st year (2010) - 153• 2nd year (2011) - 388• 3r year (2012) - 94• 300 staff trained in brief advice• 50 Clinical champions• Senior corporate support• Staff and Patient stop smoking drop in clinic set up
  55. 55. Challenges• Competing priorities within the organisation• Need for more robust data (Out of area patients)• Resistance among staff• Senior management turn around• Staff turn around• It is a very slow process, perseverance is vital!
  56. 56. There is still work to be done
  57. 57. For further information contact: Val Thomas, Public Health Consultant ( NHS Cambridgeshire Val.Thomas@cambridgeshire.nhs.uk Barbara Brafman-Price, Smoking Cessation Clinical Lead barbara.brafman-price@addenbrookes.nhs.uk
  58. 58. Derbyshire Community HealthServices NHS Trust (DCHS)The DerbyshireHealth Promoting Workforce ProjectLinda SaxeWorkforce Health and Wellbeing Project ManagerTracey AllenChief Executive
  59. 59. The Derbyshire Health Promoting Workforce Project• Jointly funded collaboration with NHS Derbyshire County, Public Health and DCHS• Motivate, train and support all DCHS frontline staff to promote health and wellbeing
  60. 60. Over 5000 opportunities every day to do or say something that may help to improve someones health and wellbeing Ultimately not only saving lives but adding quality to those lives saved
  61. 61. How do we start to promote healthy lifestyle choices?1. Getting staff to recognise those moments of engagement2. Motivating and supporting them to do or say something
  62. 62. Project Development• Steering Group• Developed with staff and patient engagement• Evaluated from the start with support from NHS Derbyshire County, Public Health Research Team• DCHS Board and senior management support• Staff workshops
  63. 63. Information Gained from Workshops• Lack of confidence, knowledge and training• Some services reported that they were promoting health and wellbeing• Staff health and wellbeing• Time and job pressures• Right approach• Public Health / Health Promotion• Job descriptions /contracts• Change• ‘Permission’
  64. 64. Patient Public Involvement• Seamless approach• Consistency• Attitude and expectation• Proactive approach and follow up• Carers and families fully engaged• Staff lead by example – examples from business• Service users at the centre• Viewed as active members of society
  65. 65. Training• Unique approach• Working with two services• Meeting with managers & team Leader• Meet with team• Facilitated training session for staff
  66. 66. Key outcomes• Increased confidence and motivation• Part of staff role• Interest and understanding of Public Health/Health Promotion• Staff health and wellbeing• Referrals to local specialist healthy lifestyle services
  67. 67. The Way Forward• Organisational vision• Embedded into values and culture• Users perspective• Ongoing evaluation• DCHS Pathfinder Project
  68. 68. For further information contact: Linda Saxe Workforce Health and Wellbeing Project Manager linda.saxe@dchs.nhs.uk 07771652957
  69. 69. Public Health at BCH: Makingevery Contact CountSarah-Jane Marsh, Chief Executive
  70. 70. Context•Three years ago our staff told us they wanted to dothings differently•They wanted to create the conditions where theycould deliver real changes to the lives of the childrenand young people who rely on our services ‘We will be an•One of the areas they wanted to focus on was advocate foradvocating for children and young people – a key part children and youngof which was to develop campaigns to supportimprovements in the lifestyles of our patients and people’their families•Our Trust Board agreed to integrate this as one of justsix key objectives going forwards
  71. 71. What did we do to prepare tomeet this objective? Commissioned a MBA student to evaluate other Engaged a range similar work and of organisations make who had recommendations experience in this area Appointed Undertook a Developed good health literature search relationships promotion to identify a with the methodology we facilitator community/ could adapt and local authority/SHA adopt around health promotion
  72. 72. We began to understand we’re ina unique position to create avirtuous circle Children come into hospital with conditions ranging from a fever to a serious heart conditionProvide big opportunities to Lifestyle issues such as diet link lifestyle changes to and exercise often have anfundraising for the hospital impact on children’s– e.g. half-marathon, BRMB conditions and their ability Walkathon to recover Worked hard to make a Parents are keen to broad range of staff our understand more about advocates for improving improving lifestyle issues at lifestyle issues this point
  73. 73. So we started a journey… Yesterday Today Tomorrow•We consulted with over •Staff from right across the •We have a network of Health Promotion hospital are equipped not1500 staff across the Champions just with key messageshospital, who wanted us toadvocate on behalf of about public health, but with •We have well developed care pathways onchildren and young people the resources and support to smoking, asthma and sexual healthand wanted us to focus point patients and theirthose efforts on lifestyle families to the right support •We have increased referrals for child safetyissues schemes and healthy start vitamins •That staff aren’t just•We recruited a Health advocates for public health, •We have created ‘an offer’, not just for patientsPromotion Lead in 2009; but are given the and their families, but also for staff: including opportunities and support to onsite exercise classes twice a week, smoking•We set about equipping change their own lifestyles cessation sessions and swimming clubsstaff with the knowledge andresources to offer public •That we evaluate the •Still need to improve on the evaluation of our impact to achievehealth advice on a range of programmes (but UoB are getting involved) sustainable fundingissues
  74. 74. Integrating our work withMECC has created extra pull…Training•We have used MECC for ourstaff training, preferring face toface over e-learning but usingboth where appropriate;•Training has been departmentbased providing opportunityfor department led actions tobe discussed and developed;•Teams are now requesting the Teams are nowtraining having recognised the requesting the trainingvalue and impact. having recognised the value and impact.
  75. 75. Conclusion•We’ve come an enormously long way inthe three years we’ve been doing publichealth campaigns at BCH•There’s a real drive for success at everylevel of the organisation•MECC has helped take us further, and thetraining support has been great•We know from the family feedback thatwe’re making a real impact on people’slives at a time they’re most willing toembrace change•But we need support in evaluation tohelp make the case for acute-based publichealth going forward
  76. 76. Piloting the MECC Toolkit within a Mental Health SettingDerbyshire Healthcare NHS Foundation TrustJulieann TremblingStaff Liaison ManagerKaren WheelerPhysical Health and Wellbeing Lead for Mental Health
  77. 77. Why we Chose to become a Pilot Site• The Mental Health Strategy “No Health without Mental Health” (DoH, 2011), has a specific objective to improve the physical health of people with mental health problems and to reduce health inequalities• The Boorman Report (2009) recognises the importance of the healthy workforce. „It is essential that all NHS Trusts put staff health and well-being at the heart of their work‟
  78. 78. Killer Facts !• People experiencing severe mental health problems face a greater risk developing physical ill health• 2 - 4 times greater risk of cardiovascular disease• 2 - 4 times greater risk of respiratory disease• 2 times greater risk of developing bowel cancer• 5 times greater risk of diabetes• A person with schizophrenia can expect to live for up to 20 years less than someone without a mental health problem
  79. 79. The Pilot - What we were asked to do• Organisational readiness (organisational assessment tool)• Staff readiness (workforce competence and resources)• Enabling and empowering the public (behaviour change pathway)
  80. 80. Delivering the Pilot• The pilot ran from August -- December 2011• Settings:• Morton Ward (acute in patient ward, Hartington Unit, Chesterfield)• Audrey House (rehabilitation unit based in community, Derby)
  81. 81. How we delivered it 2 Step team approach:• Orientation session• Implementation session
  82. 82. Lessons Learned• Health Lifestyle behaviour change is a value based topic which cannot simply be taught through a training package• Staff health is closely related and interlinked with how the health messages are portrayed to service users – our community is made up of our staff and service users, staff can be our service users and our service users can be our staff• Whole team approach which is relevant to the setting and stage of recovery• Flexible approach delivered in different ways• Ensure pathways are developed and embedded into current practice• Service User involvement in delivering this concept is important as peer advocacy is a powerful support
  83. 83. Recommendations for taking MECC Forwards • Delivering the Concept • Embedding the Concept • Supporting the Embedding
  84. 84. Delivering the ConceptRecognise the need to tailor the MECC message to address the needsof the team and consider the setting• Introduce staff to concept of MECC at Trust Induction• Coaching sessions with teams to consider and deliver the core MECC messages dependent on stage of skill required for care pathway, readiness to change of service users and adapt to settings• Potential use of individual e learning in down time during mandatory training to reinforce message and individual responsibility• Where possible introduce and link to existing quality initiatives such as part of “Productive teams work” (health & wellbeing module)
  85. 85. Embedding the ConceptRecognise that it is necessary to embed the principles withincurrent practices, using existing systems, so the philosophy runsthroughout the organisation.Using frameworks such as:• Core care standards, CPA Assessment forms ,Care planning• Releasing time to care, essence of care benchmark tools• Staff supervision - Re-enforcing the message• Recognising the experts within settings – Identifying the pathways
  86. 86. Supporting the EmbeddingRecognise that resources will be needed & shared indelivering and embedding the philosophyFor example:• Signposting information, Prompt cards• Working with community partners• Healthy Calendar• Links to national campaigns e.g. BHF Heart City – Derby• Recognising this isn‟t a stand-alone project needs to link in with other appropriate projects including Public Health
  87. 87. Supporting Drivers• CQUIN L6b (From April 2012 - to develop an implementation plan for MECC)• 4E committee addressing Health Equalities & Experience, Engagement & Enablement• Multi-professional Philosophy promoting Health & Wellbeing• Staff Health & Wellbeing group• NHS Outcomes Framework• East Midlands Health Trainer Services and Behaviour Change Hub• NHS Future Forum
  88. 88. Longer Term Developments• Service user empowerment - Peer advocacy• Developing a co-ordinated & well communicated network for tackling health related issues• Pursuing creative & innovative ideas• Consider wider issues i.e. local economy sourcing local products
  89. 89. For further information contact:Karen.wheeler@derbyshcft.nhs.ukJulieann.trembling@derbyshcft.nhs.uk
  90. 90. Moving ForwardMake Every Contact Count in your OrganisationProfessor David WalkerDirector of Public Health, NHS Midlands and EastExecutive Lead for Making Every Contact Count
  91. 91. • Training and Guidance • Implementation support coordination centre - • E- learning module – Every Contact Counts • Cohort of train the trainers – 30 train the trainer sessions • Workshops for; • Implementation leads- using the guide and toolkit • Education providers – embedding MECC • GPs- MECC in primary care• MECC Innovation fund • £5k grants to support innovative ways of capturing MECC activity and feeding back to staff- call for proposals in June• MECC on the web • E- version of Guide and Toolkit plus resources and case studies http://nhs.lc/makingeverycontactcount
  92. 92. Questions?
  93. 93. MECC Guide and Toolkit Website:http://nhs.lc/makingeverycontactcountContacts:Simon How,MECC Project Managersimon.how@dh.gsi.gov.ukSara Dunling,MECC Project Supportsara.dunling@eoe.nhs.uk

×