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Making Every Contact Count
Using Every Opportunity to Deliver Brief Advice
to Improve Health and Wellbeing


Implementation Guide and Toolkit
Launch Event
18th May 2012
Leicester Marriott Hotel
Welcome and Introductions

Professor David Walker
Director of Public Health, NHS Midlands and East
Executive Lead for Making Every Contact Count
Our Ambitions

Sir Neil McKay
Chief Executive, NHS Midlands and East
Why Make Every Contact Count?

Dr Rashmi Shukla
Regional Director of Public Health, West Midlands
Chair 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 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
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
  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
Life Years gained from stopping smoking




Life
years
gained




              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 = £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
Health Benefits of Weight Loss
of 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
Survival in 20,244 healthy adults
aged 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
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
What do we mean by evidence based
practice?

   “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
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
Who can Make Every Contact Count?

Ashok Soni
NHS Future Forum
What do Staff and Patients think about
Making Every Contact Count?

Dr Simon How
Project Manager for Making Every Contact Count
Insight was gathered from nine organisations
across the West Midlands, East Midlands and
East of England
Methodology 1
Gathering 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
Methodology 2
Patient interviews:
• attitudes to healthy lifestyles advice
• which staff groups
• what would aid the conversation

Staff 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 advice

Role playing scenarios:
• This provided valuable insight into the factors that will play a role in
   delivering/receiving health lifestyle advice
Key Themes


•   Time
•   Clinical vs. Non clinical
•   Environment
•   Effectiveness
•   Staff behaviour
•   Training
Appointments take 10-15 minutes      The NHS should give advice
in which to diagnose, treat and      if they have time – but
refer. Offering health promotion     they’re too busy. (Patient)
advice on top of that takes time
away.         (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.)
I’d give advice if patients knew
If 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.
It would need to be               Yes and we have a Gregg’s
delivered one-to-one in a         onsite which doesn't do
private area, not out in the      much to support us in
open (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
If I was already thinking           It could work,
about doing or changing             with the right
something, 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
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
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
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
How to deliver Making Every Contact Count:
The Implementation Guide and Toolkit

Dr Lola Abudu
Public Health Consultant
NHS Midlands and East

Maureen Murfin
Public Health Workforce Development Manager
NHS Derbyshire County
Introducing the Implementation
Guide and Toolkit
Background to Implementation
 Guide and Toolkit
Building 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
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
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
A Closer Look at The Toolkit
Contents
• 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
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
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
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.nhs.uk
 07785714543


 http://nhs.lc/makingeverycontactcount
Questions?
Refreshment Break
Making Every Contact Count In Practice
Case Study Examples
Making Every Contact Count at
Cambridge University Hospital
NHS Foundation Trust

Barbara Brafman-Price, Smoking Cessation Clinical Lead
Val Thomas, Public Health Consultant, NHS Cambridgeshire
Mr John Latimer, Consultant and Lead Gynaecological Oncologist
Addenbrooke‟s
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
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
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
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?)
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)
• 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
Referral Process
Creating a supportive
    environment
Corporate support is key
Gareth 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 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
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!
There is still work to be done
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
Derbyshire Community Health
Services NHS Trust (DCHS)
The Derbyshire
Health Promoting Workforce Project

Linda Saxe
Workforce Health and Wellbeing Project Manager

Tracey Allen
Chief Executive
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
Over 5000 opportunities every day to do or say
 something that may help to improve someone's
             health and wellbeing

  Ultimately not only saving lives but adding
          quality to those lives saved
How do we start to
            promote healthy lifestyle choices?


1.   Getting staff to recognise those moments of engagement

2.   Motivating and supporting them to do or say something
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
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’
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
Training


•   Unique approach
•   Working with two services
•   Meeting with managers & team Leader
•   Meet with team
•   Facilitated training session for staff
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
The Way Forward

•   Organisational vision
•   Embedded into values and culture
•   Users perspective
•   Ongoing evaluation
•   DCHS Pathfinder Project
For further information contact:

   Linda Saxe
   Workforce Health and Wellbeing Project Manager
   linda.saxe@dchs.nhs.uk

   07771652957
Public Health at BCH: Making
every Contact Count

Sarah-Jane Marsh, Chief Executive
Context


•Three years ago our staff told us they wanted to do
things differently

•They wanted to create the conditions where they
could deliver real changes to the lives of the children
and young people who rely on our services                    ‘We will be an
•One of the areas they wanted to focus on was
                                                               advocate for
advocating for children and young people – a key part      children and young
of which was to develop campaigns to support
improvements in the lifestyles of our patients and               people’
their families

•Our Trust Board agreed to integrate this as one of just
six key objectives going forwards
What did we do to prepare to
meet 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
We began to understand we’re in
a unique position to create a
virtuous circle
                               Children come into hospital
                                 with conditions ranging
                                from a fever to a serious
                                     heart condition




Provide big opportunities to                                 Lifestyle issues such as diet
  link lifestyle changes to                                  and exercise often have an
fundraising 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
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 not
1500 staff across the
                               Champions                                            just with key messages
hospital, who wanted us to
advocate on behalf of                                                               about public health, but with
                               •We have well developed care pathways on
children and young people                                                           the resources and support to
                               smoking, asthma and sexual health
and wanted us to focus                                                              point patients and their
those efforts on lifestyle                                                          families to the right support
                               •We have increased referrals for child safety
issues
                               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 patients
Promotion 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 clubs
staff with the knowledge and
resources to offer public                                                           •That we evaluate the
                               •Still need to improve on the evaluation of our      impact to achieve
health advice on a range of
                               programmes (but UoB are getting involved)            sustainable funding
issues
Integrating our work with
MECC has created extra pull…


Training

•We have used MECC for our
staff training, preferring face to
face over e-learning but using
both where appropriate;
•Training has been department
based providing opportunity
for department led actions to
be discussed and developed;
•Teams are now requesting the            Teams are now
training having recognised the       requesting the training
value and impact.                     having recognised the
                                        value and impact.
Conclusion
•We’ve come an enormously long way in
the three years we’ve been doing public
health campaigns at BCH

•There’s a real drive for success at every
level of the organisation

•MECC has helped take us further, and the
training support has been great

•We know from the family feedback that
we’re making a real impact on people’s
lives at a time they’re most willing to
embrace change

•But we need support in evaluation to
help make the case for acute-based public
health going forward
Piloting the MECC Toolkit within a Mental
               Health Setting
Derbyshire Healthcare NHS Foundation Trust

Julieann Trembling
Staff Liaison Manager

Karen Wheeler
Physical Health and Wellbeing Lead for Mental Health
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‟
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
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)
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)
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 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
Recommendations for taking MECC Forwards
              • Delivering the Concept
             • Embedding the Concept
           • Supporting the Embedding
Delivering the Concept
Recognise the need to tailor the MECC message to address the needs
of 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)
Embedding the Concept
Recognise that it is necessary to embed the principles within
current practices, using existing systems, so the philosophy runs
throughout 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
Supporting the Embedding

Recognise that resources will be needed & shared in
delivering and embedding the philosophy

For 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
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
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
For further information contact:

Karen.wheeler@derbyshcft.nhs.uk
Julieann.trembling@derbyshcft.nhs.uk
Moving Forward
Make Every Contact Count in your Organisation



Professor David Walker
Director of Public Health, NHS Midlands and East
Executive Lead for Making Every Contact Count
• 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
Questions?
MECC Guide and Toolkit Website:
http://nhs.lc/makingeverycontactcount

Contacts:
Simon How,
MECC Project Manager
simon.how@dh.gsi.gov.uk

Sara Dunling,
MECC Project Support
sara.dunling@eoe.nhs.uk

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Making Every Contact Count: Brief Advice Launch Event

  • 1. Making Every Contact Count Using Every Opportunity to Deliver Brief Advice to Improve Health and Wellbeing Implementation Guide and Toolkit Launch Event 18th May 2012 Leicester Marriott Hotel
  • 2. Welcome and Introductions Professor David Walker Director of Public Health, NHS Midlands and East Executive Lead for Making Every Contact Count
  • 3. Our Ambitions Sir Neil McKay Chief Executive, NHS Midlands and East
  • 4. Why Make Every Contact Count? Dr Rashmi Shukla Regional Director of Public Health, West Midlands Chair of MECC Steering Group
  • 5. Case for MECC • Growing evidence base • Potential scale for impact • NHS as an exemplar for health
  • 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. Global Economic Burden of NCDs: Lost output 2011-2025
  • 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. Life Years gained from stopping smoking Life years gained Age smoking stopped (yrs)
  • 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. Health Benefits of Weight Loss of 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. Survival in 20,244 healthy adults aged 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. 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. What do we mean by evidence based practice? “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. 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.
  • 17. Who can Make Every Contact Count? Ashok Soni NHS Future Forum
  • 18.
  • 19. What do Staff and Patients think about Making Every Contact Count? Dr Simon How Project Manager for Making Every Contact Count
  • 20. Insight was gathered from nine organisations across the West Midlands, East Midlands and East of England
  • 21. Methodology 1 Gathering 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
  • 22. Methodology 2 Patient interviews: • attitudes to healthy lifestyles advice • which staff groups • what would aid the conversation Staff 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 advice Role playing scenarios: • This provided valuable insight into the factors that will play a role in delivering/receiving health lifestyle advice
  • 23. Key Themes • Time • Clinical vs. Non clinical • Environment • Effectiveness • Staff behaviour • Training
  • 24. Appointments take 10-15 minutes The NHS should give advice in which to diagnose, treat and if they have time – but refer. Offering health promotion they’re too busy. (Patient) advice on top of that takes time away. (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.)
  • 25. I’d give advice if patients knew If 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.
  • 26. It would need to be Yes and we have a Gregg’s delivered one-to-one in a onsite which doesn't do private area, not out in the much to support us in open (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
  • 27. If I was already thinking It could work, about doing or changing with the right something, 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
  • 28. 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
  • 29. 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
  • 30. 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
  • 31.
  • 32. How to deliver Making Every Contact Count: The Implementation Guide and Toolkit Dr Lola Abudu Public Health Consultant NHS Midlands and East Maureen Murfin Public Health Workforce Development Manager NHS Derbyshire County
  • 34. Background to Implementation Guide and Toolkit Building 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
  • 35. 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
  • 36. 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
  • 37. A Closer Look at The Toolkit Contents • 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
  • 38. 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
  • 39. 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
  • 40. What Next? • Supported implementation • TEST, LEARN & ADAPT the guidance and expand the toolkit • Contribute to evidence base.
  • 41. For further information contact: Elaine.varley@derbyshirecountypct.nhs.uk 07881837059 maureen.murfin@derbyshirecountypct.nhs.uk 07785714543 http://nhs.lc/makingeverycontactcount
  • 42.
  • 45.
  • 46. Making Every Contact Count In Practice Case Study Examples
  • 47. Making Every Contact Count at Cambridge University Hospital NHS Foundation Trust Barbara Brafman-Price, Smoking Cessation Clinical Lead Val Thomas, Public Health Consultant, NHS Cambridgeshire Mr John Latimer, Consultant and Lead Gynaecological Oncologist
  • 49. 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
  • 50. 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
  • 51. 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
  • 52. 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?)
  • 53. What does it mean to be a Stop Smoking Champion?
  • 54. 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
  • 56. Creating a supportive environment
  • 57. Corporate support is key Gareth Goodier and Pat Reid visit the team
  • 59. 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
  • 60. 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!
  • 61. There is still work to be done
  • 62. 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
  • 63.
  • 64. Derbyshire Community Health Services NHS Trust (DCHS) The Derbyshire Health Promoting Workforce Project Linda Saxe Workforce Health and Wellbeing Project Manager Tracey Allen Chief Executive
  • 65. 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
  • 66. Over 5000 opportunities every day to do or say something that may help to improve someone's health and wellbeing Ultimately not only saving lives but adding quality to those lives saved
  • 67. How do we start to promote healthy lifestyle choices? 1. Getting staff to recognise those moments of engagement 2. Motivating and supporting them to do or say something
  • 68. 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
  • 69. 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’
  • 70. 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
  • 71. Training • Unique approach • Working with two services • Meeting with managers & team Leader • Meet with team • Facilitated training session for staff
  • 72. 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
  • 73. The Way Forward • Organisational vision • Embedded into values and culture • Users perspective • Ongoing evaluation • DCHS Pathfinder Project
  • 74. For further information contact: Linda Saxe Workforce Health and Wellbeing Project Manager linda.saxe@dchs.nhs.uk 07771652957
  • 75.
  • 76. Public Health at BCH: Making every Contact Count Sarah-Jane Marsh, Chief Executive
  • 77. Context •Three years ago our staff told us they wanted to do things differently •They wanted to create the conditions where they could deliver real changes to the lives of the children and young people who rely on our services ‘We will be an •One of the areas they wanted to focus on was advocate for advocating for children and young people – a key part children and young of which was to develop campaigns to support improvements in the lifestyles of our patients and people’ their families •Our Trust Board agreed to integrate this as one of just six key objectives going forwards
  • 78. What did we do to prepare to meet 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
  • 79. We began to understand we’re in a unique position to create a virtuous circle Children come into hospital with conditions ranging from a fever to a serious heart condition Provide big opportunities to Lifestyle issues such as diet link lifestyle changes to and exercise often have an fundraising 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
  • 80. 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 not 1500 staff across the Champions just with key messages hospital, who wanted us to advocate on behalf of about public health, but with •We have well developed care pathways on children and young people the resources and support to smoking, asthma and sexual health and wanted us to focus point patients and their those efforts on lifestyle families to the right support •We have increased referrals for child safety issues 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 patients Promotion 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 clubs staff with the knowledge and resources to offer public •That we evaluate the •Still need to improve on the evaluation of our impact to achieve health advice on a range of programmes (but UoB are getting involved) sustainable funding issues
  • 81. Integrating our work with MECC has created extra pull… Training •We have used MECC for our staff training, preferring face to face over e-learning but using both where appropriate; •Training has been department based providing opportunity for department led actions to be discussed and developed; •Teams are now requesting the Teams are now training having recognised the requesting the training value and impact. having recognised the value and impact.
  • 82. Conclusion •We’ve come an enormously long way in the three years we’ve been doing public health campaigns at BCH •There’s a real drive for success at every level of the organisation •MECC has helped take us further, and the training support has been great •We know from the family feedback that we’re making a real impact on people’s lives at a time they’re most willing to embrace change •But we need support in evaluation to help make the case for acute-based public health going forward
  • 83.
  • 84. Piloting the MECC Toolkit within a Mental Health Setting Derbyshire Healthcare NHS Foundation Trust Julieann Trembling Staff Liaison Manager Karen Wheeler Physical Health and Wellbeing Lead for Mental Health
  • 85. 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‟
  • 86. 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
  • 87. 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)
  • 88. 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)
  • 89. How we delivered it 2 Step team approach: • Orientation session • Implementation session
  • 90. 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
  • 91. Recommendations for taking MECC Forwards • Delivering the Concept • Embedding the Concept • Supporting the Embedding
  • 92. Delivering the Concept Recognise the need to tailor the MECC message to address the needs of 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)
  • 93. Embedding the Concept Recognise that it is necessary to embed the principles within current practices, using existing systems, so the philosophy runs throughout 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
  • 94. Supporting the Embedding Recognise that resources will be needed & shared in delivering and embedding the philosophy For 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
  • 95. 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
  • 96. 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
  • 97. For further information contact: Karen.wheeler@derbyshcft.nhs.uk Julieann.trembling@derbyshcft.nhs.uk
  • 98.
  • 99. Moving Forward Make Every Contact Count in your Organisation Professor David Walker Director of Public Health, NHS Midlands and East Executive Lead for Making Every Contact Count
  • 100. • 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
  • 102. MECC Guide and Toolkit Website: http://nhs.lc/makingeverycontactcount Contacts: Simon How, MECC Project Manager simon.how@dh.gsi.gov.uk Sara Dunling, MECC Project Support sara.dunling@eoe.nhs.uk