Transcript Document

An Implementation Guide and
Toolkit for Making Every
Contact Count
Making the Case Presentation
The challenge
‘strengthening self-esteem, confidence and
personal responsibility; positively promoting
healthy behaviours and lifestyles…Protecting the
population from health threats should be led by
central government, with a strong system to the
frontline.’
Healthy Lives, Healthy People
‘…every contact must count as an opportunity to
maintain, and where possible, improve their
mental and physical health and wellbeing’
‘…preventing poor health and promoting healthy
living is essential to reduce health inequalities
and sustain the NHS for future generations’.
NHS Future Forum Summary Report – Second Phase
Healthy Lifestyles in the Midlands
and East
• Smoking- 19 to 25% of population smoke
• Alcohol – 14.6 to 17.9 % drinking at increasing
risk and 4.0% to 6.1% drinking at high risk levels
• Physical activity- 61 % of men and 71% women
do not meet recommended PA levels
• Obesity- men 22% to 26%, women 24% to 28%
• Diet 75% of men and 71% of women do not eat
5 a day.
Health Inequalities
‘…people living in the
poorest areas will on
average, die 7 years earlier
than people living in the
richer areas and spend 17
years more living with ill
health’
Health Lives Healthy People:
update and way forward July 2011
Multiple influences on health
and wellbeing.
Dahlgren, G. and Whitehead, M. (1991)
Policies and strategies to promote social equity in health
Survival in 20,244 healthy adults
aged 40-79 by healthy behaviours
Overall impact:
• 14 year difference in
• life expectancy.
100
% still alive
Health Behaviours:
• Non smoker
• Alcohol <14 units/wk
• Not inactive
• Blood vitamin C
– >50 mmol/l
– (5 servings fruit and
vegetables daily).
Number of prudent
health behaviours
90
4
3
80
2
1
0
70
-2
0
2
4
6
8 10 12
Year of study
Khaw et al. PLoS Med 2008 Jan 8: 5 (1): e12
NHS Midlands and East
Example impact:
• 288,000 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.
Business case example
• 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
MECC: a definition
• There is a need for a culture change
amongst organisations towards
prevention, to bring the promotion of
mental and physical health and wellbeing
into the mainstream – doing this has
become known as MECC
• Frontline staff should be trained to raise
healthy lifestyle issues opportunistically.
This is often known as Brief advice which
is less in depth and more informal than a
brief intervention. It involves giving
information about the importance of
behaviour change and simple advice and
sign posting to appropriate lifestyle
services for support.
Drivers
• Care Quality Commission (CQC): The level of care, treatment and
support that each person requires will depend on their individual
health and social care needs. It includes actions taken to prevent
illness or disease and to promote lifestyles that maintain health
• NHS Future Forum Second Phase
• Increasing the number of people who improve their health and
wellbeing will make a significant contribution to achieving the
priorities in the NHS Outcomes Framework 11/12 and public health
indicators in ‘Improving outcomes and supporting transparency’. For
example:
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Healthy Life Expectancy
Differences in life expectancy and healthy life expectancy between communities
Mortality from cardiovascular disease
Mortality from respiratory disease
Mortality from cancer
Excess under 75 mortality in adults with serious mental illness
Infant mortality
Incidence of low birth weight in term babies
Smoking prevalence in adults.
Supporting evidence - national
• Wanless Review – fully engaged scenario
• Darzi Review – need to put prevention first
• Marmot Review - strengthen the role & impact of ill-health
prevention
• NICE – Behaviour Change Guidance
• NICE – Smoking Cessation Services Guidance
• SIPPs – alcohol brief advice
• Improving Health Changing Behaviour NHS Health Trainer
Handbook
• MINDSPACE – influencing behaviour change through policy
• COI Communications and Behaviour Change
• DH Health Inequalities National Support Team Health Gain
Programme
• COI Synthesis of key behaviour change documentation.
Supporting evidence - local
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Improving Healthy Lifestyle pilots
East Midlands Guidance Pilots
Derbyshire Community Health Services
NHS Coventry & Warwickshire Brief Intervention
Training
West Midlands Clinical Champions
East Midlands Time for a Quit Chat
Beyond the Midlands and East Cluster
Yorkshire & Humber Prevention and Lifestyle
Competency Framework
North West Synthesis of Behaviour Change
Interventions.
Why Implement the Implementation
Guide and Toolkit
• The approach to MECC within the toolkit has
been developed using expertise, experience,
learning and best practice from local
organisations that have embedded the MECC
approach
• The Implementation Guide and Toolkit
advocates a holistic approach to implementation
to enable contacts to truly count, by ensuring
that your organisation is offering a suitable
environment for MECC and supporting staff to
enable and empower the public to improve their
health and wellbeing.