Transcript Slide 1

Making Every Contact Count
Skills Workshop Session
Shaleen Meelu
28th February 2013
Developed by Tony Connell Learning and Development Consultant and the East Midlands Health Trainer Hub,
hosted by NHS Derbyshire County
Pre Session Survey
I feel knowledgeable about
By the end of the session:
• You should be able to:
• Apply Make Every Contact Count within your role
• Ask people about their lifestyle choices
• Advise people of facts and tips to help change
unhealthy lifestyle behaviours
• Be confident to deliver Brief Advice
• Refer people to appropriate help and support
• Consider how you might record your contacts
• Know where to go for more information
Today’s
Timetable
• 10.00 Introduction to MECC, the health
profile of MK, and a look at lifestyle issues
• 11.15 Break
• 11.30 Activity in pairs- What does MECC
mean to you, raising the issue, the
behavioural change approach, and
monitoring the impact of MECC
• 13.00 Lunch (45 minutes)
• 13.45 local MK services
• 14.45 Summary, questions, evaluation
Making Every
Contact Count
• Making Every Contact Count focuses on short,
one-to-one opportunities with service users to
advise
and signpost to healthy lifestyle information on:
• stopping smoking
• drinking alcohol within recommended limits
• eating a healthy diet
• taking regular physical activity
• maintaining a healthy weight
• mental health and wellbeing
MECC
approach
•
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 MECC is not
• It is not about adding another job to your already busy
working day
• It is not about you becoming a specialist in a certain
lifestyle area
• It is not about you becoming a counsellor or providing
ongoing support to particular individuals
•I t is not about you telling somebody what to do and how
to love their life
• It is about you helping other people to know how
they can improve their own health and wellbeing
What is MECC?
MECC means making the best of every
appropriate opportunity to raise the issue of healthy
lifestyle
•Systematically promoting the benefits of healthy
living across the organisation
•Asking individuals about their lifestyle and
changes they may wish to make
•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.
MECC pathway
Health profile
Milton Keynes
• Milton Keynes has higher than average smoking and obesity
rates.
• Residents have poorer diets, exercise less and consume
more
• Higher harmful levels of alcohol than the rest of the England
Lifestyle risk issue
Adults smoking
Increasing and higher risk drinking
Adults not meeting healthy eating standards
Adults not meeting recommended physical activity levels
Obese adults
Milton Keynes (%)
England (%)
22.9
20.7
19.9
22.3
73.5
71.3
90.2
88.8
25.3
24.2
What makes you
who you are?
Income
Work
Education
Culture
Religion
Interests and hobbies
Where you live
Community
Family
Place of birth
Transport
Physical Activity
Why is it important?
Regular physical activity can reduce the risk of:
- Coronary heart disease
- Strokes
- Type 2 diabetes
- Musculoskeletal disorders
- Mental illness
- Some cancers
How much activity should we be doing?
• Adults should aim to achieve 150 minutes moderate
intensity activity over the week
• 30 minutes X 5
• Reduce time spent sedentary (sitting)
• Moderate intensity will cause increased temperature,
breathing and heart rate, but should still be able to carry
on a conversation
• Example exercises; brisk walking, cycling, gardening,
sport
Healthy Eating &
Weight Management
Why is it important?
• Being overweight and not eating a healthy diet can cause many
illnesses
• In Milton Keynes 25.3% of the adult population are obese and 73.5%
of adults do not eat 5 a day of fruit and veg
What should we be aiming for?
• BMI between 18.5 – 25
• Achieving 150 minutes moderate intensity physical activity over the
week
• Base your meals on starchy foods, eat lots of fruit and veg (5 a day),
eat more fish, choose lean cuts of meat, cut down on saturated fat
and sugar, and drink plenty of water
Smoking
• Smoking is the main avoidable cause of
premature death in England
• In Milton Keynes 22.9% of the adult population
smoke
• Giving up smoking can have many benefits and
the effects can been seen almost immediately
For advice and information about smoking, quit tools,
and stories of real life quitters support is available at
www.smokefree.nhs.uk or by calling 0800 022 4 332
Alcohol
Why is it important?
Drinking to much alcohol increases the risk of
developing:
• Serious liver disease
• Stomach and pancreas disorders
• Anxiety and depression
• Accidents
• Cancers (mouth, liver, colon and breast)
• Muscle and heart disease
What should we be aiming for?
• Women should not regularly drink more than 2-3 units
a day
• Men should not drink more than 3 – 4 units a day
• Pregnant women, or women trying to become
pregnant, should be advised to avoid alcohol altogether
• Try to have 2 alcohol free days a week
Mental wellbeing
Why is it important?
Mental health problems can cause:
• Panic attacks
• Loss of interest in social activities
• Feelings of sadness or loneliness
• Low self esteem or persistent guilt
• Heavy or frequent alcohol consumption
• Smoking excessively to relieve stress
• Difficulty in sleeping
Mental Wellbeing
Suggestions you could make:
• Keep active (ideally 30 minutes exercise a day)
• Eat healthily do not smoke and only drink alcohol in
moderation
• Enjoy nature (try gardening or have a pet)
• Keep in touch with friends
• Accept the person you are and avoid harmful emotions
• Do something creative and learn new skills
• Talk about your feelings.
Health Checks
The NHS Health Checks programme aims to prevent heart
disease, stroke, diabetes and kidney disease
Everyone between the ages of 40 and 74, who has not already
been diagnosed with one of these conditions, will be invited
(once every five years) to have a check to assess their risk of
developing these illnesses and will be given support and advice
to help them reduce or manage that risk
Using a comprehensive approach;
• Inform and support people to make healthier and more responsible
choices
• Creating an environment in which the healthier and more
responsible choice is the easier choice
• Identifying, advising and treating those at risk
Activity in pairs –
What does MECC mean to me?
• What does Making Every Contact Count mean to
you in your role or at home?
• How can you use it in your everyday contacts?
• Do you think you already include MECC in your
everyday work or home life, what do you cover?
• Is there anyone or anywhere else you think you
could
use it with?
• What issues particularly affect your user group /
family?
• What might motivate them to make a change?
• Do you have any concerns?
When can you raise an issue?
• During any day to day contact with
the client
• When you hear them mention a
lifestyle problem
• When you can see that support
with a lifestyle issue may be of
help
• As part of existing information
gathering arrangements
• Consider making a list of when you
have contact with clients – face to
face, phone, forms etc.
Where to start
• Ask – use open questions
• “How do you feel about your health and wellbeing
today?”
• “What could you change to make your lifestyle
healthier?”
• “On a scale of 1-10 how important is it for you to make
your lifestyle healthier?” (1 being not important at all and
10 being very important)
• Listen to what the client tells you
• Reflect back “So what you’re saying is…”, “Can I just
check…”
• Advise – give a fact, tip and know where to signpost
to. If they are not interested don’t force the issue –
leave the door open.
Scaling
How do you feel about your health and wellbeing?
1
2
3
4
5
6
7
8
Not good
9
10
Very good
How important is it for you to make a change?
1
2
3
4
5
6
7
Not important
8
9
10
Very important
How confident do you feel to make a change?
1
2
3
Not confident
4
5
6
7
8
9
10
Very confident
Responding to a lifestyle issue
Considerations
• Time - it might only take 30 seconds to ask a question.
• You need to start from where the service user is,
not where you think they are or where they should be.
• You need to be open minded not critical or judgemental.
• Brief advice is working with the individual on their
health goals. You are not lecturing them or telling
them what to do.
• You are providing simple, clear advice and signposting.
• You can’t always tell what is going on from outward
appearances. You are not expected to be a counsellor.
Challenges to MECC
• If the service user is:
• Not interested – leave the door open
• Aggressive or confrontational
• Under the influence of drink or drugs
• Too emotional
• Too ill or injured
• Consider privacy – if the client is in a busy
waiting room they may be unwilling to engage. So
think about when and where you raise the issue.
Dealing with resistance
• What if the person
• doesn’t want to talk?
• is defensive?
• is not fluent in English?
• is tearful?
• is in a hurry?
• is not telling you the truth?
Making Effective Contacts
Look interested
Involve yourself by responding
Stay focussed on information giving
Test your understanding
Evaluate what is not being said
Neutralise your feelings.
The Behavioural Change approach
• Aim: to help individuals adopt healthy behaviours
• Methods used in this approach are targeted at the
• individual
• One-to-One
e.g. goal setting / action plans
• Education
Spiral of Change
termination
maintenance
action
Progression of
change
decision
contemplation
maintenance
action
lapse/
relaps
e
decision
contemplation
pre-contemplation
The elephant in the room
We might find it difficult to raise a lifestyle issue
with a client if we…
• smoke
• drink too much
• eat an unhealthy diet
• don’t exercise enough
• have sexual health issues
• have emotional health problems
…ourselves!
The elephant in the room
• We have a responsibility to
convey healthy lifestyle
messages to our clients
• Providing information provides
choice
• Proving information and
support about unhealthy
behaviours may lead to us
considering lifestyle changes
ourselves.
Time to have a go
Monitoring the impact of MECC
How do you know you have had an
impact?
How do you monitor?
Discuss how you can monitor your
contacts and the impact MECC
may have had
Monitoring needs to be tailored
according to the needs and
structure of your team/organisation
Any questions?
Post session surveys
I feel knowledgeable about
How confident do you feel about raising
a lifestyle issue with a colleague?
1 = not confident at all
2 = a little confident
3 = fairly confident
4 = very confident
Contact:
Jennifer Howells
[email protected]
01908 254267
Sarah Worbey
[email protected]
01908 254205