At the start of the year we met Ash Soni (Joint Lead for the NHS's Future Forum) who proposed the Make Every Contact Count (MECC) policy accepted by government. A group of accredited trainers including myself have since been recruited by the Department of Health to deliver training to NHS staff who will implement this policy.
Training the Trainer to deliver MECC
We train managers and service leads to support their staff to deliver brief advice in relation to diet, physical activity, alcohol and tobacco control. Most people working in health and public health are aware of the 3 A model for enabling individuals to quit smoking - Ask, Advise and Act. Brief advice encompasses this and also provides an opportunity to record (e.g. smoking status and other lifestyle risk factors) and refer. A similar model is applied to each of the other lifestyle areas with a focus on providing consistent advice in relation to healthy eating, physical activity, smoking cessation, alcohol intake, mental health and weight management.
Concerns about MECC
Initial response to the policy was not entirely positive as describe in this Guardian article. However, the training content addresses the challenges and issues raised by the Royal College of GPs, Royal College of Nurses and Patients Association. For example, we consider the multiple factors contributing towards lifestyle choice and health risk including poverty, poor access to support services, social and cultural influences etc. We also address staff concerns; What if a patient says 'it's none of your business?' What if staff are overweight or smokers themselves?
The training aims to ensure 'raising the issue' occurs in a non-judgmental manner. Staff are expected not to project personal opinions in relation to lifestyle.Training lasts for a full day and participants are given the opportunity to practice delivering brief advice. Sarah Banfield, the MECC support officer at NHS Bedfordshire and Luton where the first 'training the trainer' session took place said:
It is the practice of these techniques which builds confidence in delivery. We want participants to take the plunge and deliver brief advice immediately following the training.
Supporting Patients to Improve Health and Wellbeing
The generic MECC training developed by Department of Health (East Midlands) is adapted by an implementation lead to include information about local lifestyle services. In the case of NHS Bedfordshire and Luton, Sarah was appointed to drive delivery of MECC across health, social care and partner organisations. She works for Craig Lister (Public Health Manager for Healthy Weight) and Raj Gangotra (Programme Manager for Training, Capacity and Long Term Conditions). The team recruited trainees by advertising internally and through provider and partner organisations. On the training day itself, attendees from a range of backgrounds and workplaces were able to network and share valuable information about the services they deliver. Sarah commented:
Locally we hope that the programme will promote healthier lifestyles to staff across health and social care through the contacts they have with service users. Ultimately, we want members of the public to know there is help available locally to lead a healthier lifestyle and to provide information on how to access services. This increased awareness results in people living longer, healthier lives which should impact positively on quality of life and help address health inequalities. This makes both economic sense and sense in terms of social responsibility.
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