Implementing the Health Gain Programme

1. Implementing the Health Gain Programme Maureen Murfin & Elaine Varley East Midlands Health Trainer Hub 11 January 2011

2. Presentation Overview • What we have gained from the Health Trainer Programme – nationally and locally • Competences, tools, evidence, evaluation • East Midlands Behaviour Change Framework Development • Local example from Derbyshire County

3. Learning from the National Health Trainer Programme • Competent to practice: • HT1 Make relationships with communities • HT2 Communicate with individuals about promoting their health • HT3 Enable individuals to change their behaviour to improve their own health and wellbeing • HT4 Manage and organise your own time and activities • National qualifications • Evidence based: Improving Health Changing Behaviour: Health Trainer Handbook • Reviewed in 2010 and made available as e learning: www.healthtrainerhandbook.com

4. National Figures - 1 • Deprivation status • GP Registered

5. National Figures - 2

6. Learning from the Local Health Trainer Programme • Health Trainer Services commissioned from 7 out of 9 PCTs in the East Midlands • 138 Health Trainers • 51 Trainees • Over 70 Health Champions • Over 17,000 clients: • 61% are from the 2 most deprived deprivation quintiles • Over 30% provided with information • Over 20% signposted • Over 40% proceed to assessment

7. Learning from the Local Health Trainer Programme • Of clients going onto develop a personal health plan following an assessment • 58% achieved their PHP • 23% part achieved their PHP • 19% did not achieved their PHP

8. East Midlands Health Gain Programme for Making Every Contact Count • Learning from best practice • Making our local case • Facts and figures • Synthesis of national behaviour change documentation • Stakeholders and Steering Group • Community of Practice • Exploration of competence for individuals • Gap in organisational competence

9. Framework DevelopmentNHS Sustainability Model

10. East Midlands Health Gain Programme for Making Every Contact Count • Potential use of NHS Sustainability Model covering process, staff and organisation • Tailored to making every contact count & ensuring relevance to non-NHS Settings • Incorporate examples and resources • Exploring the Map of Medicine and embedding behaviour change within clinical pathways • Testing out the framework and evaluation

11. Health Gain Programme in Derbyshire • Partnership working & whole systems approach – not just about training! • Changing hearts and minds • Understanding hurdles and barriers • Closer working with 2 teams • Delivery of training • User views and evaluation

12. Nurturing a Community led workforce Paid Role Volunteers Individuals/Communities

13. TrainingTo motivate, encourage, support & train staff to promote health & wellbeing as part of their role as an employee of DCHS • Content takes participants through a journey • The meaning of health and wellbeing to individuals, Employee health & wellbeing, Definitions of heath & wellbeing, Determinants of health, Health inequalities, Health Promotion & promoting health & wellbeing, Barriers to promoting health and wellbeing, Understanding behaviour change, Core communication skills, Where to access information, Referrals to Health Promotion Specialists • 3 hours long with PowerPoint presentation, group exercises, discussion & individual reflection. Staff are encourage to undertake steps 1-3 of the NHS Derbyshire e-learning Level 2 Award in Understanding Health Improvement accredited by the Royal Society for Public Health www.uhi-online.co.uk

14. What We Are Learning - 1 • The need to work with and train teams, rather than individuals – this is being tested through work with 2 separate teams (Wheelchair Services and an Intermediate Care Team) • The value of having a ‘champion’ within the team and an agreed vision for team’s responsibility to promoting health to guide practice and help sustainability • The need to re-write the content of public health induction module to accommodate personal responsibility of health employees in health improvement • The need to shift the original outcomes of the project to include emphasis on appropriate use of NHS services and referrals into lifestyle services as well as brief health advice and simple health messages

15. What We Are Learning - 2 • That staff do think they have a role in promoting healthy lifestyles and feel more confident once they have been trained • That staff themselves are able to identify the best ways to incorporate ‘chats for change’ into their day to day work • The need for staff to know where/how to locate lifestyle information and services so that they can signpost and advise effectively • Staff need up to date information about lifestyle related disease in the populations they serve • The need to avoid taking staff away from their normal duties (thus reducing productivity) whilst encouraging them to engage in conversations about health improvement • That we still need to pin down what we mean by ‘brief’ intervention • That this work needs to fit with QiPP and OD processes and seems to permeate everywhere!

16. Next Steps • Continue Evaluation and work with PPI and Users • To track referrals and impact of change • To develop learning from the project into an organisational readiness tool for use by other providers (using NHS Sustainability Model ) • To agree a behaviour change framework across the community (in partnership with regional work) • To work with MAP of Medicine to develop and test clinical pathway • Mainstream work following initial phase Linda.saxe@derbyshirecountypct.nhs.uk

17. Contact Us Maureen.Murfin@ntlworld.com Elaine.Varley@nhs.net