Dr Paul Goldsmith Consultant Neurologist / SCN Clinical Lead Neurological Conditions Introduction and Welcome

Every Contact A Health Improvement Contact ( ECHIC ) Amanda Healy Director of Public Health South Tyneside Council

37.7% of 10/11 year olds are overweight or obese (n=2,474) 20.7% of adults smoke (n=23,947) 27.7% adults are high risk/ binge drinkers (n=31,812) Why Are We Doing It ? Local Context A compact Borough with a long track record of close partnership working Fantastic assets in local communities Over 2500 people have told us ‘what being healthy means to them’

‘Health is Everyone’s Business’ (Marmot 2010) NICE Guidelines on Behaviour Change (2007: PH6) and (2014: PH 49) Alignment with Key Priority Areas of Work Joint Strategic Needs Assessment Joint Health and Wellbeing Strategy Independent Evaluation: University of Sunderland Underpinning Evidence

Key Drivers Leadership and Vision Corporate and Elected Member ‘Buy In’ Public Health ‘Coming Home’ 5,500 Council Workforce – 70% live locally Deliver ECHIC within Council and roll out to partner organisations including 3 rd sector 5 year programme – cultural shift in mindset – healthier lifestyles as the social ‘norm’

Leadership & Corporate Support Action Planning Programme Roll Out Staff embracing health messages Evaluate & Review Embedding ECHIC across services Impact on individual, workforce & families Our Journey So Far…..

Mapping Exercise: ―Identified all staff groups, roles and responsibilities (total workforce n=5,500) Diversity of Teams: ―social workers, refuse collectors, councillors, school cooks, pension staff and beyond.... Programme Outline: ―Level One: aimed at staff with little or no contact with public ―Level Two: aimed at staff with regular contact with public Skills and Confidence Building: ―Knowledge on key health messages ―Skills development on behaviour change techniques ―Advocacy role in supporting healthier lifestyle choices Workforce Development: Key Aims

800 Council Staff Elected Members – Councillor Guide 100 participants from Partner Organisations Whole systems approach Roll out to public and 3 rd sector partner organisations Progress To Date: Participation and Partnerships

Individual Change Organisational Change Partnership Change Long Term Behaviour Change Progress To Date: Impact and Outcomes

Independent evaluation undertaken by University of Sunderland 93% of staff participants completed evaluation questionnaire A sample of participants (n=100) took part in semi structured interviews, telephone interviews and focus groups Outcomes: Fully Engaged - already doing it Engaged - with concern about application Not engaged - don’t see it as part of their role Segmenting workforce and aligning programme to segments Evaluation and Measuring Impact

Develop programme further with support from Academic Health Sciences Network:  Develop networking partnership group  Pilot measurement tool within staff groups and partner organisations  Volunteer Health Advocates to embed ECHIC into mainstream activities Developing a framework to measure outcomes Long term behaviour change: reductions in smoking, excess weight, alcohol and physical inactivity Overall improvement in health and wellbeing Next Steps

John G, aged 57, shed four stone by ‘attacking the fruit bowl’ John B aged 49, a diabetic lost four and half stone I lost 4 stone after swapping cream cakes for a healthier diet of fish and chicken (Ian) Supervisor David said after seeing what a portion size should be, I’ve lost two and half stone Since losing the excess weight my blood pressure and cholesterol gone down to healthier levels (David) It was through taking part in the work programme that I decided to do something about my weight (David)

Academic Health Science Network Making Every Contact Count (MECC): A project to implement best practice in Foundation Trusts and Local Authorities

Background What we know about MECC It needs to be driven through all levels of an organisation Staff need a lot of support (and permission) to do MECC They need to know how to do it including raising issues that have strong social taboos We need strategies for keeping it on the agenda

Aim The aim of this project is to work with staff in four partner organisations, two Foundation Trusts and two Local authorities to implement MECC and to identify what helps or hinders this. The project will consider how MECC is implemented within organisations and the lessons learned from this will inform future implementation across organisations.

Project Outline Stage 1: Priority Setting Stage 2: Skill Development Stage 3: Evaluation and lessons learned Stage 4: Dissemination

The 4 projects Healthy ageing in Gateshead QE Hospital MECC champions network in South Tyneside Location and workforce based development in Darlington Endoscopy care pathway in Sunderland City Hospital

Impact on Systems and Patients The approach taken ensures that senior staff in each partner organisation are fully involved and to ensure MECC is built into policy and practice in a sustainable way. This way, frontline staff delivering MECC have the support necessary to use the skills developed.

Future Programme Development Network Support Partnership Pioneer Changing Conversations Delivering Every Contact health conversations Delivering Every Contact health conversations Planning & Review Management Group Health Champions / Advocates Health Champions / Advocates Personal Development Measuring Impact Case Study Development & Sharing Good Practice

Setting the Scene NICE BEHAVIOUR CHANGE GUIDELINES (2007/2014 ) Recommended Principles Planning Social context Education and training Individuals Communities Populations Effectiveness Cost effectiveness Developing Capacity (MECC Guidance Model 2012) Developing the infrastructure to operationalise MECC Ensuring MECC is embedded and sustainable Ensuring people have the capability and vision to operationalise (Dahlgren and Whitehead 1991 Adapted by Barton and Grant 2006)