Making Every Contact Count Dr Sallie Bacon ADPH NHS Hampshire

Making Every Contact Count to create a healthier population Using every opportunity to achieve health and wellbeing Achieving long term behaviour change Building an organisational culture that supports health improvement and reducing health inequalities Making Every Contact Count (MECC) represents a simple and novel approach to public health service delivery. It seeks to radically extend the delivery of public health advice to the public by training non specialist staff from a wide range of service organisations, for minimal investment, in the basic skills of health promotion and prevention and thus create an extended sales force’ for healthier living'1. The aim of MECC is to mobilise the NHS's greatest asset, its workforce, in delivering simple and timely advice to the vast potential number of service users they come into contact with on a daily basis. Its aim is to ensure that a wide range of NHS staff are trained and confident to make the most of these opportunities which help people stay healthy and reduce system-wide costs to the Reducing costs Behaviour change in front line staff – started with NHS but gone viral – other organisations – fire /LA/ police/ childrens services/pharmacies etc Future Forum report on public health - controversial Need a cultural shift in how healthcare staff use their time with patients . Make better use of the time that healthcare staff have with patients . Maximise opportunities to pro actively raise the issue of lifestyle. Spiralling costs due to unhealthy lifestyles – unsustainable It has come out of the need to transform the relationship between staff and patients/clients in order to reduce the toll of ill-health and the cost to the NHS and social care caused by the sharply rising numbers of people with conditions linked to lifestyle is needed (Future Forums). Wanless – 2004 Securing good health for the population Darzi review 2008 - High quality care forall set out the need to put prevention first and the Marmot Review on health inequalities in England post 2010, set out six objectives to tackle health inequalities, one of which was to strengthen the role and impact of ill health prevention. Not just front line staff On line training for anyone who comes into contact with the general public Having a vital first conversation

So what are we up against?

This is why we need it MECC is about using the contact with have with others to have short conversations and provide signposting on lifestyle issues, (no matter what the original appointment or contact was about). MECC focuses on: Stopping smoking Drinking alcohol only within the recommended limits Healthy eating Being physically active Keeping to a healthy weight As these are the lifestyle issues that, when addressed, can make the greatest improvement to an individual’s health. Its ok to ask

Making Every Contact Count EPIC study 1993-2006 NICE guidance on behaviour change Evidence about process of implementation across several organisations But will it work? Evidence for adopting a healthy lifestyle EPIC study 14 year difference in life expectancy for those adopting four healthy behaviours – stop smoking, healthy diet, physical activity, sensible alcohol and High quality care for all set out the need to put prevention first and the Marmot Review on health inequalities in England post 2010, set out six objectives to tackle health inequalities, one of which was to strengthen the role and impact of ill health prevention. MECC NICE GUIDANCE on behaviour change provides supporting evidence for the approach Evidence about the process of implementation But what are the long term impacts? But ? This approach – what do you think? Clare Gerada - muddled off putting for patients Peter Carter – awareness raising campaigns more effective Katherine Murphy – patients association – patients need more advice about lifestyles but need to address wider determinanst esp poverty What do you think? What do you need to implement successfully?

Making Every Contact Count Embed in organisation Systematic approach Senior level buy in Skilling up front line staff What needs to happen for it to work? Cultural change Senior management support Staff need training and to build their confidence to start the conversation Face to face training for staff How staff feel about their own health was important Appropriate environment Patients need to know its ok to ask Senior level buy in Culture that encourages and promotes prevention and health improvement Suitable environment for staff Skills for staff ? Support for staff to adopt healthy lifestyles Senior level buy in – need cultural change in an organisation – healthy patients and staff

WE HAVE KNOWN for some time that things need to change to improve the public’s health NEED TO TRY A DIFFERENT APPROACH How to get people to start to change

Making Every Contact Count What is the contribution that MECC can make to the public’s health? Prevention Address health inequalities Life expectancy gap Improving health outcomes Particulalry important with the move to Local authorities with opportunity to influence a wide range of front line staff

Making Every Contact Count 80% of heart disease, stroke and Type II diabetes and 33% of cancers could be prevented by following a healthy lifestyle Health Inequalities Improve health outcomes Public Health Outcomes Framework Impact on other outcomes frameworks

Making Every Contact Count Why should the development and implementation of MECC be the role of Public Health teams? Delivery of PH priorities Expanding the PH workforce Evaluation

Evaluation