1. Emily Jenkins-Pandya- MECC Co-ordinator
Bath & North East Somerset, Swindon and Wiltshire

2. Overview What is Making Every Contact Count? Links to cancer strategy
Making Every Contact Count in the South West
Why is MECC relevant for you and how can you get involved?

3. is Making Every Contact Count?
Making Every Contact Count enables organisations and individuals to develop and be able to use a different approach to working with people to address health and wellbeing. Telling people what to do is not the most effective way to help them to change. Making Every Contact Count is about altering how we interact with people through learning how to recognise opportunities to talk to people about their wellbeing.
Making Every Contact Count (MECC) is about supporting workforces to maximise on the public health opportunity they have with their regular contact with the public. Staff from a variety of organisation can make a difference to the health and wellbeing of the population by encouraging people to change behaviours that may be damaging to their health.
DEFINITION
Making Every Contact Count training allows workforces to:
Deliver a ‘very brief’ or ‘brief’ evidence based advice/intervention for lifestyle behavioural change;
Be competent and confident to do this; and
Be knowledgeable about local services and how to access them.
MECC is about transforming the culture to one that looks to enhance positive outcomes through providing people with information and encouragement.
MECC is not about additional workload but developing skills to enable staff to use a different approach to engage with people to support them to make changes to their lifestyles to improve their health.
MECC is for everyone,

4. Benefits of MECC
Staff wellbeing – healthy conversations within the workplace
Patient / Service user benefits – longer, healthier lives
Quality Benefits – Improving quality of services and patient outcomes
Organisational development and change – system-wide prevention and early intervention

5. The need for MECC
These are the policy drivers for Making Every Contact Count:
The NHS – Five Year Forward View, (NHS 5YFV) talks about a ‘radical upgrading of prevention and public health’ and the role the NHS has in enabling self-care and management of health. “The  NHS has an important public health role in making every contact count. The NHS must focus on preventing illness, with staff using every contact they have with people as an opportunity to help people stay in good health – by not smoking, eating healthily, drinking less alcohol, and exercising more.”
The Health Education England mandate sees the role it has in helping the workforce to make the NHS 5YFV happen. The mandate makes plain the role HEE has in developing people to have the confidence, skills and knowledge to make every contact count.
The Local Government Association (LGA) can see the important role local authorities have in supporting the implementation of MECC. Their services bring opportunities to making every contact count and can impact on the wider determinants of health (i.e. housing, social care, transport). (LGA, 2014)
Public Health England (PHE) PHE in Evidence into Action talks about a ‘fundamentally new approach to creating and sustaining health, mental and physical, at every stage of life and across all our communities is needed’. PHE have an important role in working with others to take Making Every Contact Count forward both locally and nationally. This is to make sure the way MECC is taken forward works well and is consistent and can build the evidence-base.
NHS England – NHS Standard Contract - The NHS Standard Contract is mandated by NHS England for use by commissioners for all contracts for healthcare services other than primary care. Standard Condition 8.6 states:
The Provider must develop and maintain an organisational plan to ensure that Staff use every contact that they have with Service Users and the public as an opportunity to maintain or improve health and wellbeing, in accordance with the principles and using the tools comprised in Making Every Contact Count Guidance.

6. MECC in the NHS
“The Provider must develop and maintain an organisational plan to ensure that Staff use every contact that they have with Service Users and the public as an opportunity to maintain or improve health and wellbeing, in accordance with the principles and using the tools comprised in Making Every Contact Count Guidance.”
- NHS England 2016/17 NHS Standard Contract Service Conditions
Over the years, national policy has seen a shift towards focusing health care models more on prevention and Public Health in order to ensure positive health and wellbeing outcomes for populations. Some key policy drivers (below) highlight that we need to look at what we can do differently and large scale across our services if we are to support and deliver on this agenda:
• The MECC Consensus Statement (PHE, 2016(a)) recommends that the MECC approach should be applied across all health and social care organisations. Signed by a wide range of organisations, including Health Education England, Local Government Association and Care Quality Commission, it describes the commitment to the MECC approach as a way of supporting positive behaviour change.
• Sustainability and Transformation Plans show how local services will evolve and become sustainable over the next 5 years - ultimately delivering the 5 Year Forward View as a vision of better health, better patient care and improved NHS efficiency. MECC is included in the 5 Year Forward View.
• The Health Education England Mandate (DH, 2015) sees the role it has in helping the workforce to make the NHS 5 Year Forward View happen. The mandate makes plain the role HEE has in developing people to have the confidence, skills and knowledge to Make Every Contact Count.
• Public Health England Evidence into Action (PHE, 2014) talks about a ‘fundamentally new approach to creating and sustaining health, mental and physical, at every stage of life and across all our communities’ being needed. PHE have an important role in working with others to take MECC forward both locally and nationally ensuring this is done consistently and successfully to build a good evidence base.
• NHS Future Forum (2012) made the recommendation that every healthcare organisation should deliver MECC and “build the prevention of poor health and promotion of healthy living into their day-to-day business”.

7. Staff who regularly come
into contact with people for 30 minutes or more who are at higher risk
Staff who have an opportunity to encourage and support people who’s health and wellbeing could be at risk
For everyone in direct contact with the general public
To raise awareness motivate and signpost people to help them improve their health and wellbeing.
High Intensity Interventions
Specialist
Practitioners
Behaviour change interventions mapped to NICE Behaviour Change: Individual Approaches
Extended Brief Interventions
Brief Interventions
Very Brief
Interventions
MECC is in the bottom half of pyramid – however, people may be signposted to specialist services higher up the pyramid and there are links between all service areas in the diagram.
Many present at cancer networks will sit at the top of the pyramid, but this shows how services link together.
- Although I am mindful that a lot of you and the teams you work with sit at the top of this pyramid; all of you with know of or work with people at the bottom of he pyramid as well. MECC is instigating a culture change with improved positive outcomes, providing information and support in order to empower the public to take responsibility for their health and behaviours. Therefore it is important that even though at the bottom of the triangle have the skills and confidence to deliver these messages.

8. MECC Cancer Prevention
“We will do this by engaging clinicians, commissioners and local authority providers in new initiatives to change behaviour, increasing public awareness of risk factors and health promotion, especially with vulnerable groups.”
Cancer strategy Implementation Plan “Achieving World Class Cancer Outcomes – Taking the strategy forward”
Radically upgrading prevention and public health is the first major building block for change in the plan
Aim is to significantly reduce the 40% of cancers caused by behavioural, lifestyle and environmental factors
We will do this by see above - “increasing public awareness of risk factors and health promotion”
Our priorities for 2016/17 are:
The Government will publish the new Tobacco Control Plan by the end of 2016.
Working with Public Health England and other partners, the Department of Health will publish the national childhood obesity strategy in late 2016.
Public Health England will publish their alcohol evidence review in autumn 2016.

9. Early Diagnosis MECC can support early diagnosis by:
Promoting screening uptake
Promoting cancer campaigns
Promoting healthy lifestyles, getting more active, quitting smoking, achieving a healthy weight, drinking less alcohol

10. Living with and beyond Cancer
MECC skills can be used to:
Support health optimization pre and post surgery/ treatment.
Reduce and manage long term consequences of treatment.
Support and signpost family members of cancer patients.

11. MECC in the South West MECC SW steering group Strategy :
We are using the Wessex Model to make MECC about long-term organisational change
Coordinated and consistent approach to support system-wide change
Ensuring organisational readiness (STP level buy-in)
Ensuring staff readiness and training
Robust review and evaluation process to develop the future implementation of MECC.

12. Why is MECC relevant for you and how can you get involved?
MECC will be rolling out in acute trusts during 2018.
MECC leads will be planning implementation and training, including prioritisation of staff groups.
Make contact with your local MECC lead, identify any priority areas, and support staff who are identified for training.

13. Contact Details Bristol, North Somerset and South Gloucester:
B&NES, Swindon and Wiltshire:
(Emily)
Somerset:
(Louise)
Gloucestershire:
Devon: