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Jayne Tunstall Chief Operating Officer

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1 Jayne Tunstall Chief Operating Officer
Members Event Healthy Lifestyle (Long Term Conditions) Jayne Tunstall Chief Operating Officer

2 Ashley Smith Physical Activity Advisor
Motivation Ashley Smith Physical Activity Advisor

3 Alan Jarvis Head of Lifestyle Services

4 Lifestyle Services Promote Positive Health
Aim Promote Positive Health Objectives Health promotion is a process of enabling people to exert control over the determinants of health & thereby improve their health. This is achieved by: Practiced bespoke strategies Enabling people to take action Develop skills to achieve & maintain positive change Take an holistic approach to health

5 Lifestyle Services Overview
Lifestyle choices are the strongest determinants of many chronic diseases, including coronary heart disease, cancer, stroke and diabetes. It is these “chronic diseases of lifestyle” that are responsible for most of the avoidable morbidity & mortality of the Walsall population. The focus of all Lifestyle Services is to increase life expectancy and mental well being, through a programme of health improvement targeting areas with poorest health outcomes to reduce health inequalities. Lifestyles services, works in partnership across the health economy in Walsall to deliver a wrap around delivery model that aims to addresses the health needs of the Walsall population resulting in a positive patient experience

6 Lifestyle Services Lifestyles, Acute primary care and all other aspects of health delivery in Walsall should have a symbiotic relationship, working in partnership to deliver a wrap around delivery model that addresses the health needs of the Walsall population resulting in a positive patient experience.

7 What are Lifestyle Services
Referrals Stop Smoking Service Physical Activity Lifestyle Link Health Trainer Older People Substance Misuse Mental Health and Wellbeing Health In The Workplace

8 Walsall Healthcare NHS Trust
Lifestyle Link 8

9 Our Aim The aim of this initiative was to develop and maintain a single booking system for all lifestyle services that can be accessed easily by either telephone or online, this is open to the general public to self refer and referring agencies. 9

10 Why a single booking system
NATIONALLY The White Paper ‘Our health, our care, our say, a new direction for community health services’, DoH, February 2006 emphasises the importance of service delivery as close to the user as possible The service will be fully compliant with the national quality requirements of the ‘Core Standard’ as set out by the Care Quality Commission . The service will comply with any reviews carried out by the Care Quality Commission. LOCALLY Simple, not only had we managed to confuse potential clients we had all confused NHS staff Clients and staff were frustrated by having to repeat information 10

11 Comparison of bookings taken January – October 2010 vs
The object of Lifestyle Link was to encourage everyone to access the service via one number. January – October January – October Bookings have increased by over 50% since the launch of this service. 11

12 Clients referals : 1 November 2010 – 1 November 2011 there have been 4255 bookings taken, a selection of referrals coming from: 757 of these have been referred from GP’s 1089 have been referred by Other Health Professionals which include referrals from: 32 from Cardiology 29 from CPN’s 26 from COPD 21 from the Diabetes team 20 from the Infertility Clinic at the Manor 45 from Midwives 21 from the Outpatients 458 from Practice Nurses. 12

13 Walsall Health Trainer Service
Walsall Healthcare NHS Trust Walsall Health Trainer Service Sue Caulfield -Health Trainer Manager Sue has worked in a number of roles within health promotion including smoking cessation and older peoples services. She currently manages Walsall’s Health Trainer Service. The service is made up 14 members of staff from varied backgrounds and a wide skill mix. 13

14 Background Recommendations from the Choosing Health (2004) White Paper
Aim to reduce health inequalities Health Trainers focus on encouraging and enabling individuals from disadvantaged communities to make healthier choices that are right for them. One to one personalised support to help people to make changes to improve health 14

15 Service Offered Locally based – service for local people, delivered by
Provides one to one personalised support and motivation Cancer screening prompts Key areas: alcohol consumption, physical activity, smoking cessation and weight management Personal health plans setting SMART achievable goals improves access to preventative services in deprived areas communicates key health messages to individuals from deprived communities 15

16 A Service that can…… Signpost to mainstream services
Collect & maintain accurate records & data systems Evaluate effectiveness of services locally Act as a catalyst to reduce the inequalities gap

17 Long Term Conditions and Lifestyle
Smoking, obesity, alcohol consumption, physical inactivity are all important modifiable risk factors that can impact on health outcomes. Supporting people with long term conditions to adopt healthier lifestyles can halt the development of additional conditions and aid overall management of long term conditions.

18 Rapid Access Angina Clinic
‘One Stop’ clinic approach Reviewed by a consultant cardiologist Referred to health trainer for 1-1 support Family centred approach 

19 Patients with Impaired Glucose Tolerance
Prevalence in the south of Walsall higher than the local and National average

20 Strong evidence that type 2 diabetes can be delayed or prevented by lifestyle intervention. (1)
In the absence of any interventions about 50% of IGT patients will develop type 2 diabetes in 5 – 10 years. (1) Working with area partnerships in the South of Walsall to raise awareness and increase referrals for lifestyle interventions for IGT patients (1) Diabetes UK Position Statement (2009)

21 2013 Delivery to Date Since its launch in January 2007 the Health Trainer Service in Walsall has continued to grow and develop to meet the needs of the local population. 19,109 referrals into the service since 2007 74% of all referrals from deprivation quintiles 1and 2 73% of clients referred achieved or part achieved goals Total weight loss of clients for 2011/12 equates to 10,2181kg, or 1609 stone 21


23 Service Objectives To increase physical activity levels within Walsall by providing opportunities to take part in physical activity within communities across the borough for adults, children and families Increase awareness of the importance of physical activity and the relationship to health and the prevention of chronic diseases Encourage adults and children to increase their activity levels to the current guidance set by the CMO and Department of Health (2011) “150 minutes of moderate intensity activity per week” (this could be broken into 5 x 30 minutes per week) “60 min of physical activity everyday of the week for children including weight bearing activity on 3 days per week”

24 Benefits of Physical Activity
Decreased risk of: Cardiovascular Disease Stroke Type 2 Diabetes Cancer Falls Depression, anxiety and stress Positive effects on: Hypertension Osteoporosis Body Weight and Composition Psychological Health Social Health Musculoskeletal Conditions

25 What do we do?... Deliver a weekly timetable of FREE opportunities for adults, children and families to take part in Physical Activity across the borough on a variety of days at a range of times Deliver Active Clubs/Active Ability Training for staff within schools, out of school clubs and parents to increase capacity and sustainability of PA opportunities Deliver physical activity awareness training to health care professionals part of “Weights Over”. Develop and deliver physical activity initiatives within workplaces to encourage activity in the workplace Delivery of Specialist physical activity sessions e.g. Aqua Natal, Level 4 Obesity Clinics and women’s only sessions to break down cultural barriers to participation in activity Make it Count which is a locally developed physical activity and obesity prevention/treatment programme for 4-7 yr old and their families.


27 For more information on the Make It Count programme phone
Make it Count is a 12-week programme for 4-7 year olds and their families, and uses a family centered approach to increase physical activity levels and knowledge of healthy eating. The programme aims to support families making small changes to become healthier by promoting the national Change4Life message. Each week children and their families can take part in 60 minutes of fun by playing a variety of games and developing their knowledge of healthy and unhealthy food choices as well as understanding how the different areas of the Eat Well Plate help their bodies to develop. Children will build up a week by week folder of information about healthy living which includes colouring sheets, crosswords and word searches. Throughout the programme parents are encouraged to play the games with their children and act as an active role model. The parents will also get the opportunity to gain tips about preparing healthy meals and how to reduce salt, sugar and fat. For more information on the Make It Count programme phone Lifestyle Link on

28 Access to Service Between April 12 – March 13 we had 22,000 face to face contacts with people attending our physical activity sessions Currently 8500 people on the data base reflecting the number of Walsall people that have accessed the Physical Activity Service since November 2008 Over 180 school and out of school staff trained in Active Clubs Self Satisfying Questionnaires completed by service users during April 12 – March 13 evidenced that more than 96% of clients reported both physical and psychological benefits from being more physically active Face to face contacts includes attending physical activity sessions, training, brief interventions 28


30 Walsall Stop Smoking Service
Walsall Healthcare NHS Trust Walsall Stop Smoking Service Service lead – Erica Pugh Senior Advisors – Rebekah Few and Emily Bissell Advisors – Faye Bennett, Carol Shepherd and Sue Durkin Admin Team – Steph Coyne and Dinesh Patel 30

31 Walsall Stop Smoking Service
Make a change, keep the change! The objectives of the Lifestyle Services Stop Smoking Team are to: Provide training, education and information that supports a reduction of smoking in the Walsall borough Provide a 12 week stop smoking course including treatment in both 1:1, group and home visit settings Provide support to those with Smoking related illness in attempting a ‘quit’ Support the Healthy Workplace Awards in promoting Stop Smoking Provide specific support to smoking pregnant mothers Provide a holistic service where signposting and referral to other services are carried out 31

32 Walsall Stop Smoking Service
Service Offered 12 week stop smoking course (if client continues to successfully quit) offering behavioral support Nicotine Replacement Therapy or tablet Medication Intermediate Advisor training, Annual Update Training and locality management for partners 1:1 clinics, Group clinics and phone support Home visits for housebound clients Stop smoking groups within a work place Support and information to other health colleagues General smoking cessation promotion 32

33 Walsall Stop Smoking Service
Treatment Offered Microtab Patches Mouth Spray Inhalator Cools lozenge Lozenge & Mini Lozenge Nasal Spray Gum 33

34 Walsall Stop Smoking Service
Smoking Paraphernalia Pipe Low tar cigarette Smokeless tobacco; betel, paan, snuff Roll-up cigarette Nicotine chewing gum Menthol cigarette Cigar Herbal cigarette ‘Normal’ cigarette Shisha Electronic cigarette 34

35 Walsall Stop Smoking Service
Benefits of Quitting The quitting timeline After 20 minutes your blood pressure and pulse return to normal. After 24 hours your lungs start to clear. After two days your body is nicotine-free and your sense of taste and smell improve. After three days you can breathe more easily, and your energy increases. After two to 12 weeks, your circulation improves. After three to nine months coughs, wheezing and breathing improves. After one year your heart attack risk is  half that of a smoker. After 10 years your lung cancer risk is half that of a smoker 35

36 Walsall Stop Smoking Service
Health Benefits of Quitting You will reduce your risk of developing illness, disability or death caused by cancer, heart or lung disease. You will reduce your risk of gangrene or amputation caused by circulatory problems. You will protect the health of those around you by not exposing them to secondhand smoke. You will reduce the chances of your children suffering from bronchitis, pneumonia, asthma attacks, meningitis and ear infections. You will improve your fertility levels and your chance of a healthy pregnancy and baby. You will improve your breathing and general fitness. You will enjoy the taste of food more. 36

37 Walsall Stop Smoking Service
2011/12 Delivery and Current Figures In 2011/ people set a quit date, 1628 were smoke free at 4 weeks giving the service a 42% success rate. In addition to this, 61% (1000) remained smoke free at 12 weeks. So far in 2012/13 – 2900 people have set a quit date. To date 1117 were smoke free at 4 weeks giving the service a 39% success rate. We do not yet have the 12 week data. 19 borough wide specialist advisor clinics We have a total of 81 partners consisting of 39 in pharmacies, 23 in GP’s and 19 in other settings. All of these partners provide smoking cassation on behalf of the Walsall Specialist Stop Smoking Service Correct at 16/04/13 37

38 Substance Misuse Service
Walsall Healthcare NHS Trust Substance Misuse Service Emilie Stone & Amber Marshall 38

39 Substance Misuse Service
Service provided in line with following guidance: National Alcohol Strategy (2012) National Drugs Strategy (2010) NTA Families Matter (2008) (amongst others) ‘Drugs matter to the whole of society; as all of us feel the impact’ Drug Strategy 2010

40 Some examples of work: Basic Drug & Alcohol Awareness Courses (full day & half day) What is a drug? Short & long term effects of alcohol & drug use Risks of alcohol & drug use Effects on family and wider society ‘Legal highs’ Calculating alcohol units & guidance on safer drinking Possible reasons and indicators for abuse Support services available in Walsall Bite-size Drug & Alcohol Awareness sessions 1hr and 2hr mini versions of the above

41 Some examples of work: Identification & Brief Advice Training (IBA)
A proven way of helping those drinking above recommended guidelines reduce their intake. Uses basic screening tools to identify problem drinking followed by simple, structured advice. Raises awareness of harmful drinking patterns and associated effects. Drug Use Screening Tool (DUST) Training Developed with Safer Walsall Partnership and T3 Young Person’s Drug & Alcohol Service. Easily accessible, quick-to-use tool aimed to help staff decide how best to respond to substance use. Incorporates a referral form for T3 support.

42 Some examples of work: Work in Schools Community Awareness Raising
Training PSHE Co-ordinators Lessons to pupils Loan of resources Community Awareness Raising Attending Community Events and Health Days Providing Information Signposting to appropriate services Awareness Campaigns Developed in line with local strategy to reduce alcohol related hospital admissions

43 Feedback From Our Training
“Interesting. Enjoyed it. Thank you.” “Very good and Interesting course” “Very educational” “I feel the sessions have been very helpful and informative and the children have taken in lots of useful facts.” “Good information, well presented, thank you.” “The children really enjoyed the session and came up with really good ideas. There were good discussions at the tables.” “Great interactive resources. Well Presented. Thank you.” “SHOULD GIVE OUT FREE SAMPLES.”

44 Emotional Health and Wellbeing Service Walsall Healthcare NHS Trust
Steve Upton: Emotional Health & Wellbeing Manager Anne Pledger: Emotional Health & Wellbeing Specialist Joanne Stallard: Health Trainer for Emotional Health & Wellbeing Steve – background: registered MH nurse etc.. Anne: Primary care mental health worker, BSc Psychology, Post Grad in Public Health Jo: HT city and guilds, working towards Psychology BSc 44

45 ‘There is no health without Mental Health’ Dept of Health, 2011
The Emotional Health & Wellbeing Service: Provide training, education and information that supports a reduction of suicide, improved mental health, increased wellbeing and resilience, particularly targeting high risk groups Training sessions: MHFA and Youth MHFA – 2 day training session building up confidence and knowledge of recognising and supporting someone experiencing mental health problems Supporting the Healthy Workplace Awards scheme by delivering: Start Living, Stop Stressing! and Preventing Stress: Positive Manager Behaviour One to one support: up to 8 sessions of low level support for individuals who are experiencing low mood, anxiety or symptoms of stress. Based on the five areas approach, using CBT approach. Referrals via: Occupational Health, Health Trainers, Cardiac Rehab 45

46 Mental Health Promotion
The team also promote positive mental wellbeing and ways that individuals can improve their wellbeing The main mental health promotion message is: The Five Ways to Wellbeing World Mental Health Day (10th October) is the main mental health promotion event. The team plan events across the borough to promote community engagement and to encourage positive wellbeing – keep your eye out for this year’s events!

47 2012 / 13 performance The one to one support service launched in February 2012. To date the team have supported: Cardiac Rehabilitation: 49 referrals, 22 ongoing clients Occupational Health: 84 referrals, 42 ongoing clients Health Trainers: 58 referrals, 17 ongoing clients * Improve Walsall Mental Health Literacy 47

48 Feedback from one to one sessions
Just having someone to talk to and understand me was a big help. I can’t thank the service enough. I found the meetings very helpful. I felt so low and negative about myself and my attitude to weight loss. Both Anne and Eileen managed to change my mindset and I now feel in control and positive. Just like to thank you for all your help and support. I hope in a nice way that I don’t have to have your service as I feel a lot better in myself, thank you.

49 2012 / 13 performance MHFA: 97 trained mental health first aiders
YMHFA: 34 trained youth mental health first aiders Healthy Workplace Award, worked with the following companies: whg, Echo Managed Services, South Staffs Water, Brownhills Job Centre, Job Centre Plus Walsall, Walsall Council Bitesize Stress Management: 116 people trained Preventing Stress: Positive Manager Behaviour: 110 managers trained

50 Feedback from training sessions
A practical and realistic course, offering genuine guidance that can be used in my daily practice. Well presented, highly recommended Very useful information. I learnt a lot I greatly enjoyed the course Hopefully I now have the tools to recognise mental health problems and to be able to help It was good to hear someone reinforce the link between good management and stress Excellent and thought provoking

51 The Future Books on Prescription
The books provide helpful information and step- by-step self-help techniques for managing common conditions, including depression and anxiety Need to sign up to library services (if not already a member) National launch – 3rd June, local launch 10th June

52 The Future The team are supporting Public Health to update the Suicide Prevention Strategy, due to be launched later in 2013 Development of a new suicide risk assessment training programme to be rolled out The team have been involved in developing a Dementia training module for Health and Social Care staff in Walsall, due to launch very soon. This work is in partnership with Walsall Council and DWMHT Continuation of Healthy Workplace Awards: TKMAXX and Walsall Libraries signed up for stress management support

53 Health Promotion Service
Walsall Healthcare NHS Trust Older People’s Health Promotion Service Fran Hancock: Health Promotion Specialist For Older People Older People’s Service – 1 WTE Fran – Bsc Hons in Sport & Exercise Science with Health Studies. Previous roles include: exercise supervisor in Cardiac Rehab setting, Falls Prevention Physical Activity instructor. 53

54 National Service Framework for Older People recognises 3 broad categories of older people
Entering older age: People who are nearing the end of or who have completed their career in paid employment and/or child rearing. This is a socially constructed definition which can include people as young as 50, or those who have reached retirement age. Transitional phase: This group are in transition between healthy, active life and fragility. This transition often occurs in the seventh or eighth decades but can occur at any stage of older age. Frail older people: These people are vulnerable as a result of health problems such as stroke or dementia, social care needs or a combination of both. The Older People’s Health Promotion service recognises that age is very individual. Overall the service supports people over the age of 50, but has more of an emphasis on the transitional and frail older people stages = work is generally more targeted at over 65s.

55 Older Peoples Health Promotion Service…
Promotes healthy ageing by supporting older people, focusing on physical activity, nutrition, falls prevention, 5 ways to wellbeing, and social inclusion. Is responsible for National campaigns such as Falls awareness Week and Older People’s Day.

56 Some examples of work: Work with local community groups and local organisations in the form of brief advice, healthy lifestyle courses, health checks and promotional talks. 1:1 client work Mobility & wellbeing exercise sessions Brief advice Attending local events Pilot projects such as Walking Football & Nintendo Wii & DS The service has close links with various local partners & services – including Age UK, WHG, ILC, Silver Keys Project, Stan Ball Centre, Specialist Falls Service.

57 National Falls Awareness Week
2013 – ‘Healthy Feet’ 17th – 21st June - This week!! About 30 per cent of over-65s and 50 per cent of those over 80 will fall every year. However, there are many simple things that older people can do to prevent a fall and its potentially devastating consequences. The aim is to raise awareness and provide information about how to reduce the risk of falls, access local falls prevention and health promotion services. 2010 – ‘Get Up and Go 2011 – ‘Watch Your Step’ 2012 – ‘Boost Your Bones June theme of Healthy Feet. Previous promotional events have included - promotional events and activities in a number of health centres, Walsall Town Centre Market Stalls, events at local supermarkets, Safe slipper exchanges, balance testing, and exercise tasters. We work closely with the hospital to promote Falls Awareness week for staff, patients‘ and their families too. Information is available at the end of the session. 57

58 Mobility & Wellbeing Exercise
“I really enjoy coming along to the class, it really loosens me up and I feel smashing! I have made new friends from attending the class and we have a real laugh every week. The class has inspired me to enrol at the local leisure centre, where I have been attending swimming sessions, and am currently awaiting an appointment with a gym instructor for some individualised exercises”. Clients from the Stan Ball day care group access the session, people who come along to the luncheon club join in, as well as a number of learning disability groups that come along to participate. The weekly sessions are open to anyone who lives in the Walsall borough and are completely free. The class is based around the principles of Extend, and provides a group based session of gentle exercise to music. The sessions are aimed at people 65 or over, but are also open to anyone with a disability. The session aims to promote health, increase mobility and independence, improve strength, co-ordination and balance and to counteract loneliness and isolation.

59 Health in the work place Lisa Sylvester
Walsall Healthcare NHS Trust Health in the work place Lisa Sylvester Specialist Health Trainer for the Workplace 59

60 Healthy Workplace Awards
Working days lost 29.3 million days were lost overall (1.24 days per worker), 24.6 million due to work-related ill health and 4.7 million due to workplace injury. Ill health 1.2 million people who worked during the last year were suffering from an illness (long-standing as well as new cases) they believed was caused or made worse by their current or past work of these were new cases

61 Healthy workplace awards
To reward local businesses for participating in activities that promotes healthy lifestyle choices, and support those aspiring to do so. To raise awareness of personal healthy lifestyle choices and the value of Health Promotion in the workplace. To develop a successful delivery model that could be used in other businesses.

62 Walsall Healthy Workplace project can supports organization to
Supporting Health Initiatives Providing health information resources Assisting businesses in there application for the Walsall Health Workplace Awards Structured opportunity to promote health in the workplace Recognise best practice activities and projects Open to all businesses regardless of industry. Policy development Support staff with long term conditions Pro actively address poor health

63 The Healthy Workplace Awards benefit employees by providing them with
Healthy working conditions Healthy information at work Practical help to be healthy A sense of team spirit and reward A boost to morale and motivate Good management/employee relations Benefits of working for a responsible employer Fun, social events The chance to improve their awareness of health issues and make a difference to their lifestyle

64 The Healthy Workplace Awards can give employers
A healthier, happier workplace (financial benefit) A motivated team with high morale (financial benefit) Good management/employee relations Less sickness turnover (financial benefit) Positive links with your community The PR benefits that come from being involved in a Walsall Borough Award Programme that makes a difference to peoples working lives, home lives and to the community

65 The key programme themes are:
Awareness programmes. Lifestyle change programmes Supportive environment programmes Individual health checks NHS health checks for over 40’s Bespoke health initiative Five ways to well being Smoking cessation Physical activity Awards programme

66 Some examples and testimonies from previous award winners
Brownhills JCP have worked with NHS Healthy workplace award scheme for over three years now. Lisa has given continued advice and support. Anne from The Emotional Health & Wellbeing has supported us and helped tackle stress by running stress work shops for all staff and also an in house lunchtime stress group. Numerous Staff have accessed Lifestyle Services and as a result of all activities undertaken we have lost over 12 stone in weight between us given there are only 34 of us this is a huge achievement. We have run numerous events and activities over the last three years, country walks, canoeing, tobogganing, bowling, Go-Carting, meals out, in house healthy eating events and fun day activities and events on site. Staff moral and health has significantly improved sick, absenteeism has reduced from 18.4 to 7.4.

67 Make Every Contact Count

68 The MECC CQUIN Individually coloured cards will be given to each ward
To achieve the MECC CQUIN wards are asked to distribute Lifestyle Link Cards and issue brief advice Individually coloured cards will be given to each ward When clients are contacted they will be asked the colour of the card given


70 Brief Advice Ask Advise Act
Do you smoke, are you worried about your weight, have you considered exercising ….. Advise Did you know there is a free of charge service to help you with this? Act Here’s their information - Direct referrals can also be made to , referral pads available on request

71 Do not underestimate your influence as a health professional
Why Give Brief Advice? Intervention Outcome Numbers needed to treat Brief advice from a health professional (regarding smoking cessation) Prevent 1 premature death 80 Statin’s 1 death over 5 yrs 107 Antihypertensive therapy Prevent 1stroke/MI death over 1 year 700 SMEAR 1 death over 10 yrs 1140 Do not underestimate your influence as a health professional


73 E-Learning 2 modules Brief encounters Motivating change
Accessible though ESR 2 modules Brief encounters Motivating change

74 find us on the global email
Contact Darlaston Health Centre Pinfold Street WS10 8SY Lifestyle Link Fax Smoking Cessation: Rebekah few, Emily Bissell (Erica Pugh) Mental Health and Well-being: Steven Upton, Anne Pledger Older Persons: Fran Hancock Drug and Alcohol: Emilie Stone Physical Activity: Tracy Thompson Health Trainers: Sue Caulfield Lifestyle Link: Marion Ball find us on the global

75 Information Point Lifestyle Services Information Point situated outside route 006 in the Out Patients Department Free health monitor to measure weight, height, BMI, blood pressure and body fat %. Lifestyle advice and support

76 Anne Pledger Emotional Health & Wellbeing Specialist
Relax Anne Pledger Emotional Health & Wellbeing Specialist

77 Thank you for listening, any questions?

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