4Lifestyle Services Promote Positive Health AimPromote Positive HealthObjectivesHealth promotion is a process of enabling people toexert control over the determinants of health & therebyimprove their health. This is achieved by:Practiced bespoke strategiesEnabling people to take actionDevelop skills to achieve & maintain positive changeTake an holistic approach to health
5Lifestyle 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 theWalsall 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
6Lifestyle ServicesLifestyles, 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.
9Our AimThe 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
10Why a single booking system NATIONALLYThe 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 possibleThe 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.LOCALLYSimple, not only had we managed to confuse potential clients we had all confused NHS staffClients and staff were frustrated by having to repeat information10
11Comparison of bookings taken January – October 2010 vs The object of Lifestyle Link was to encourage everyone to access the service via one number.January – OctoberJanuary – OctoberBookings have increased by over 50% since the launch of this service.11
12Clients 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’s1089 have been referred by Other Health Professionals which include referrals from:32 from Cardiology29 from CPN’s26 from COPD21 from the Diabetes team20 from the Infertility Clinic at the Manor45 from Midwives21 from the Outpatients458 from Practice Nurses.12
13Walsall Health Trainer Service Walsall Healthcare NHS TrustWalsall Health Trainer ServiceSue Caulfield -Health Trainer ManagerSue 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
14Background Recommendations from the Choosing Health (2004) White Paper Aim to reduce health inequalitiesHealth 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 health14
15Service Offered Locally based – service for local people, delivered by Provides one to one personalised support and motivationCancer screening promptsKey areas: alcohol consumption, physical activity, smoking cessation and weight managementPersonal health plans setting SMART achievable goalsimproves access to preventative services in deprived areascommunicates key health messages to individuals from deprivedcommunities15
16A Service that can…… Signpost to mainstream services Collect & maintain accurate records & data systemsEvaluate effectiveness of services locallyAct as a catalyst to reduce the inequalities gap
17Long Term Conditions and Lifestyle Smoking, obesity, alcohol consumption, physical inactivity are all importantmodifiable risk factors that can impact on health outcomes.Supporting people with long term conditions to adopt healthier lifestyles can halt thedevelopment of additional conditions and aid overall management of longterm conditions.
18Rapid Access Angina Clinic ‘One Stop’ clinic approachReviewed by a consultant cardiologistReferred to health trainer for 1-1 supportFamily centred approach
19Patients with Impaired Glucose Tolerance Prevalence in the south of Walsall higher than the local and National average
20Strong 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)
212013 Delivery to DateSince its launch in January 2007 the Health Trainer Service in Walsall hascontinued to grow and develop to meet the needs of the local population.19,109 referrals into the service since 200774% of all referrals from deprivation quintiles 1and 273% of clients referred achieved or part achieved goalsTotal weight loss of clients for 2011/12 equates to 10,2181kg, or 1609 stone21
23Service ObjectivesTo increase physical activity levels within Walsall by providing opportunities to take part in physical activity within communities across the borough for adults, children and familiesIncrease awareness of the importance of physical activity and the relationship to health and the prevention of chronic diseasesEncourage 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 30minutes per week)“60 min of physical activity everyday of the week for children including weight bearing activity on 3 days per week”
24Benefits of Physical Activity Decreased risk of:Cardiovascular DiseaseStrokeType 2 DiabetesCancerFallsDepression, anxiety and stressPositive effects on:HypertensionOsteoporosisBody Weight and CompositionPsychological HealthSocial HealthMusculoskeletal Conditions
25What 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 timesDeliver Active Clubs/Active Ability Training for staff within schools, out of school clubs and parents to increase capacity and sustainability of PA opportunitiesDeliver 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 workplaceDelivery 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 activityMake it Count which is a locally developed physical activity and obesity prevention/treatment programme for 4-7 yr old and their families.
27For 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 knowledgeof 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 phoneLifestyle Link on
28Access to ServiceBetween April 12 – March 13 we had 22,000 face to face contacts with people attending our physical activity sessionsCurrently 8500 people on the data base reflecting the number of Walsall people that have accessed the Physical Activity Service since November 2008Over 180 school and out of school staff trained in Active ClubsSelf 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 activeFace to face contacts includes attending physical activity sessions, training, brief interventions28
30Walsall Stop Smoking Service Walsall Healthcare NHS TrustWalsall Stop Smoking ServiceService lead – Erica PughSenior Advisors – Rebekah Few and Emily BissellAdvisors – Faye Bennett, Carol Shepherd and Sue DurkinAdmin Team – Steph Coyne and Dinesh Patel30
31Walsall 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 boroughProvide a 12 week stop smoking course including treatment in both 1:1, group and home visit settingsProvide support to those with Smoking related illness in attempting a ‘quit’Support the Healthy Workplace Awards in promoting Stop SmokingProvide specific support to smoking pregnant mothersProvide a holistic service where signposting and referral to other services are carried out31
32Walsall Stop Smoking Service Service Offered12 week stop smoking course (if client continuesto successfully quit) offering behavioral supportNicotine Replacement Therapy or tablet MedicationIntermediate Advisor training, Annual Update Trainingand locality management for partners1:1 clinics, Group clinics and phone supportHome visits for housebound clientsStop smoking groups within a work placeSupport and information to other health colleaguesGeneral smoking cessation promotion32
33Walsall Stop Smoking Service Treatment OfferedMicrotabPatchesMouth SprayInhalatorCools lozengeLozenge & Mini LozengeNasal SprayGum33
34Walsall Stop Smoking Service Smoking ParaphernaliaPipeLow tar cigaretteSmokeless tobacco; betel, paan, snuffRoll-up cigaretteNicotine chewing gumMenthol cigaretteCigarHerbal cigarette‘Normal’ cigaretteShishaElectronic cigarette34
35Walsall Stop Smoking Service Benefits of QuittingThe quitting timelineAfter 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 oftaste and smell improve.After three days you can breathe more easily, and yourenergy 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 smoker35
36Walsall Stop Smoking Service Health Benefits of QuittingYou will reduce your risk of developing illness, disabilityor death caused by cancer, heart or lung disease.You will reduce your risk of gangrene or amputationcaused by circulatory problems.You will protect the health of those around you by notexposing them to secondhand smoke.You will reduce the chances of your children sufferingfrom bronchitis, pneumonia, asthma attacks, meningitisand ear infections.You will improve your fertility levels and your chance ofa healthy pregnancy and baby.You will improve your breathing and general fitness.You will enjoy the taste of food more.36
37Walsall Stop Smoking Service 2011/12 Delivery and Current FiguresIn 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 clinicsWe 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 ServiceCorrect at 16/04/1337
38Substance Misuse Service Walsall Healthcare NHS TrustSubstance Misuse ServiceEmilie Stone & Amber Marshall38
39Substance 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
40Some examples of work:Basic Drug & Alcohol Awareness Courses (full day & half day)What is a drug?Short & long term effects of alcohol & drug useRisks of alcohol & drug useEffects on family and wider society‘Legal highs’Calculating alcohol units & guidance on safer drinkingPossible reasons and indicators for abuseSupport services available in WalsallBite-size Drug & Alcohol Awareness sessions1hr and 2hr mini versions of the above
41Some 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) TrainingDeveloped 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.
42Some examples of work: Work in Schools Community Awareness Raising Training PSHE Co-ordinatorsLessons to pupilsLoan of resourcesCommunity Awareness RaisingAttending Community Events and Health DaysProviding InformationSignposting to appropriate servicesAwareness CampaignsDeveloped in line with local strategy to reduce alcohol related hospital admissions
43Feedback 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.”
44Emotional Health and Wellbeing Service Walsall Healthcare NHS Trust Steve Upton: Emotional Health & Wellbeing ManagerAnne Pledger: Emotional Health & Wellbeing SpecialistJoanne Stallard: Health Trainer for Emotional Health & WellbeingSteve – background: registered MH nurse etc..Anne: Primary care mental health worker, BSc Psychology, Post Grad in Public HealthJo: HT city and guilds, working towards Psychology BSc44
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 groupsTraining sessions: MHFA and Youth MHFA – 2 day training session building up confidence and knowledge of recognising and supporting someone experiencing mental health problemsSupporting the Healthy Workplace Awards scheme by delivering: Start Living, Stop Stressing! and Preventing Stress: Positive Manager BehaviourOne 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 Rehab45
46Mental Health Promotion The team also promote positive mental wellbeing and ways that individuals can improve their wellbeingThe main mental health promotion message is:The Five Ways to WellbeingWorld 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!
472012 / 13 performanceThe one to one support service launched in February 2012.To date the team have supported:Cardiac Rehabilitation: 49 referrals, 22 ongoing clientsOccupational Health: 84 referrals, 42 ongoing clientsHealth Trainers: 58 referrals, 17 ongoing clients* Improve Walsall Mental Health Literacy47
48Feedback 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.
492012 / 13 performance MHFA: 97 trained mental health first aiders YMHFA: 34 trained youth mental health first aidersHealthy Workplace Award, worked with the following companies: whg, Echo Managed Services, South Staffs Water, Brownhills Job Centre, Job Centre Plus Walsall, Walsall CouncilBitesize Stress Management: 116 people trainedPreventing Stress: Positive Manager Behaviour: 110 managers trained
50Feedback from training sessions A practical and realistic course, offering genuine guidance that can be used in my daily practice. Well presented, highly recommendedVery useful information. I learnt a lotI greatly enjoyed the courseHopefully I now have the tools to recognise mental health problems and to be able to helpIt was good to hear someone reinforce the link between good management and stressExcellent and thought provoking
51The Future Books on Prescription The books provide helpful information and step- by-step self-help techniques for managing common conditions, including depression and anxietyNeed to sign up to library services (if not already a member)National launch – 3rd June, local launch 10th June
52The FutureThe team are supporting Public Health to update the Suicide Prevention Strategy, due to be launched later in 2013Development of a new suicide risk assessment training programme to be rolled outThe 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 DWMHTContinuation of Healthy Workplace Awards: TKMAXX and Walsall Libraries signed up for stress management support
53Health Promotion Service Walsall Healthcare NHS TrustOlder People’sHealth Promotion ServiceFran Hancock: Health Promotion Specialist For Older PeopleOlder People’s Service – 1 WTEFran – Bsc Hons in Sport & Exercise Science with Health Studies.Previous roles include: exercise supervisor in Cardiac Rehab setting,Falls Prevention Physical Activity instructor.53
54National 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.
55Older 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.
56Some 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 workMobility & wellbeing exercise sessionsBrief adviceAttending local eventsPilot projects such as Walking Football & Nintendo Wii & DSThe service has close links with various local partners & services – including Age UK, WHG, ILC, Silver Keys Project, Stan Ball Centre, Specialist Falls Service.
57National 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 Go2011 – ‘Watch Your Step’2012 – ‘Boost Your BonesJune 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
58Mobility & 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.
59Health in the work place Lisa Sylvester Walsall Healthcare NHS TrustHealth in the work placeLisa SylvesterSpecialist Health Trainer for the Workplace59
60Healthy Workplace Awards Working days lost29.3 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 health1.2 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
61Healthy 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.
62Walsall Healthy Workplace project can supports organization to Supporting Health InitiativesProviding health information resourcesAssisting businesses in there application for the Walsall Health Workplace AwardsStructured opportunity to promote health in the workplaceRecognise best practice activities and projectsOpen to all businesses regardless of industry.Policy developmentSupport staff with long term conditionsPro actively address poor health
63The Healthy Workplace Awards benefit employees by providing them with Healthy working conditionsHealthy information at workPractical help to be healthyA sense of team spirit and rewardA boost to morale and motivateGood management/employee relationsBenefits of working for a responsible employerFun, social eventsThe chance to improve their awareness of health issues and make a difference to their lifestyle
64The Healthy Workplace Awards can give employers A healthier, happier workplace (financial benefit)A motivated team with high morale (financial benefit)Good management/employee relationsLess sickness turnover (financial benefit)Positive links with your communityThe 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
65The key programme themes are: Awareness programmes.Lifestyle change programmesSupportive environment programmesIndividual health checksNHS health checks for over 40’sBespoke health initiativeFive ways to well beingSmoking cessationPhysical activityAwards programme
66Some 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.
68The 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 adviceIndividually coloured cards will be given to each wardWhen clients are contacted they will be asked the colour of the card given
70Brief Advice Ask Advise Act Do you smoke, are you worried about your weight, have you considered exercising …..AdviseDid you know there is a free of charge service to help you with this?ActHere’s their information -Direct referrals can also be made to , referral pads available on request
71Do not underestimate your influence as a health professional Why Give Brief Advice?InterventionOutcomeNumbers needed to treatBrief advice from a health professional (regarding smoking cessation)Prevent 1 premature death80Statin’s1 death over 5 yrs107Antihypertensive therapyPrevent 1stroke/MI death over 1 year700SMEAR1 death over 10 yrs1140Do not underestimate your influence as a health professional
74find us on the global email ContactDarlaston Health CentrePinfold StreetWS10 8SYLifestyle LinkFaxSmoking Cessation: Rebekah few, Emily Bissell (Erica Pugh)Mental Health and Well-being: Steven Upton, Anne PledgerOlder Persons: Fran HancockDrug and Alcohol: Emilie StonePhysical Activity: Tracy ThompsonHealth Trainers: Sue CaulfieldLifestyle Link: Marion Ballfind us on the global
75Information PointLifestyle Services Information Point situated outside route 006 in the Out Patients DepartmentFree health monitor to measure weight, height, BMI, blood pressure and body fat %.Lifestyle advice and support
76Anne Pledger Emotional Health & Wellbeing Specialist RelaxAnne PledgerEmotional Health & Wellbeing Specialist