Making Every Contact Count – An opportunity for transformation across Arden John Linnane, Director of Public Health

What is MECC? Why MECC? What is the evidence? Our ambition Overview

MECC: a definition There is a need for a culture change amongst organisations towards prevention, to bring the promotion of mental and physical health and wellbeing into the mainstream – doing this has become known as MECC Making Every Contact Count’ (MECC) means using every [appropriate] contact with the public to improve their health particularly promoting lifestyle change.

Brief advice: definition MECC uses a brief advice approach to raise issues with patients. Brief Opportunistic advice usually lasts up to 5 minutes. It involves raising a lifestyle issue with an individual [where appropriate] and signposting to further information. This can be used by anyone engaging with members of the public alongside their everyday work. It is an opportunity to dispel myths and give accurate advice

Why MECC: The challenge ‘strengthening self-esteem, confidence and personal responsibility; positively promoting healthy behaviours and lifestyles…Protecting the population from health threats should be led by central government, with a strong system to the frontline.’ Healthy Lives, Healthy People ‘…preventing poor health and promoting healthy living is essential to reduce health inequalities and sustain the NHS for future generations’. NHS Future Forum Summary Report – Second Phase

Health Inequalities ‘…people living in the poorest areas will on average, die 7 years earlier than people living in the richer areas and spend 17 years more living with ill health’ Health Lives Healthy People: update and way forward July 2011 Multiple influences on health and wellbeing. Dahlgren, G. and Whitehead, M. (1991) Policies and strategies to promote social equity in health

Healthy Lifestyle Profile Smoking – 25% of our population smoke Alcohol – 21% are drinking at increasing risk or high risk levels Obesity – 26% of adults are obese Physical Activity – Only 11% of adults achieve recommended levels of physical activity Diet – 26.4% of adults eat healthily Mental Health – An estimated 25% of people will have a mental health illness during their lifetime By Middle Super Output Area – Life expectancy ranges from 71.9 to 83.5 years for men and 76.9 to 97.7 years for women Smoking – 25% of our population smoke Alcohol – 21% are drinking at increasing risk or high risk levels Obesity – 26% of adults are obese Physical Activity – Only 11% of adults achieve recommended levels of physical activity Diet – 26.4% of adults eat healthily Mental Health – An estimated 25% of people will have a mental health illness during their lifetime By Middle Super Output Area – Life expectancy ranges from 71.9 to 83.5 years for men and 76.9 to 97.7 years for women Smoking – 19% of our population smoke Alcohol – 22% are drinking at increasing risk or high risk levels Obesity – 26% of adults are obese Physical Activity – Only 11% of adults achieve recommended levels of physical activity Diet – 28% of adults eat healthily Mental Health – An estimated 25% of people will have a mental health illness during their lifetime By district or Borough – Life Expectancy ranges from 77 to 84 years Smoking – 19% of our population smoke Alcohol – 22% are drinking at increasing risk or high risk levels Obesity – 26% of adults are obese Physical Activity – Only 11% of adults achieve recommended levels of physical activity Diet – 28% of adults eat healthily Mental Health – An estimated 25% of people will have a mental health illness during their lifetime By district or Borough – Life Expectancy ranges from 77 to 84 years Within Warwickshire: Within Coventry:

Implementing MECC will increase the numbers of people who are motivated and supported to make positive lifestyle changes, saving lives and reducing costs. A true win win situation

Effectiveness If I was already thinking about doing or changing something, it might be a good final push. (patient) Research shows that brief advice is effective, for example: 1 in 8 people respond to brief advice about alcohol intake by reducing their drinking behaviour by one level e.g. from increasing risk to lower risk 1 in 20 people go on to quit smoking following brief advice The communications campaign supporting MECC will promote this fact to help both staff and patients understand the impact MECC can have Fine, give it to me. I won’t necessarily take it though (patient) It could work, with the right people (staff)

Survival in 20,244 healthy adults aged by health behaviours by health behaviours Health Behaviours: Non smoker Alcohol <14 units/wk Not inactive Blood vitamin C >50  mol/l (5 servings fruit and vegetables daily) Overall impact: 14 year difference in life expectancy Khaw et al. PLoS Med 2008 Jan 8: 5 (1): e12 (EPIC-Norfolk prospective study Number of Healthy behaviours Year of study % still alive

Introducing the Implementation Guide and Toolkit

Much more than training staff Organisational development and culture change Led by staff within the context of their service and role A collective responsibility – staff & organisation TOGETHER! Grown from the needs of the public and what they need, want and expect A path to delivering system and scale. What does the Guidance Say?

Our ambition for Arden “All agencies/partners shall be aware of and adopt the ‘Making Every Contact Counts’ philosophy. This means that, when ever appropriate, opportunity to reinforce advice about healthy lifestyles and or/signpost to the relevant services is exercised”.