1. Presented by: Darren Plant Healthy Lifestyles Commissioner NHS Worcestershire November 2010 Health Trainers

2. Health Trainers - Background First identified in the 2004, ‘Choosing Health: Making healthier choices easier’ White Paper. This gave a commitment that NHS Health Trainers would be operating in the most disadvantaged communities in England. Health Trainers reach out to people who are in circumstances that put them at a greater risk of poor health. They often come from, or are knowledgeable about, the communities they work with. In most cases, Health Trainers work from locally based services which offer outreach support from a wide range of local community venues. Identified in Choosing Health as a Public Health shift away from: “Advice from on high to support from next door”.

3. Health Trainers – Progress and outcomes Nearly 90% of Primary Care Trusts have a Health Trainer Service More than 3100 Health Trainers (level 3) and Health Trainer Champions (level 2) either trained or in training 60,000 clients have been seen by Health Trainers Nearly half of Health Trainer clients are drawn from the 20% most deprived communities in the country Two thirds of clients fall within one or more deprivation indicators More than two thirds of clients have achieved a goal within their Personal Health Plans (PHPs)

4. What is a Health Trainer? They are a new workforce generally drawn from local communities, or they are knowledgeable about the community they serve. The majority are Band 3 posts, but there are also specialist Health Trainers and Senior Health Trainers that operate at Band 4 and 5. Their primary focus is to work with clients on a 1-2-1 basis to assess their current lifestyle behaviour and offer advice and support to make positive changes. They follow a process of changing a clients behaviour, which is outlined in the NHS Health Trainer Handbook. The Health trainer Handbook can be found on the DoH website

5. What is a Health Trainer? They also tackle a range of wider health related issues.

6. Behaviour Change

7. Work with the client to set achievable goals, agree a plan of action based on making small changes, and provide practical support and motivation where necessary. Signpost clients into a range of services and activities that are available locally and nationally. Accompany clients to local activities. Monitor and review progress and revise action plan where necessary for a period of up to 12 months or 6 contacts. Behaviour Change

8. Health trainers - Training This award provides knowledge and understanding of the benefits of good health and well-being, and of how to direct individuals towards further practical support in attaining a healthier lifestyle. RSPH Level 2 Award in Understanding Health improvement The Level 3 Certificate for Health Trainers This is a Vocationally related Qualification (VRQ) comprising of four mandatory units: Unit 301 – Establishing and maintaining relationships with communities while working as a Health Trainer. Unit 302 – Communicate with individuals about promoting their health and wellbeing while working as a Health Trainer. Unit 303 – Enable individuals to change their behaviour to improve their health and wellbeing while working as a Health Trainer Unit 304 – Manage and organise your own time and activities while working as a Health Trainer.

9. Health Trainers - Referrals Health Trainer services are currently aimed at adults, however there are plans to extend it to cover children at some point in the future. Most services are targeted towards a particular population group. I.E. People living in a deprived area, those most at risk of developing a chronic condition, or ethnic minority groups. Specialist Health Trainers tend to sit within a particular discipline such as a mental health team, diabetes team, or dietetics department. Most services utilise a variety of methods for generating referrals. These include traditional marketing for self referrals, such as attending events, using posters and fliers, visiting other local services and community groups. Services have also developed more robust referral pathways into the service.

11. Countywide service Following a smaller pilot programme in 3 localities, there are now 11.3 WTE Health Trainers operating across a range of sites throughout Worcestershire. Current sites covered: Wychavon Redditch Bromsgrove Wyre Forest Worcester Malvern Satellite sessions will also be offered in other areas where a need is recognised. These can be delivered from most venues due advancements in mobile technology.

12. Countywide service continued Age The client is over 16 years of age Existing lifestyle risk factors E.g. smoking, overweight, low levels of physical activity, poor diet, and excessive alcohol consumption Existing long term condition (Diabetes, hypertension) NB – these clients should be referred with the agreement of their clinical team and be stable for all other aspects of their condition. IE – medication management. Previously referred to a lifestyle service but failed to attend or complete programme. E.g. stop smoking or weight management. The following clients are eligible for the pilot service

13. Service outcomes 1220 total referrals

14. Service outcomes

16. Other Health Trainer work Probation – Work is currently being undertaken with West Mercia Probation Service to develop a pilot health trainer programme in Worcestershire. This will be an integrated model, which utilises Category D prisoners from HMP Hewell to work at Probation offices. The same prisoners will also offer weekly sessions at HMP Hewell (Cat D). Other schemes are also planned for: Brockhill Blakenhirst And HMP Long Lartin (Cat A).

17. The End Any questions? Darren Plant – Health Lifestyles Commissioner darren.plant@worcestershire.nhs.uk 01905 733821 Jayne McCullough – Health Trainer Service Coordinator Jayne.mccullough@worcspct.nhs.uk