1. Difficult Conversations
Supporting Community Pharmacy across Avon

2. What is a ‘healthy conversation
A healthy conversation supports the individual to explore their own world.
It helps them find solutions from within and plan to make change

3. Healthy Conversation Skills
Use Open Questions to help someone explore an issue
Reflect on your practice and conversations
Spend more time listening than giving information or making suggestions
“You may use some or all of these skills every day, but this training is an opportunity for some time-out to focus on these skills. They will be used over and over throughout the training, within a range of activities giving plenty of opportunities to practise them. Training will be interactive and participatory, primarily led by your agenda and needs. Therefore, the starting point is to hear about your world and work.”

4. Beliefs Being given information makes people change.
Information may plant the seed but may need support
It is possible to persuade people to change their habits.
Yes
People come to us with solutions.
People will know what they like to do eg like walking but don’t like the gym, enjoys art etc- you can work with these to find something that works for them
I am responsible for the choices people make
No your not.
Place the “agree” and “disagree” posters at each corner/side of the room to represent a strong belief (negative/positive). Ask trainees to stand up in the centre of the room and to position themselves along this “axis” according to their belief about the statements you are about to read. The beliefs to be explored underpin the training philosophy, reflecting the beliefs of the research team. Exploring these beliefs enables trainees to reflect on their own practice. It helps them understand why using healthy conversation skills is a more effective approach to empowering individuals and supporting change.
Being given information makes people change. (information alone does not make people change)
It is possible to persuade people to change their habits. (It is not possible to persuade people to change)
People come to us with solutions. (they do come to us with the solutions)
I am responsible for the choices people make. ( workers are not responsible)

5. How do you start difficult conversations?
Using Open Questions
Making Every Contact Count is not about you giving advice. It is about asking questions and listening and responding to the person.
By starting a conversation with someone you are raising a topic.
There are different types of questions we can ask people.
What i.e. What happens when you do that? 
How i.e. How are you feeling today?
Where i.e. Where would I go for more information? Etc...
Other open questions that can be used begin with why, when, where, who and which.
They ask the respondent to think and reflect
They will give you people's opinions and feelings
They hand control of the conversation to the talker

6. Developing exploratory questions/ Open Discovery questions
What would you say next to the following statements?
My Doctor says I’m obese; I think I need to lose weight?
I feel embarrassed going to the gym.
I know my cholesterols high but it’s hard to change my diet when my husbands a fussy eater.
I know I should cut down on smoking but my partner smokes.
It’s too expensive to eat healthily
Its very easy with the pub right next door
I’ve fallen twice recently and I’m worried about falling again

7. How do you think your own health influences your confidence in starting a conversation about health?
Your thoughts about having a healthy conversation may include personal barriers such as:
I smoke/drink/have an unhealthy diet therefore I cannot ask about their lifestyle, it’s wrong for me to ask…
However you could say:
I understand how difficult... What do you think you could do to change [eating/physical activity etc…]?