1. Making Every Contact Count
Dr Sallie Bacon
ADPH
NHS Hampshire

2. Making Every Contact Count to create a healthier population
Using every opportunity to achieve health and wellbeing
Achieving long term behaviour change
Building an organisational culture that supports health improvement and reducing health inequalities
Making Every Contact Count (MECC) represents a simple and novel approach to public health service delivery. It seeks to radically extend the delivery of public health advice to the public by training non specialist staff from a wide range of service organisations, for minimal investment, in the basic skills of health promotion and prevention and thus create an extended sales force’ for healthier living'1. The aim of MECC is to mobilise the NHS's greatest asset, its workforce, in delivering simple and timely advice to the vast potential number of service users they come into contact with on a daily basis. Its aim is to ensure that a wide range of NHS staff are trained and confident to make the most of these opportunities which help people stay healthy and reduce system-wide costs to the Reducing costs
Behaviour change in front line staff – started with NHS but gone viral – other organisations – fire /LA/ police/ childrens services/pharmacies etc
Future Forum report on public health - controversial
Need a cultural shift in how healthcare staff use their time with patients . Make better use of the time that healthcare staff have with patients . Maximise opportunities to pro actively raise the issue of lifestyle. Spiralling costs due to unhealthy lifestyles – unsustainable
It has come out of the need to transform the relationship between staff and patients/clients in order to reduce the toll of ill-health and the cost to the NHS and social care caused by the sharply rising numbers of people with conditions linked to lifestyle is needed (Future Forums).
Wanless – Securing good health for the population
Darzi review High quality care forall set out the need to put prevention first and the
Marmot Review on health inequalities in England post 2010, set out six objectives to tackle health inequalities, one of which was to strengthen the
role and impact of ill health prevention.
Not just front line staff
On line training for anyone who comes into contact with the general public
Having a vital first conversation

3. So what are we up against?

4. This is why we need it
MECC is about using the contact with have with others to have short conversations and provide signposting on lifestyle issues, (no matter what the original appointment or contact was about).
MECC focuses on:
Stopping smoking
Drinking alcohol only within the recommended limits
Healthy eating
Being physically active
Keeping to a healthy weight
As these are the lifestyle issues that, when addressed, can make the greatest improvement to an individual’s health.
Its ok to ask

5. Making Every Contact Count
EPIC study
NICE guidance on behaviour change
Evidence about process of implementation across several organisations
But will it work?
Evidence for adopting a healthy lifestyle
EPIC study 14 year difference in life expectancy for those adopting four healthy behaviours – stop smoking, healthy diet, physical activity, sensible alcohol and
High quality care for
all set out the need to put prevention first and the
Marmot Review on health inequalities in England
post 2010, set out six objectives to tackle health
inequalities, one of which was to strengthen the
role and impact of ill health prevention.
MECC
NICE GUIDANCE on behaviour change provides supporting evidence for the approach
Evidence about the process of implementation
But what are the long term impacts?
But ? This approach – what do you think?
Clare Gerada - muddled off putting for patients
Peter Carter – awareness raising campaigns more effective
Katherine Murphy – patients association – patients need more advice about lifestyles but need to address wider determinanst esp poverty
What do you think?
What do you need to implement successfully?

6. Making Every Contact Count
Embed in organisation
Systematic approach
Senior level buy in
Skilling up front line staff
What needs to happen for it to work?
Cultural change
Senior management support
Staff need training and to build their confidence to start the conversation
Face to face training for staff
How staff feel about their own health was important
Appropriate environment
Patients need to know its ok to ask
Senior level buy in
Culture that encourages and promotes prevention and health improvement
Suitable environment for staff
Skills for staff
? Support for staff to adopt healthy lifestyles
Senior level buy in – need cultural change in an organisation – healthy patients and staff

7. WE HAVE KNOWN for some time that things need to change to improve the public’s health
NEED TO TRY A DIFFERENT APPROACH
How to get people to start to change

8. Making Every Contact Count
What is the contribution that MECC can make to the public’s health?
Prevention
Address health inequalities
Life expectancy gap
Improving health outcomes
Particulalry important with the move to Local authorities with opportunity to influence a wide range of front line staff

9. Making Every Contact Count
80% of heart disease, stroke and Type II diabetes and 33% of cancers could be prevented by following a healthy lifestyle
Health Inequalities
Improve health outcomes
Public Health Outcomes Framework
Impact on other outcomes frameworks

10. Making Every Contact Count
Why should the development and implementation of MECC be the role of Public Health teams?
Delivery of PH priorities
Expanding the PH workforce
Evaluation

11. Evaluation