Jayne Tunstall Chief Operating Officer

Members EventHealthy Lifestyle (Long Term Conditions)

Ashley SmithPhysical Activity Advisor

Motivation

Alan Jarvis Head of Lifestyle Services

Lifestyle services

Aim Promote Positive Health

ObjectivesHealth promotion is a process of

enabling people toexert control over the determinants

of health & thereby improve their health. This is

achieved by:

Practiced bespoke strategies Enabling people to take action Develop skills to achieve &

maintain positive change Take an holistic approach to

health

Lifestyle 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 the

Walsall 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

Lifestyle Services

Lifestyles, 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.

Lifestyle Services

Referrals

Lifestyle Link

HealthIn

The Workplace

Mental Healthand

Wellbeing

Older People

Stop SmokingService

HealthTrainer

Substance Misuse

Physical Activity

What are Lifestyle Services

Walsall Healthcare NHS TrustLifestyle Link

Our Aim

The 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.

Why a single booking system NATIONALLY The 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 possible

The 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.

LOCALLY

Simple, not only had we managed to confuse potential clients we had all confused NHS staff

Clients and staff were frustrated by having to repeat information

Comparison of bookings taken January – October 2010 vsJanuary – October 2011

0

500

1000

1500

2000

2500

3000

3500

4000

4500

January - October 2010 January - October 2011

Bookings Taken by Lifestyle Link January - October 2010 vs January - October 2011

The object of Lifestyle Link was to encourage everyone to access the service via one number.

• January – October 2010 2772 • January – October 2011 4196• Bookings have increased by

over 50% since the launch of this service.

Clients 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’s

1089 have been referred by Other Health Professionals which include referrals from:

• 32 from Cardiology

• 29 from CPN’s

• 26 from COPD

• 21 from the Diabetes team

• 20 from the Infertility Clinic at the Manor

• 45 from Midwives

• 21 from the Outpatients

• 458 from Practice Nurses.

Walsall Healthcare NHS Trust

Walsall Health Trainer Service

Sue Caulfield -Health Trainer Manager

Sue 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.

Background

Recommendations from the Choosing Health (2004) White Paper

Aim to reduce health inequalities

Health 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 health

Service Offered

Locally based – service for local people, delivered by

local people

Provides one to one personalised support and motivation

Cancer screening prompts

Key areas: alcohol consumption, physical activity, smoking cessation and weight management

Personal health plans setting SMART achievable goals

improves access to preventative services in deprived areas

communicates key health messages to individuals from deprived communities

A Service that can……

Signpost to mainstream services

Collect & maintain accurate records & data systems

Evaluate effectiveness of services locally

Act as a catalyst to reduce the inequalities gap

Long 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.

 

Rapid Access Angina Clinic

‘One Stop’ clinic approach

Reviewed by a consultant cardiologist

Referred to health trainer for 1-1 support

Family centred approach 

Patients with Impaired Glucose Tolerance

Prevalence in the south of Walsall higher than the local and National average

Strong 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)

2013 Delivery to Date

Since its launch in January 2007 the Health Trainer Service in Walsall has

continued to grow and develop to meet the needs of the local population.

19,109 referrals into the service since 2007

74% of all referrals from deprivation quintiles 1and 2

73% of clients referred achieved or part achieved goals

Total weight loss of clients for 2011/12 equates to 10,2181kg, or 1609 stone

Service Objectives

To increase physical activity levels within Walsall by providing opportunities to take part in physical activity within communities across the borough for adults, children and families

Increase awareness of the importance of physical activity and the relationship to health and the prevention of chronic diseases

Encourage 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 30 minutes per week)

“60 min of physical activity everyday of the week for children including weight bearing activity on 3 days per week”

Benefits of Physical Activity

Decreased risk of:◦ Cardiovascular Disease◦ Stroke◦ Type 2 Diabetes◦ Cancer◦ Falls◦ Depression, anxiety and

stress

Positive effects on:◦ Hypertension◦ Osteoporosis◦ Body Weight and

Composition◦ Psychological Health◦ Social Health◦ Musculoskeletal

Conditions

What 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 times

Deliver Active Clubs/Active Ability Training for staff within schools, out of school clubs and parents to increase capacity and sustainability of PA opportunities

Deliver 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 workplace

Delivery 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 activity

Make it Count which is a locally developed physical activity and obesity prevention/treatment programme for 4-7 yr old and their families.

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 phone

Lifestyle Link on 01922 44 40 44.

Access to Service

Between April 12 – March 13 we had 22,000 face to face contacts with people attending our physical activity sessions

Currently 8500 people on the data base reflecting the number of Walsall people that have accessed the Physical Activity Service since November 2008

Over 180 school and out of school staff trained in Active Clubs

Self 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 active

Service lead – Erica PughSenior Advisors – Rebekah Few and Emily Bissell

Advisors – Faye Bennett, Carol Shepherd and Sue DurkinAdmin Team – Steph Coyne and Dinesh Patel

Walsall Healthcare NHS Trust

Walsall Stop Smoking Service

Make a change, keep the change!

The objectives of the Lifestyle Services Stop Smoking Team are to:

1. Provide training, education and information that supports a reduction of smoking in the Walsall borough

2. Provide a 12 week stop smoking course including treatment in both 1:1, group and home visit settings

3. Provide support to those with Smoking related illness in attempting a ‘quit’

4. Support the Healthy Workplace Awards in promoting Stop Smoking

5. Provide specific support to smoking pregnant mothers

6. Provide a holistic service where signposting and referral to other services are carried out

Walsall Stop Smoking Service

Service Offered 12 week stop smoking course (if client continues to successfully quit) offering behavioral support

Nicotine Replacement Therapy or tablet Medication

Intermediate Advisor training, Annual Update Training and locality management for partners

1:1 clinics, Group clinics and phone support

Home visits for housebound clients

Stop smoking groups within a work place

Support and information to other health colleagues

General smoking cessation promotion

Walsall Stop Smoking Service

Treatment Offered Walsall Stop Smoking Service

Lozenge & Mini Lozenge

Mouth Spray

Gum

Inhalator

Nasal Spray

Microtab

Patches

Cools lozenge

Smoking Paraphernalia

Walsall Stop Smoking Service

Pipe

Low tar cigarette

Smokeless tobacco; betel, paan, snuff

Roll-up cigarette

Nicotine chewing gumMenthol

cigaretteCigar

Herbal cigarette

‘Normal’ cigarette

Shisha

Electronic cigarette

Benefits of QuittingThe quitting timeline

After 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 of taste and smell improve.

After three days you can breathe more easily, and your energy 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 smoker

Walsall Stop Smoking Service

Health Benefits of Quitting You will reduce your risk of developing illness, disability

or death caused by cancer, heart or lung disease.

You will reduce your risk of gangrene or amputation caused by circulatory problems.

You will protect the health of those around you by not exposing them to secondhand smoke.

You will reduce the chances of your children suffering from bronchitis, pneumonia, asthma attacks, meningitis and ear infections.

You will improve your fertility levels and your chance of a healthy pregnancy and baby.

You will improve your breathing and general fitness.

You will enjoy the taste of food more.

Walsall Stop Smoking Service

2011/12 Delivery and Current Figures

In 2011/12 - 3857 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 clinics

We 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 Service

Correct at 16/04/13

Walsall Stop Smoking Service

Walsall Healthcare NHS Trust

Substance Misuse Service

Emilie Stone & Amber Marshall

Substance 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

Some examples of work: Basic Drug & Alcohol Awareness Courses

(full day & half day)◦ What is a drug?◦ Short & long term effects of alcohol & drug use◦ Risks of alcohol & drug use◦ Effects on family and wider society◦ ‘Legal highs’◦ Calculating alcohol units & guidance on safer

drinking◦ Possible reasons and indicators for abuse◦ Support services available in Walsall

Bite-size Drug & Alcohol Awareness sessions◦ 1hr and 2hr mini versions of the above

Some 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) Training

◦ Developed 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.

Some examples of work:

Work in Schools

◦ Training PSHE Co-ordinators◦ Lessons to pupils◦ Loan of resources

Community Awareness Raising◦ Attending Community Events and Health Days◦ Providing Information◦ Signposting to appropriate services

Awareness Campaigns◦ Developed in line with local strategy to reduce

alcohol related hospital admissions

Feedback From Our Training

“Very good and Interesting course”

“Interesting. Enjoyed it. Thank you.”

“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.”

“I feel the sessions have been very helpful and

informative and the children have taken in lots of useful

facts.”

“Great interactive resources. Well

Presented. Thank you.”

“Very educational”

“SHOULD GIVE OUT FREE SAMPLES.”

Walsall Healthcare NHS Trust

Emotional Health and Wellbeing Service

Steve Upton: Emotional Health & Wellbeing ManagerAnne Pledger: Emotional Health & Wellbeing Specialist

Joanne Stallard: Health Trainer for Emotional Health & Wellbeing

‘There is no health without Mental Health’ Dept of Health, 2011The 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 groups

• Training sessions: MHFA and Youth MHFA – 2 day training session building up confidence and knowledge of recognising and supporting someone experiencing mental health problems

• Supporting the Healthy Workplace Awards scheme by delivering: Start Living, Stop Stressing! and Preventing Stress: Positive Manager Behaviour

• One 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 Rehab

Mental Health Promotion

The team also promote positive mental wellbeing and ways that individuals can improve their wellbeing

The main mental health promotion message is:

The Five Ways to Wellbeing

World 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!

2012 / 13 performance

• The one to one support service launched in February 2012.

To date the team have supported:

Cardiac Rehabilitation: 49 referrals, 22 ongoing clients

Occupational Health: 84 referrals, 42 ongoing clients

Health Trainers: 58 referrals, 17 ongoing clients

Feedback from one to one sessions

I found the meetings very helpful.

Just having someone to talk to and understand me was a big help. I can’t thank the service enough.

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.

• MHFA: 97 trained mental health first aiders• YMHFA: 34 trained youth mental health first aiders• Healthy Workplace Award, worked with the

following companies: whg, Echo Managed Services, South Staffs Water, Brownhills Job Centre, Job Centre Plus Walsall, Walsall Council Bitesize Stress Management: 116 people trained Preventing Stress: Positive Manager Behaviour: 110

managers trained

2012 / 13 performance

Feedback from training sessionsVery useful information. I

learnt a lot

I greatly enjoyed the

courseHopefully I now have the tools to recognise

mental health problems and to be able to help

A practical and realistic course, offering genuine

guidance that can be used in my daily

practice. Well presented, highly

recommended

Excellent and thought provoking

It was good to hear someone

reinforce the link between good

management and stress

• Books on Prescription• The books provide helpful information and step-

by-step self-help techniques for managing common conditions, including depression and anxiety

• Need to sign up to library services (if not already a member)

• National launch – 3rd June, local launch 10th June

The Future

The Future The team are supporting Public Health to update the

Suicide Prevention Strategy, due to be launched later in 2013

Development of a new suicide risk assessment training programme to be rolled out

The 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 DWMHT

Continuation of Healthy Workplace Awards: TKMAXX and Walsall Libraries signed up for stress management support

Walsall Healthcare NHS Trust

Older People’s Health Promotion Service

Fran Hancock: Health Promotion Specialist For 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.

National Service Framework for Older People recognises 3 broad categories of older people

Older 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.

Some 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 work

Mobility & wellbeing exercise sessions

Brief advice

Attending local events

Pilot projects such as Walking Football & Nintendo Wii & DS

National Falls Awareness Week 2013 – ‘Healthy Feet’ 17th – 21st June - This week!!

2010 – ‘Get Up and Go2011 – ‘Watch Your Step’2012 – ‘Boost Your Bones

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.

Mobility & Wellbeing Exercise

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.

“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”.

Walsall Healthcare NHS Trust

Health in the work placeLisa Sylvester

Specialist Health Trainer for the Workplace

Healthy 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. 551 000 of these were new cases

Healthy 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.

Walsall Healthy Workplace project can supports organization to

Supporting Health Initiatives

Providing health information resources

Assisting businesses in there application for the Walsall Health Workplace Awards

Structured opportunity to promote health in the workplace

Recognise best practice activities and projects

Open to all businesses regardless of industry.

Policy development Support staff with long

term conditions Pro actively address

poor health

Healthy working conditions Healthy information at work Practical help to be healthy A sense of team spirit and reward A boost to morale and motivate Good management/employee relations Benefits of working for a responsible employer Fun, social events The chance to improve their awareness of health

issues and make a difference to their lifestyle

The Healthy Workplace Awards benefit employees by providing them with

A healthier, happier workplace (financial benefit) A motivated team with high morale (financial

benefit) Good management/employee relations Less sickness turnover (financial benefit) Positive links with your community The 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

The Healthy Workplace Awards can give employers

The key programme themes are:

Awareness programmes.

Lifestyle change programmes

Supportive environment programmes

Individual health checks

NHS health checks for over 40’s

Bespoke health initiative

Five ways to well being Smoking cessation Physical activity Awards programme

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.

Some examples and testimonies from previous award winners

Make Every Contact Count

The MECC CQUIN To achieve the MECC CQUIN wards are asked to distribute

Lifestyle Link Cards and issue brief advice

Individually coloured cards will be given to each ward

When clients are contacted they will be asked the colour of the card given

MECC CARDS

Brief Advice Ask 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?

Act Here’s their information -

Direct referrals can also be made to 01922 444044, referral pads available on request

Why Give Brief Advice?Intervention Outcome Numbers

needed to treat

Brief advice from a health professional (regarding smoking cessation)

Prevent 1 premature death

80

Statin’s 1 death over 5 yrs

107

Antihypertensive therapy Prevent 1stroke/MI death over 1 year

700

SMEAR 1 death over 10 yrs

1140

Do not underestimate your influence as a health professional

E-Learning Accessible though ESR

http://twitter.com/ECCwmids

2 modules

• Brief encounters

• Motivating change

Contact

Darlaston Health CentrePinfold StreetWS10 8SYLifestyle Link 01922 444044Fax 01922 444143

Smoking Cessation: Rebekah few, Emily Bissell (Erica Pugh)

Mental Health and Well-being: Steven Upton, Anne Pledger

Older Persons: Fran Hancock

Drug and Alcohol: Emilie Stone

Physical Activity: Tracy Thompson

Health Trainers: Sue Caulfield

Lifestyle Link: Marion Ball

Information Point

Lifestyle Services Information Point situated outside route 006 in the Out Patients Department

Free health monitor to measure weight, height, BMI, blood pressure and body fat %.

Lifestyle advice and support

Anne PledgerEmotional Health & Wellbeing

Specialist

Relax

Thank you for listening, any questions?