Slide 1

Jayne Tunstall Chief Operating OfficerMembers EventHealthy Lifestyle (Long Term Conditions)Ashley SmithPhysical Activity AdvisorMotivation

Alan Jarvis Head of Lifestyle ServicesLifestyle services AimPromote 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 strategiesEnabling people to take actionDevelop skills to achieve & maintain positive changeTake an holistic approach to healthLifestyle ServicesOverview

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 experienceLifestyle ServicesLifestyles, 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 ServicesReferralsLifestyle LinkHealthInThe WorkplaceMental Healthand WellbeingOlder People

Stop SmokingServiceHealthTrainerSubstance MisusePhysical ActivityWhat are Lifestyle ServicesWalsall Healthcare NHS TrustLifestyle Link

8Our AimThe 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.

9Why 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 staffClients and staff were frustrated by having to repeat information

10Comparison of bookings taken January October 2010 vsJanuary 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 4196Bookings have increased by over 50% since the launch of this service.

11 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 GPs1089 have been referred by Other Health Professionals which include referrals from:32 from Cardiology 29 from CPNs 26 from COPD 21 from the Diabetes team 20 from the Infertility Clinic at the Manor 45 from Midwives 21 from the Outpatients458 from Practice Nurses.

12Walsall Healthcare NHS TrustWalsall 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 Walsalls Health Trainer Service. The service is made up 14 members of staff from varied backgrounds and a wide skill mix.

13 BackgroundRecommendations 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

14 Service OfferedLocally based service for local people, delivered by local peopleProvides one to one personalised support and motivationCancer 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

15A 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 LifestyleSmoking, 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 TolerancePrevalence 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 hascontinued 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

21

Service ObjectivesTo increase physical activity levels within Walsall by providing opportunities to take part in physical activity within communities across the borough for adults, children and familiesIncrease awareness of the importance of physical activity and the relationship to health and the prevention of chronic diseasesEncourage 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 ActivityDecreased risk of:Cardiovascular DiseaseStrokeType 2 DiabetesCancerFallsDepression, anxiety and stress

Positive effects on:HypertensionOsteoporosisBody Weight and CompositionPsychological HealthSocial HealthMusculoskeletal 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 womens 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 phoneLifestyle Link on 01922 44 40 44.

Access to ServiceBetween 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

28Face to face contacts includes attending physical activity sessions, training, brief interventions

Service lead Erica PughSenior Advisors Rebekah Few and Emily BissellAdvisors Faye Bennett, Carol Shepherd and Sue DurkinAdmin Team Steph Coyne and Dinesh Patel

Walsall Healthcare NHS TrustWalsall Stop Smoking Service

30Make a change, keep the change!The objectives of the Lifestyle Services Stop Smoking Team are to:

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

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

Provide support to those with Smoking related illness in attempting a quit

Support the Healthy Workplace Awards in promoting Stop Smoking

Provide specific support to smoking pregnant mothers

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

Walsall Stop Smoking Service31Service Offered12 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 Service32Treatment Offered

Walsall Stop Smoking Service

Lozenge & Mini LozengeMouth SprayGumInhalatorNasal SprayMicrotabPatches

Cools lozenge

33Smoking Paraphernalia

Walsall Stop Smoking Service

PipeLow tar cigaretteSmokeless tobacco; betel, paan, snuffRoll-up cigaretteNicotine chewing gumMenthol cigaretteCigarHerbal cigaretteNormal cigaretteShishaElectronic cigarette

34Benefits 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 Service35Health Benefits of QuittingYou 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

362011/12 Delivery and Current FiguresIn 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 GPs 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 Service37Walsall Healthcare NHS TrustSubstance Misuse Service

Emilie Stone & Amber Marshall

38Substance 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 useRisks of alcohol & drug useEffects on family and wider societyLegal highsCalculating alcohol units & guidance on safer drinkingPossible reasons and indicators for abuseSupport services available in WalsallBite-size Drug & Alcohol Awareness sessions1hr 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) TrainingDeveloped with Safer Walsall Partnership and T3 Young Persons 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 SchoolsTraining PSHE Co-ordinatorsLessons to pupilsLoan of resourcesCommunity Awareness RaisingAttending Community Events and Health DaysProviding InformationSignposting to appropriate servicesAwareness CampaignsDeveloped in line with local strategy to reduce alcohol related hospital admissions

Feedback From Our TrainingVery good and Interesting courseInteresting. 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 educationalSHOULD GIVE OUT FREE SAMPLES.Walsall Healthcare NHS TrustEmotional Health and Wellbeing Service

Steve Upton: Emotional Health & Wellbeing ManagerAnne Pledger: Emotional Health & Wellbeing SpecialistJoanne Stallard: Health Trainer for Emotional Health & Wellbeing

44Steve background: registered MH nurse etc..Anne: Primary care mental health worker, BSc Psychology, Post Grad in Public HealthJo: HT city and guilds, working towards Psychology BScThere 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 Rehab45Mental Health PromotionThe team also promote positive mental wellbeing and ways that individuals can improve their wellbeingThe 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 years events!2012 / 13 performanceThe 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

47* Improve Walsall Mental Health LiteracyFeedback from one to one sessionsI found the meetings very helpful.

Just having someone to talk to and understand me was a big help. I cant 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 dont have to have your service as I feel a lot better in myself, thank you.

MHFA: 97 trained mental health first aidersYMHFA: 34 trained youth mental health first aidersHealthy 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 performanceFeedback from training sessionsVery useful information. I learnt a lotI greatly enjoyed the courseHopefully I now have the tools to recognise mental health problems and to be able to helpA practical and realistic course, offering genuine guidance that can be used in my daily practice. Well presented, highly recommendedExcellent and thought provokingIt was good to hear someone reinforce the link between good management and stressBooks on PrescriptionThe books provide helpful information and step-by-step self-help techniques for managing common conditions, including depression and anxietyNeed to sign up to library services (if not already a member)National launch 3rd June, local launch 10th JuneThe FutureThe FutureThe team are supporting Public Health to update the Suicide Prevention Strategy, due to be launched later in 2013Development of a new suicide risk assessment training programme to be rolled outThe 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 DWMHTContinuation of Healthy Workplace Awards: TKMAXX and Walsall Libraries signed up for stress management supportWalsall Healthcare NHS TrustOlder Peoples Health Promotion Service

Fran Hancock: Health Promotion Specialist For Older People

53Older Peoples Service 1 WTE Fran Bsc Hons in Sport & Exercise Science with Health Studies. Previous roles include: exercise supervisor in Cardiac Rehab setting, Falls Prevention Physical Activity instructor.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 peopleThe Older Peoples Health Promotion service recognises that age is very individual. Overall the service supports people over the age of 50, but has more of an emphasis on the transitional and frail older people stages = work is generally more targeted at over 65s. 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 Peoples 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

The service has close links with various local partners & services including Age UK, WHG, ILC, Silver Keys Project, Stan Ball Centre, Specialist Falls Service.

National Falls Awareness Week2013 Healthy Feet 17th 21st June - This week!!

2010 Get Up and Go2011 Watch Your Step2012 Boost Your BonesAbout 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.

2013 - 17 - 21 June 2013 - theme of Healthy Feet.Previous promotional events have included - promotional events and activities in a number of health centres, Walsall Town Centre Market Stalls, events at local supermarkets, Safe slipper exchanges, balance testing, and exercise tasters. We work closely with the hospital to promote Falls Awareness week for staff, patients and their families too. Information is available at the end of the session.

57

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. Clients from the Stan Ball day care group access the session, people who come along to the luncheon club join in, as well as a number of learning disability groups that come along to participate. The weekly sessions are open to anyone who lives in the Walsall borough and are completely free.Walsall Healthcare NHS TrustHealth in the work placeLisa Sylvester Specialist Health Trainer for the Workplace

59Healthy Workplace AwardsWorking 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 casesHealthy workplace awardsTo 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 toSupporting Health InitiativesProviding health information resourcesAssisting businesses in there application for the Walsall Health Workplace AwardsStructured opportunity to promote health in the workplace Recognise best practice activities and projects Open to all businesses regardless of industry. Policy developmentSupport staff with long term conditionsPro actively address poor healthHealthy working conditions Healthy information at workPractical help to be healthyA sense of team spirit and rewardA boost to morale and motivateGood management/employee relationsBenefits of working for a responsible employerFun, social eventsThe chance to improve their awareness of health issues and make a difference to their lifestyle

The Healthy Workplace Awards benefit employees by providing them withA healthier, happier workplace (financial benefit)A motivated team with high morale (financial benefit)Good management/employee relationsLess sickness turnover (financial benefit)Positive links with your communityThe 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 employersThe key programme themes are:

Awareness programmes.Lifestyle change programmesSupportive environment programmesIndividual health checks NHS health checks for over 40sBespoke health initiative Five ways to well beingSmoking cessationPhysical activityAwards 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 winnersMake Every Contact Count

The MECC CQUINTo 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 AdviceAsk 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 Heres their information - Direct referrals can also be made to 01922 444044, referral pads available on request

Why Give Brief Advice?InterventionOutcome Numbers needed to treatBrief advice from a health professional (regarding smoking cessation)Prevent 1 premature death80Statins1 death over 5 yrs107Antihypertensive therapy Prevent 1stroke/MI death over 1 year700SMEAR1 death over 10 yrs1140Do not underestimate your influence as a health professional

E-LearningAccessible 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 PledgerOlder Persons: Fran HancockDrug and Alcohol: Emilie StonePhysical Activity: Tracy ThompsonHealth Trainers: Sue CaulfieldLifestyle Link: Marion Ball

find us on the global email Information PointLifestyle 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 supportAnne PledgerEmotional Health & Wellbeing SpecialistRelax

Thank you for listening, any questions?

77Chart127724196

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

Sheet1January - October 20102772January - October 20114196

Sheet1

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

Sheet2

Sheet3