Be WISE for WELLBEING: Making Every Contact Count in Secondary Care

This simple course will help you to Make Every Contact Count for wellbeing in Secondary Care

This means making the most of everyday opportunities to have conversations with people whom you meet in order to raise awareness of issues that can impact on wellbeing, and to encourage and support the person to make changes that will enhance their wellbeing. 

MAKING EVERY CONTACT COUNT FOR WELLBEING in Secondary Care

INTRODUCTION

Welcome to Making Every Contact Count for Wellbeing: Level One

This course is for all frontline staff working in a Secondary Care setting

It will help you to deliver Level One MECC interventions about wellbeing

This means spotting opportunities to have a very brief chat (just a minute or so) with patients and carers where you can raise the issue of wellbeing, say something encouraging if they are interested in improving their wellbeing, and signpost to support

Please Make Every Contact Count - and make a real difference.

There are other resources available to support you to do this.


WHY IT'S IMPORTANT TO MAKE EVERY CONTACT COUNT FOR WELLBEING

WELCOME TO BE WISE FOR WELLBEING

YOU CAN USE THIS BRIEF COURSE ALONGSIDE THE "BE WISE" WORKBOOK IF YOU WISH

WELLBEING

WELLBEING MATTERS!

Wellbeing matters. Wellbeing is about feeling good and functioning well; about flourishing in your life whatever your circumstances. Focusing on wellbeing is important as it can strengthen individuals and communities (DH 2014). Here are some of the benefits of wellbeing:

  • Wellbeing adds years to life and life to years
  • Aids recovery from illness: poor wellbeing is associated with slower wound healing
  • Is associated with positive outcomes: people with good wellbeing are more likely to have a healthy diet, be physically active and less likely to smoke
  • Young people with high levels of wellbeing are less likely to engage in unhealthy or risk-taking behaviours
  • Spreads through social pathways and Influences the wellbeing of others close to us
  • May ultimately reduce the health and social care burden
  • Is associated with broader positive outcomes such as employment, education and relationships


WELLBEING MATTERS!

Wellbeing is a resource that supports us throughout our life journey

Wellbeing is for EVERYBODY

-Patients

-Carers

-You


HEALTH AND WELLBEING

HEALTH IS IMPORTANT FOR WELLBEING

People are living longer nowadays than ever before, but not necessarily living longer with good health.

The top 5 preventable conditions in the UK today are:

  • Coronary Heart Disease
  • Stroke
  • Respiratory Diseases
  • Cancers
  • Liver Disease

and the greatest cause of mortality is now 

* Dementia including Alzheimers

Health behaviours (whether or not we smoke, eat a healthy, balanced diet, keep physically active, drink alcohol and cope well with stress) all impact on the risk of people developing these killer conditions.

They also link to other common health conditions (co-morbidities) such as Type 2 Diabetes and Depression.

Helping people to make some simple but significant changes in their lifestyles can have a big impact on health. Quitting smoking, for example, is still the most important thing that a person can do to improve their health.

Even if the person has a medical condition, such as type 2 diabetes or coronary heart disease, then adopting a healthier lifestyle can make a big difference to how well the person recovers and how they manage their health into the future.

Some lifestyle behaviours are closely linked to mental health too. Drinking too much alcohol can affect a person’s mood and sleeping patterns; when people feel under pressure they may use smoking, food and alcohol as coping mechanisms. Being more active can have a huge impact on how a person feels.

It’s a complicated picture, but we do know that our lifestyle behaviours have a big impact on health and wellbeing.


WHAT IMPACT DO LIFESTYLE BEHAVIOURS HAVE ON WELLBEING?

  • No impact at all
  • They can increase the risk of coronary heart disease, stroke, respiratory diseases, liver disease and some cancers
  • They only impact on physical health and are not important for wellbeing

5 KEY THEMES THAT ARE IMPORTANT FOR WELLBEING

Wellbeing is NOT just about health

Here are 5 key themes that are important for wellbeing

Do you recognise any of these issues as being important for your patients?

Think about how these 5 key themes are important for your own wellbeing

WHAT ARE THE 5 KEY THEMES THAT AFFECT WELLBEING?

  • health, education, living environment, language, family
  • health, independence, genetics, number of children, home environment
  • health, relationships, participation, security, independence

WHOSE ROLE IS IT TO MAKE EVERY CONTACT COUNT?

                                           "WHY SHOULD I MAKE EVERY CONTACT COUNT?"

Sometimes people are not sure that it is their role to make every contact count.

Here are some frequently asked questions;

  • I’m not sure it’s my job?

If you work in health care, in any role,  then you can make every contact count. You will simply be raising the issue of wellbeing, (perhaps when there is a national campaign on, being encouraging and supportive of change and signposting to further sources of information and advice. 

  • I don’t have the time to do this – surely someone else who spends more time chatting with people could do it instead?

You can make every contact count in less than a minute.

Secondary Care is an obvious setting in which to support people to improve their wellbeing

 Adopting healthy lifestyle behaviours and doing simple things to improve wellbeing helps people to                                         - prevent or delay the onset of certain conditions

                        - self-manage and cope better with long-term conditions

                        - if the person is a carer of someone else then improving wellbeing is a good way to ensure

                           that the carer is looking after their own needs too


Making Every Contact Count helps us to live out our Trust's value of being CARING

It is supported by Trust leaders, and helps us to become a health-promoting environment as well as a source of excellence for treatment

       


WHO CAN MAKE EVERY CONTACT COUNT FOR WELLBEING?

  • Professionals who work long term with patients
  • Any staff in Primary Care who meets the public
  • Professionals who are experts in health issues

BE WISE FOR WELLBEING - a simple conversation framework (copy)

W= THINK WELLBEING

W = THINK WELLBEING AND SET THE SCENE

Here are some ways that you can set the scene to make every contact count in Secondary Care

Put up posters about the ONE YOU campaign 

Put out leaflets about current campaigns and services to support people to change 

Put up a poster that says “Your wellbeing is important to us. Don’t be surprised if we ask you about your wellbeing……” 

 Put up a poster that says “Whatever your reason for coming here today, if you need information or signposting to other services to improve your wellbeing, then It’s OK to ASK” 

Wear a badge that says “Ask me about Wellbeing”


Always THINK WELLBEING

I = IDENTIFY OPPORTUNITIES TO MAKE EVERY CONTACT COUNT FOR WELLBEING

I= IDENTIFY SUITABLE OPPORTUNITIES TO HAVE A BRIEF CHAT ABOUT WELLBEING

I = IDENTIFY SUITABLE OPPORTUNITIES 

RECEPTIONISTS, NURSES, DOCTORS and ALLIED HEALTH PROFESSIONALS CAN ALL MAKE EVERY CONTACT COUNT IN A MINUTE:

- MENTION NATIONAL or LOCAL CAMPAIGNS - 

 “I don’t know if you are aware of the Physical Activity Awareness campaign that’s on at the moment…..? "

"You may have seen the Be Clear on Cancer campaign on TV. We want to encourage everyone who visits us to take up opportunities to have their cancer screening checks. Can I just check that you have received your invitation for bowel screening....? 

“There is a campaign on at the moment to make everyone aware of how to reduce the risk of accidents and injuries at home. Because of the link with smoking and house fires, we are asking everyone whether someone in their household smokes…...do you or anybody who lives in your home smoke?” 

 - SAY SOMETHING ABOUT WELLBEING THAT IS PERTINENT TO THE PERSON

 “As you are nearly ready to go home, it’s important that you keep physically active to help your recivery. May I just ask how active you are at the moment?”  

- MENTION SOMETHING PERTINENT THAT YOU HAVE OBSERVED

 “I noticed that you were having a look at our healthy eating booklets – is that something you are interested to know more about?” 

“You seem to still have that chesty cough. We have some leaflets here about how to quit smoking if you are interested....?"

 The important thing about ASK is that you use a “light touch” If the person isn’t interested, then you can move away from the subject at once.

- LISTEN OUT FOR THINGS PEOPLE MENTION THAT MAY BE A "DOOR OPENER" TO A BRIEF CHAT

Sometimes the other person says something that can lead into you making every contact count. 

They may mention that they would like to lose weight or quit smoking. 

Or maybe they mention that they have been feeling lonely or isolated recently

ALWAYS TRY TO IDENTIFY OPPORTUNITIES TO MAKE EVERY CONTACT COUNT







COMMUNICATE WELL

THINK ABOUT THE SIGNALS YOU ARE GIVING OUT

Even in a very brief chat of a minute or so, your communication skills matter

BODY LANGUAGE: Are you sending out signals that you are approachable and interested in what the person needs?

VERBAL LANGUAGE: Think about how you phrase your questions. Be sensitive, especially when asking about how someone perceives themselves. They may feel embarrassed about being a smoker, being overweight or feeling that they are not coping well.

We NEVER JUDGE, we are here to HELP

We NEVER TELL people to change, just let them know that SUPPORT is there if and when they need it

Using good communication skills, even in a brief chat, can lower resistance 

WHICH ARE APPROPRIATE CONVERSATION STARTERS?

  • "You look like you could do with some support to lose weight - what do you think?"
  • "I noticed that you have been looking at our healthy lifestyle leaflets - is that something that interests you?"
  • "We are asking all our patients if they would like to know more about how to improve wellbeing"
  • " I can see that you smoke - you simply must quit"
  • "If you are overweight or a smoker then it's time to stop right now"
  • "Wellbeing is a resource for life and it matters to us that our patients know how to improve wellbeing. Would you like a leaflet about some of our local activities?"
  • "As a carer, it is important that you take care of your own wellbeing. Can I just share this information with you?"
there are 4 correct answers

S =SAY SOMETHING INTERESTING AND USEFUL

S = SAY SOMETHING INTERESTING AND USEFUL

Making Every Contact Count isn’t about telling people what to do. 

Rather it is about giving information that may be interesting and useful to the person. 

We give information in a neutral manner then invite the person to consider what it might mean for them.

PHYSICAL ACTIVITY:

INTERESTING:  Did you know that we should all try to be active for about 30 minutes on at least 5 days in the week?”

USEFUL: “You can do activity in 10 minutes chunks instead of all at once. Anything that takes a bit of effort and makes you breathe a little faster will count. Things like having a brisk walk, or doing some gardening or even some housework will all do. What do you think about this?” 


SMOKING:

INTERESTING: “It’s never too late to quit smoking. Certainly quitting smoking will help you to recover more quickly from your recent operation”

USEFUL: “The best way to successfully quit smoking is through a combination of treatment and support from Stop Smoking Services. I have the number if you are interested”

You can see from these examples how brief the conversation can be. And yet we have still managed to say something interesting and useful to help the person consider what action, if any, they would like to take. You will find many examples of INTERESTING and USEFUL statements in the next part of the course



    




 

POP IN A POSITIVE!

POP IN A POSITIVE!

If you only have a moment or two, remember to Pop in a Positive. This means saying something positive about local services or NHS Choices - such as "Lots of our patients have found these resources really helpful"

Or you can Pop in a Positive by saying something like:

"It's great that you are thinking about looking after yourself well as you prepare to go home"


POSITIVE statements can help people to feel more confident about making some changes

It only takes a few seconds to Pop in a Positive

PHYSICAL ACTIVITY

- interesting

Adults should aim to be active every day and avoid sitting down for too long

Aim to be moderately active for at least 150 minutes a week

-useful

By moderate activity we mean anything that takes a bit of effort and makes your heart beat a little faster and your breathing to be a little quicker.

Do a mixture of activities that are good for cardiovascular health - eg  brisk walking or swimming

-for strength eg lifting shopping baskets or digging in the garden

-and for flexibility eg yoga or Tai Chi




PHYSICAL ACTIVITY

BE ACTIVE EVERY DAY!

Being active is one of the best things you can do t improve your health and wellbeing

It's great for your cardiovascular health, your bone health, your flexibility and pain relief

It doesn't matter how old you are - be more active every day and start to feel great


HEALTHY EATING

 -interesting

Aim to have a balanced diet. A Mediterranean -style diet is good, with plenty of fresh fish and fresh vegetables. Aim for your 5 a day.

Limit salt to a maximum of 6gms/day

Eat less sugar

Have more fibre in your diet

Watch out for portion sizes

-useful

Have lots of different coloured foods on your plate. vegetables and fruit can be fresh, frozen or tinned.

6gms is about a teaspoon of salt. But be aware that a lot of salt is already in food!

Watch out for the sugar content in drinks and in "low-fat" foods

Have a look at the Eat Well Plate to get an idea of portion sizes




HEALTHY EATING

HEALTHY EATING

Having a balanced diet is good for health and wellbeing

QUITTING SMOKING

 -interesting

Quitting smoking is still one of the most important things that you can do to improve your health and wellbeing

Did you know that smoking actually raises anxiety levels rather than decreasing them?

-useful

You are much more likely to successfully quit smoking with a combination of treatment (using pharmacotherapy to help you to cope with nicotine cravings) and support from Stop Smoking services

Many people are now using E Cigarettes to quit. It is much safer than continuing to smoke, though getting support from Stop Smoking Services will still increase the chances of quitting for good

QUITTING SMOKING

HAVE A SMOKE FREE HOME AND CAR

Smoking can affect the people who live or work with us as well as ourselves. If you can't quit right away, then have a smoke free home and car to reduce the risk to others

ALCOHOL

-interesting

There is no such thing as safe drinking - only LOW RISK drinking

Low risk drinking means drinking no more than 14 units /week if you are a man or a woman

Spread your drinking out over the week and have at least 2 alcohol free days each week too

If you are pregnant do not drink alcohol at all

You should also check with your GP if it is safe to drink alcohol if you are taking medication


-useful

The amount of units in any one drink depends on the SIZE of the glass, can or bottle and the STRENGTH (alcohol by volume) of the drink

A half pint of 3.5% beer, cider or lager is one unit

A small (125ml) glass of wine (8% abv) is one unit

A 25ml measure of spirits (40% abv) is one unit

ALCOHOL

ALCOHOL

Encourage people to keep a simple drink diary

There are some great Alcohol Apps which are freely available

Drink Less App is a good place to start

5 WAYS TO WELLBEING

 - interesting

The New Economics Foundation identified 5 ways to wellbeing that are easy to remember

Connect - meet other people on a regular basis

Learn - keep your mind active 

Active - keep physically active every day

Notice - take notice of the world around you

Give - give something back to others eg a smile

-useful

Help people to weave the 5 ways to wellbeing into their everyday activities

CLANG! is a useful acronym to help you to remember the 5 ways to wellbeing

5 WAYS TO WELLBEING

SIMPLE CHANGES CAN MAKE A BIG DIFFERENCE

What can YOU do take the 5 ways to wellbeing?

WHAT GENERAL KEY MESSAGES CAN YOU GIVE ABOUT IMPROVING WELLBEING?

  • Carry on smoking but try to cut down a bit
  • Quit smoking completely and have a smoke free home and car
  • Weave opportunities into your everyday life to do activities that you love and that help you to feel good
  • Be active! It's great for health and wellbeing. Aim to be active for at least 150 minutes each week
  • Take the 5 ways to wellbeing
  • It's safe to drink alcohol as long as you don't get drunk too often
  • Wellbeing is a resource for life
  • It's never too late to improve wellbeing
there are 6 correct answers

REMEMBER THAT WELLBEING IS MORE THAN PHYSICAL AND MENTAL HEALTH

RELATIONSHIPS

The quality of relationships is important. Maybe the person can't physically meet friends and family easily - but can they learn to SKYPE?

PARTICIPATION

Can the person become more involved in local community activities? Do they need transport?  Or just a friendly helping hand?


SECURITY

Does the person have a safe place to live?  Do they need support to be financially more secure?


INDEPENDENCE

Does the person feel that they have a say in their care? Do they need more support to be as independent as possible?

HEALTH RELATIONSHIPS PARTICIPATION SECURITY INDEPENDENCE

Whatever your role in Secondary Care- always think WELLBEING

A brief supportive chat and signposting to further help can make a real difference

E = ENCOURAGE THE PERSON TO ACCESS FURTHER INFORMATION AND SUPPORT IF THEY ARE INTERESTED

E = ENCOURAGE THE PERSON TO ACCESS FURTHER INFORMATION AND SUPPORT 

Signpost the person to trusted sources of information and support.

NHS CHOICES

ONE YOU

CHANGE4LIFE

AGE UK

LOCAL SERVICES for WELLBEING eg walking groups, singing groups, gardening groups, cookery groups 

Not everyone will need or want to be signposted to a service, but they may appreciate knowing where they can access some on-line information and support.

So tell them about APPS such as 

ONE YOU

Five Ways to Wellbeing 

Drink Less

Smoke Free

It’s about being encouraging and supportive of them thinking about change

“It’s great that you are thinking about quitting smoking. I know a lot of people who find the SMOKEFREE APP a great place to start.” 

SIGNPOSTING

MAKE A LIST OF LOCAL SERVICES

It's important that you signpost to trusted sources of information and support

Have a list of local services handy

Signpost to local community activities for wellbeing - walking groups, singing groups, gardening groups etc as well as to services



WELLBEING AND YOU

WELLBEING IS ABOUT YOU TOO!

As a valued member of Secondary Care staff it is important that you look after your own wellbeing.

Why not start with ONE YOU? 

Think about some simple changes you could make to help you be the best you can be

Check out some local activities that you would love to do - and then make a plan to do them

WHAT IS WELLBEING AND WHO IS IT FOR?

  • Wellbeing is a resource for life that has many facets including health, relationships and participating in activities
  • Wellbeing is just about how healthy a person feels
  • Wellbeing is just a state of mental health
  • Wellbeing can add years to your life and life to your years
  • Anyone can make a contact count for wellbeing - by raising the issue, being encouraging and supportive, and signposting to further information and support
  • You have to be an expert in health to have a chat about wellbeing
  • Wellbeing is for everyone - patients, carers and staff
  • Wellbeing is only for people who are very ill
There are 4 correct answers

THANK YOU FOR MAKING EVERY CONTACT COUNT

AND FOR MAKING A REAL DIFFERENCE!

ALWAYS BE WISE FOR WELLBEING