Wednesday 29 June 2011

Health Trainers in the new NHS

The Health Trainer Service is a product of the 2004 White Paper Choosing Health; Making Healthier choices easier. This document draws from a wide range of scientific evidence that people are more likely to make and sustain healthy life style changes when they are provided with one to one support.

Over the years, the Health Trainer service has grown across England with about 80% of Primary Care Trusts in the country having some form of a Health Trainer Service in operation. There are currently 2,011 Health Trainers in the country and they have seen more than 250,000 people supporting them to stop smoking, eat healthier, increase physical activity, reduce alcohol and manage their weight better. With an average success rate of 75%, this is a great service in the community especially as it targets the hard to reach and people who are socially disadvantaged. The aim of the Health Trainer service is to support lifestyle change and reduces health inequalities among hard to reach groups.



Recent pronouncements of the Coalition government, makes it clear that the NHS will undergo radical changes. Though there are still uncertainties in what shape some of these changes will take, it is clear that the new focus of government is to empower individuals and communities to take a more active role in shaping their own health, and a focus on preventative side of health rather than treatment.



This in itself means that the Health Trainer Service is perfectly suited to carry forward the vision of government, however, in an era of cuts, there is the possibility that Health Trainer Services up and down the country could be a victim of circumstance, taking cuts against more traditional services.



In the same light, the support structure for Health Trainers in the country are loosing their funding. Each Health Trainer service is part of a regional hub. Most of the funding for the Hubs will end by September 2011. The last of them will survive only till March 2012.



All these factors put together means that the picture is not too bright for the Health Trainers. It means that all those years of hard work, all those training and learning, all those community contacts and projects that have been set up could be lost, if there is no concerted plan to coordinate the activities of Health trainers at a national level. Health Trainers need to have a voice, a platform for interaction and how to learn about best practices, standards need to be set across the country and health trainers and their clients need to get the recognition that they deserve for the great work they have done.



One way to overcome these challenges is to set up a National Association of Health Trainers, this will be an independent organization made up of health trainers, membership will also be open to health champions other people who support health trainer services through training and service delivery. This association will be the voice for Health Trainers across the country, it will ensure that Health Trainers have a place in the future of the NHS, it will ensure that service standard are maintained and it will ensure that best practice are shared and improved upon. This organization will be a platform for recognizing and highlighting achievements of individual health trainers and services, it also means that for the first time the over 2, 000 health trainers and more than 12,000 health champions can express their collective views about the way our NHS is changing and offer what we can to improve it for the good of all.



To have this organization set up raises a number of questions and barriers, but as Health Trainers, we are used to overcoming barriers to make a healthy change. If you support the establishment of the National Association of Health Trainers in England, show your support by emailing ukonu.obasi@nhs.net Join the NHS Health Trainer group on Facebook or join at NHS Networks www.networks.nhs.uk and show your support. We would like as many people to let us know what you think.



About the writer:

Ukonu Obasi is Senior Health Trainer for NHS Berkshire West Health Trainer Service. A passionate public health professional, he has been part of a number of regional and national consultation on public health and health trainer services across the country. He is the group administrator for the NHS Health Trainer Facebook Group and the online Health Trainer Network. He is a Fellow of the Royal Society of Public Health
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Shaping a Quality Approach to Health Literacy in Primary Education - Seminar Overview

A group of senior public health, policy and education practitioners from across many different sectors came together in June to discuss the importance of health literacy in primary education.  This was a highly interactive event and well supported by all participants. 

 
Professor Richard Parish, Chief Executive of RSPH, welcomed everybody to the session and conveyed the RSPH’s support for developing a practical approach to health literacy. He was joined by Dr Selwyn Hodge, Chairman of the Society, who explained why he has adopted health literacy as the theme for his chairmanship. He clearly articulated his personal passion for health literacy and the need to develop a high-quality practical approach to embedding the concept in primary school education. 
 
After hearing from Andrew Carter OBE (head teacher and national adviser on head teacher leadership) about the role and purpose of primary education,  the participants were encouraged to consider  the many different ways of thinking about health literacy. This included decoding information, the acquisition of knowledge and tools, skills, keeping healthy and well, and personal development, nurturing.  The challenge for participants was to discuss whether it was possible to articulate a practical definition of health literacy including some or all of these elements. 
 
The concept of a health literacy ‘journey’ was also discussed, as were the key health, social, educational and economic benefits of early health education. It was agreed that our understanding of the meaning of health literacy and context determine our beliefs about its benefits and also how we as a society value it.
 
Participants were asked to suggest benefits under these category headings and propose additional categories, based on the following discussion questions:
 
a) What does your organisation believe are the benefits of early exposure to health education? Why?
 
b) Are you aware of any evidence or research to measure the impact of early exposure to information about health and well-being determinants on future health choices? Is your organisation involved in any work to determine or evaluate the benefits of health literacy?
 
The seminar then looked at the current policy context and the potential opportunities and challenges for health literacy in primary education:
 
  1. The Health and Education White Papers
  2. Recognition of the need for joined up working on public health and education
  3. The Curriculum and PSHE reviews
  4. The focus on teacher quality and employment based training and teaching schools
 
Participants were also asked to consider the challenges in developing a national approach to health literacy at primary level as well as considering what health literacy projects are already underway.
 
The group finally agreed that going forward the immediate actions included the need to understand some of the policy drivers in more detail and evaluating the available opportunities and/or forming a campaigning alliance.  A meeting was also suggested for early 2012 to look at progress.  For further details or to contribute to our work in supporting health literacy in primary education please contact Nelly Araujo on 0207 2657 322.

“ESOL for Health” Programme accredited by the RSPH

Women who do not have English as a first language can find access to healthcare challenging at important stages of their lives. They may not be able to interpret, read or write the necessary English vocabulary and the UK healthcare systems may not be familiar to them. They may also benefit from additional basic Health information about healthy lifestyles, their anatomy and changes to their bodies which can take place at different times.
 
RSPH is pleased to announce it has accredited an “ESOL for Health” training programme developed by Joseph Chamberlain College, Birmingham, with support from Heart of Birmingham PCT.
 
The programme provides ESOL language knowledge for pre-entry, entry 1 and entry 2 levels. (ESOL being “English for Speakers of Other Languages”). At the same time, the vocabulary taught, and the scenarios used as the basis for the programme, are relevant to women’s lives – including modules relating to pregnancy, birth and child development, healthy lifestyles, women’s health and carers.
 
Following a pilot study, the conclusions of an independent report has noted that learners have a marked increase in confidence in contacting health professionals, attending appointments on their own and explaining their concerns to professionals. The programme has a style sympathetic to the culture and position of immigrant women. Training utilises comprehensive workbooks, video clips, reading tasks and interactive activities. The programme will be available to others in the form of a comprehensive tutor package later this year.
 
Other organisation who would like their training programme considered for RSPH accreditation should contact the Accreditation Department at accreditation@rsph.org.uk

Making Every Contact Count: An introduction to the behaviour change competence framework

So many aspects of healthcare are concerned with preventable or avoidable conditions. But the cost of dealing with them is under pressure more than ever before. A key theme in the Government’s next White Paper will be the need to reduce these costs, and every healthcare worker has their part to play. Every contact with a patient is an opportunity to encourage healthier lifestyle choices. But tackling sensitive issues such as weight loss, smoking cessation or alcohol abuse requires expertise, confidence and knowledge, in order to deliver the message effectively. Preventing avoidable conditions and encouraging behaviour change is an essential part of delivering an affordable health service for the future. Prevention is both better for the patient and cheaper for the provider. But do you and your team have the knowledge and skills to take this on? 


Prevention and Behaviour Change: a competence framework
The RSPH is offering a new programme designed to introduce participants to this competence framework which has been developed by NHS Yorkshire and The Humber.  It is designed for use at all levels of experience and provides a common approach against which skills can be assessed, either within a single programme or for an entire workforce. This will enable individuals to identify gaps in their knowledge, Commissioners to address weaknesses in their provision, and Service Providers to offer exactly what is needed.

This is a one day introductory programme, designed for those with an interest in encouraging behaviour change in their community or workforce. It is intended for people who will be playing a part in the development of healthy communities, whether as a Commissioner, provider of service or a member of frontline staff.  For further information or to book onto the course please contact Nicolette Boustaoui or by phone 020 7256 7325.

RSPH Training Solutions has also developed a unique suite of programmes called “Enabling and Guiding Choice for Health and Wellbeing”.  These include Influencing Behaviour Change and Behaviour Change in Practice.  In addition we will be running master classes and workshops for senior managers.  These suites will be available from September.  To register your interest or for more information please contact Nicolette Boustaoui or by phone 020 7256 7325.

Youth Health Champion: Bringing Health into the Lives of Children

The Government’s White Paper Healthy Lives, Healthy People, emphasised a new approach to health, which would empower local communities, enable professional freedoms and introduce a system that would be based on the evidence of what works best, in order to tackle health inequalities and improve the nation's health and well being.

The Royal Society for Public Health (RSPH) supports the principles outlined in the White Paper, that every single one of us has a critical role to play in helping to tackle current health issues.  By encouraging and empowering people to take responsibility for their health, we positively promote healthy behaviours and lifestyles and educate people to make healthier choices.

The Youth Health Champion (YHC) is one such initiative, implemented by NHS North East Essex (NHS NEE) and commissioned under their Health Trainer Service, which enables young children to act as “health advisors” to their peers.  The aim of the scheme, to reach out and educate children about health in order to reduce health inequalities in the most deprived areas, has been highly commended by the RSPH.  In recognition of their success, RSPH awarded NHS NEE the national RSPH Health Promotion Award 2010 and were very pleased, therefore, to host a dissemination seminar in June with NHS North East Essex PCT to explain the rationale and practice underpinning the success of YHC.

Background
The Youth Health Champion scheme was introduced in 2006 by NHS North Eash Essex following the success of the Health Trainer Service, whereby Health Trainers/Champions sought to improve the communities’ health by reaching out to those in the most deprived areas, with the worst health.

The purpose of the Youth Health Champion scheme is to recruit and train students from local secondary schools to raise awareness amongst their peers about lifestyle related risks to health and be able to provide safe signposting information about local services for health and wellbeing.  The Youth Health Champions, who are recruited from Years 10, 11 and 12, undertake four days intensive training in health promotion and safe signposting, focusing on emotional health, wellbeing and sexual health.   

The Benefits
There are numerous positive results from implementing the Youth Health Champion scheme in schools.  Firstly, not only is the scheme free to introduce and maintain, but it has a strong dual purpose.  The children who become youth champions become educated and interested in health and health promotion, thereby increasing their own knowledge and awareness.  The scheme also contributes to their personal development, by improving their communication and planning skills, as well as giving them responsibility and a greater sense of empowerment.  The young adults have also noted an increase in their confidence and believe the scheme gives them a purpose and a focus.  The students take the RSPH Level 1 Award in Health Awareness course, which can then lead on to the RSPH Level 2 Award in Understanding Health Improvement course, once again helping to build skills and understanding in health. 

Evidence demonstrates that we are more likely to seek advice from our peers.  For this reason, Youth Health Champions are more effective at getting health messages across to other students and making a notable difference to health.  By targeting their peers, Youth Health Champions are able to form relationships and appeal to other students, enabling them to educate, to advise and signpost services to young adults who would be unaware of services or too embarrassed to seek information on the support available to them.  Consequently, the scheme reaches out to people in the community, who would otherwise “fall through the net” and helps tackle health inequalities.  By helping to diminish social isolation and promoting health, we encourage and empower people to make healthier lifestyle choices from a young age.

Jake Camp, 17, a Youth Health Champion from Clacton County High School says that through the YHC scheme:

I have built a great sense of community between me and the rest of the school, increasing relationships and being able to know I am making a difference with the campaigns... I have learnt great amounts about my own health and making sure I maintain being positive and un-hypocritical role model, by sticking to Youth Health Champions own ideology

Five students from Manningtree School presented their experiences at the seminar and described them as “invaluable”.  They also described the skills that they have developed and the great sense of satisfaction and achievement they felt from being involved in a scheme that helped others. 

The seminar provided an opportunity for the Service Lead of the Health Trainer scheme to discuss how schools benefit by adopting the scheme.  There were examples of how to approach and appeal to the schools, as well as how to implement the YHC programme and what processes needed to be in place to ensure the maximum effectiveness within the school.
Some of these points included:

  • Gaining the support of a senior member of staff in the school who will be committed to run and support the scheme
  • Highlighting to the school that the scheme is free and does not interfere with the curriculum.
  • Incorporating an interview process to select and appoint YHC to give the scheme greater validity and status.
  • Demonstrating to the schools that all students can benefit.
  • Ensuring that preparation and planning takes place in advance for scheduled activities.  

Karen Stimpson, Health Trainer Coordinator at Anglia Community Enterprise:


“Our programme utilises young peoples’ energy and enthusiasm, gives education and knowledge and exposes the myths in all areas of health”

Martin Page, Assistant Head Teacher, Manningtree High School:

“I have found that the YHC programme has been one of the most effective vehicles I have come across in delivering the Health aspects of our PSHE programme. Peer led sessions on health have been a huge success, students feel that they can connect with the YHT students and that the message is much clearer and engaging. The profile of the YHTs around school has meant that many students who in the past may not have known where to source help have gone directly to a YHT who have been able to signpost them to the right Health Professional.”
                                                                                  

Current Status
Since the Youth Health Champion programme began three hundred children have been trained as Health Champions and there are currently nine schools who are involved in the scheme.  The Youth Health Champions scheme has also been highly commended in the NHS Alliance awards for excellence as well as presented at the 20th IUHPE World Conference for Health Promotion and Education (11-15th July 2010, Geneva). 

Conclusion
It became evident, that those who attended the seminar were clearly enthused by the developments taking place in North East Essex and were considering how they could use the YHC approach in their work.  

The RSPH has, for some time been leading on the development of the national education and training pathways for health trainers and health champions and sees YHC as the next stage in moving the concept into more and varied 
settings.
 
The young people involved in YHC in North East Essex have taken a truly positive leadership role and the RSPH is convinced that there is potential to develop this type of approach even further as a national programme.

Friday 10 June 2011

Getting Sex-Wise

The Government’s White Paper "Health Lives, Healthy People" made clear that children’s health and well-being needed to be put high on the public health agenda.  It stated that teenagers and young people are among the biggest lifestyle risk-takers, with issues surrounding binge drinking, smoking, drugs, and poor sexual health.  The White Paper flagged up that the rates of Sexually Transmitted Infections (STIs) such as Chlamydia have continued to rise since the 1990's with 15-24 year olds being the most affected group.

Facts for Thought:
The Health Protection Agency (HPA) compiled a report in 2008 called "Sexually Transmitted Infections and Young People in the United Kingdom".  It found that young people account for nearly half of all the STIs diagnosed in the UK despite representing only 12% of the population.  The statistics showed that they account for 65% of all Chlamydia, 50% of genital warts and 50% of gonorrhoea infections diagnosed in genitourinary medicine clinics across the UK in 2007.

The most common STI is genital Chlamydia with 79,557 diagnoses made in 2007 (1,102 per 100,000 population aged 16-24), a rise of 7% since 2006.  High rates were also reported for genital warts (682 per 100,000), a rise of 8% since 2006.  In addition in 2007, 702 young people were diagnosed with HIV, representing 11% of all new HIV diagnoses. Although increases in STIs may reflect greater ascertainment of cases through rises in testing and improved diagnostic methods, it also indicates increased unsafe sexual behaviour among young people.

The NusringTime.Net published an article at the end of last year, explaining that the worrying rises in STIs is the result of a lack of knowledge and misconceptions about sexual infection and reproductive health.  The study "The Face Of Global Sex 2010: They won’t know unless we tell them" found a high level of ignorance about STIs across Europe.  The Study was the Fifth in the Durex Network's research series and involved more than 15,000 people aged between 15 to 20 in 15 European countries.  Some of the countries involved in the study were Belgium, France, Italy, Slovenia and Turkey and the UK.  From the research it was found, worryingly, that Britons were relaxed about their sexual health, with almost eight out of ten young Britons (79.8%) believing they are at little or no risk of contracting STIs.

Although efforts have been made to educate young people about the negative effects of having unsafe sex, it is clear that the message is still not be absorbed and policy makers, schools, local governments still have a huge part to play in reaching out to all young adults.

The 2008 report published by the HPA produced some recommendations including making access easy for young people to sexual health services, that can provide screening and treatment of STIs, as well as delivering high quality personal relationship and sexual health education.    

What You Can Do?

The RSPH is offering a course called "Introduction to Sexual Health and Young People" which is being held on the  27th July in London.  The one day event is designed to give participants the confidence to support the sexual health needs of young people and techniques for incorporating discussion about sex and relationships into their everyday working practice.  The course is for anyone in the voluntary organisation, education or the health and social care sector, with particular responsibility for young people.

For further Information please contact Nicolette Boustaoui or on 020 3177 1625