Members Event
Healthy Lifestyle (Long Term Conditions)
Jayne Tunstall
Chief Operating Officer
Motivation
Ashley Smith
Physical Activity Advisor
Lifestyle
services
Alan Jarvis
Head of Lifestyle Services
Lifestyle Services
Aim

Promote Positive Health
Objectives
Health promotion is a process of enabling people to
exert 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.
What are Lifestyle Services
Referrals
Stop
Smoking
Service
Physical
Activity
Lifestyle Link
Health
Trainer
Older People
Mental Health
and Wellbeing
Health
In
The Workplace
Substance
Misuse
Walsall Healthcare NHS Trust
Lifestyle 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.
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 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.
Bookings Taken by Lifestyle Link January - October 2010 vs
January - October 2011
4500
4000
3500
3000
2500
2000
1500
1000
500
0
January - October 2010
January - October 2011
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

Smoking, obesity, alcohol consumption, physical inactivity are all important
modifiable risk factors that can impact on health outcomes.

Supporting people with long term conditions to adopt healthier lifestyles can halt the
development of additional conditions and aid overall management of long
term conditions.

‘One Stop’ clinic approach

Reviewed by a consultant cardiologist

Referred to health trainer for 1-1 support

Family centred approach

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



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”
Decreased risk of:
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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

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 knowledge
of 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.

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
Walsall Healthcare NHS Trust
Walsall Stop Smoking Service
Service lead – Erica Pugh
Senior Advisors – Rebekah Few and Emily Bissell
Advisors – Faye Bennett, Carol Shepherd and Sue Durkin
Admin Team – Steph Coyne and Dinesh Patel
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
Microtab
Patches
Mouth Spray
Inhalator
Cools lozenge
Lozenge & Mini Lozenge
Nasal Spray
Gum
Walsall Stop Smoking Service
Smoking Paraphernalia
Smokeless tobacco;
betel, paan, snuff
Electronic cigarette
Low tar cigarette
Menthol
cigarette
‘Normal’
cigarette
Nicotine
chewing
gum
Cigar
Roll-up cigarette
Pipe
Herbal
cigarette
Shisha
Walsall Stop Smoking Service
Benefits of Quitting
The 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 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)
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
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.”
“Very educational”
“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.”
“SHOULD GIVE OUT FREE SAMPLES.”
Walsall Healthcare NHS Trust
Emotional Health and
Wellbeing Service
Steve Upton: Emotional Health & Wellbeing Manager
Anne Pledger: Emotional Health & Wellbeing Specialist
Joanne Stallard: Health Trainer for Emotional Health & Wellbeing
‘There is no health without Mental Health’
Dept of Health, 2011
The 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



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
I found the meetings
very helpful.
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 having someone
to talk to and
understand me was a
big help. I can’t thank
the service enough.
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.
2012 / 13 performance
•
•
•
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
Very useful information. I
learnt a lot
Hopefully I now have
the tools to recognise
mental health problems
and to be able to help
Excellent and thought
provoking
I greatly
enjoyed the
course
It was good to
hear someone
reinforce the link
between good
management and
stress
A practical and
realistic course,
offering genuine
guidance that can
be used in my daily
practice. Well
presented, highly
recommended
•
•
•
•
Books on Prescription
The books provide helpful information and stepby-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

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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
National Service Framework for Older People
recognises 3 broad categories of 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.
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

2013 – ‘Healthy Feet’ 17th – 21st June - This week!!
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.
2010 – ‘Get Up and Go
2011 – ‘Watch Your Step’
2012 – ‘Boost Your Bones
“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”.

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.
Walsall Healthcare NHS Trust
Health in the work place
Lisa Sylvester
Specialist Health Trainer for the
Workplace
Working days lost
29.3 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 health
1.2 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




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.
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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

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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

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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
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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.

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

Ask
Do you smoke, are you worried about your weight, have you
considered exercising …..

Advise
Did 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
Intervention
Outcome
Numbers
needed to treat
Brief advice from a health
professional (regarding smoking
Prevent 1
premature death
80
Statin’s
1 death over 5
yrs
107
Antihypertensive therapy
Prevent
700
1stroke/MI death
over 1 year
SMEAR
1 death over 10
yrs
cessation)
1140
Do not underestimate your influence as a health
professional

Accessible though ESR
2 modules
•Brief encounters
•Motivating
change
http://twitter.com/ECCwmids
Darlaston Health Centre
Pinfold Street
WS10 8SY
Lifestyle Link 01922 444044
Fax 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

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
Relax
Anne Pledger
Emotional Health & Wellbeing Specialist
Thank you for listening, any questions?