https://publichealthmatters.blog.gov.uk/2018/01/08/its-good-to-talk-making-the-most-of-our-conversations/

It’s good to talk: Making the most of our conversations

This blog looks at starting conversations about health and is part of a short series addressing the contribution health and care professionals can make to improving health and wellbeing. Please also see our blogs about making referrals and on our research into front line professionals views on the wider prevention agenda. Don’t forget to also take a look at All Our Health which helps all health and care professionals maximise their contribution to achieving a radical upgrade in prevention.

As we move into 2018 we are reminded how hard our front line health and care staff are working and how many people need their help, particularly at this time of year.

And of course, there’s a wider story about health in England; people are living longer but spending more of that time suffering from illnesses that could have been prevented.

This problem is more pronounced in some communities, such as those living in deprived areas or experiencing a mental health condition, where people can face many years living with ill health or die years younger than people in affluent areas.

As well as the obvious human cost, all of this only adds to the pressures on our health and care services.

National and local government play a role in improving population health and the impact that every health and care professional can have is also of vital importance.

With an estimated two million health and care professionals working across the country, your collective efforts can be a real force for change.

Your trusted advice

Surveys often show that no other occupational groups command the same public trust as our front line health professionals. So how do we make the most of that trust?

In this blog I want to look at some of the resources available to help us have conversations with members of the public, whether offering brief advice through to longer term health coaching.

We recognise that some health professionals can be apprehensive about talking about risk factors for premature death and ill health (like a patient’s weight, alcohol consumption, their smoking or physical inactivity).

But these conversations have a crucial role in improving the health of our population and surveys often show that patients expect and value them (the BWeL study, for instance, highlights that 4 out of 5 patients reported that a brief opportunistic discussion initiated by their doctor regarding their weight was helpful).

Crucially, this doesn’t have to be about adding lots of new work to your already busy day and it doesn’t mean extensive training. Neither is it about preaching or telling people what to do.

Providing brief advice on specific risk factors

You don’t need to be an expert in smoking cessation, alcohol harm, physical activity or obesity in order to provide effective brief advice. Why not take a look at these resources and implement the learning in your practice?

  • Smoking: Very brief advice for smoking cessation aims to identify and support patients who smoke to make a quit attempt - it can be provided in as little as 30 seconds. A short online training module is available which provides everything you’ll need.
  • Alcohol: Alcohol identification and brief advice aims to identify and influence patients who are increasing or higher risk drinkers. In its simplest form this means asking the 3 questions of AUDIT-C verbally and scoring the answers, or giving patients an AUDIT-C scratch card to self-complete, feeding back to the patient what their score indicates about their health risk, encouraging them to think about this (and cut back if indicated) and providing a patient information leaflet. Patients identified as potentially dependent drinkers can be referred to a specialist.
  • Overweight/obesity: “Let’s talk about weight” is a practical guide to initiating a conversation about a patient’s weight. It includes a simple infographic to use as a conversation guide.
  • Physical inactivity: The UK Chief Medical Officers have produced a set of infographics that can help health professionals explain why and how people should get more active.

Motivational interviewing

One of the ways we can prompt healthy behaviour change amongst our patients is through motivational interviewing. PHE and the BMJ have provided a free e-learning module on ‘Motivational interviewing in brief consultations’ which explains the approach, looks at how you can recognise situations where it can be used, as well as how it can improve outcomes for patients.

Health coaching

Health coaching is about helping patients gain the knowledge, skills, tools and confidence to become active participants in their care so that they can reach their self-identified health goals. A wide range of practical resources is available on the Better Conversation, Better Health website.

It’s good to talk

Better conversations can improve patients’ physical and mental wellbeing, helping people to take control of their health, avoid illness and in turn reduce pressure on our stretched NHS and social care services.

That’s why the need to make every contact count (MECC) is backed by the NHS, Public Health England and a range of professional bodies. You can access MECC e-learning online.

Whilst specialist advice and treatment will always be needed for patients in specific risk groups, a really important message is that brief interventions and advice can be delivered by any health and care professional at any time (please also read my blog about making referrals).

It’s also worth pointing out the importance of “health literacy” amongst the public, which is being able to use health information, make subsequent decisions and engage with health care structures and systems.

A study by PHE showed that around 6 in 10 of the working age population can find it difficult to understand health and wellbeing information so it’s important to learn more about effective approaches to health literacy, and better conversations. Find out more via a set of practical resources.

More and more health professionals are building the prevention of ill health into their day to day practice.

For information please visit All Our Health, a resource which provides a range of advice and information on how you can demonstrate your impact.

Image: by St Ambrose University. White text/blue box added to the original. Used under creative commons

1 comment

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