1 PHE Practical MECC Resources Quality Marker Checklist

1 PHE Practical MECC Resources • Quality Marker Checklist for Training Resources • Evaluation Framework • Implementation Guide Andy Boote Public Health www. worcestershire. gov. uk

2 Quality Marker Checklist for Training Resources www. worcestershire. gov. uk

3 National Definition(s) of MECC For Organisations… MECC means providing staff with leadership, environment, training and information they need to deliver the MECC approach For Staff MECC means having the competence and confidence to deliver healthy lifestyle messages, to encourage people to change their behaviour, and to direct them to local services for support For individuals MECC means seeking support and taking action to improve their own lifestyle by eating well, maintaining healthy weight, not smoking, drinking alcohol sensibly and looking after their wellbeing and mental health www. worcestershire. gov. uk

4 Quality Marker Indicators of quality – what needs to be in place to meet quality marker Your assessment Fully met =3 Partially = 2 In development =1 Not Met =0 Context of training – Why MECC? 1. The training demonstrates the impact that MECC can have at n individual and population level Training includes key statistics on population levels unhealthy behaviours and NCD and impact of +ive lifestyle change 2. The training enables learners to understand how MECC fits in to their role and the core business of their organisation Training explains PH responsibility of the org and employees role. Reference to relevant national policy (NHS 5 YFV) www. worcestershire. gov. uk Local plan to meet

5 Quality Marker Indicators of quality – what needs to be in place to meet quality marker Your assessment Fully met =3 Partially = 2 In development =1 Not Met =0 Skills and Knowledge: how to deliver MECC 3. Training includes a brief introduction to behaviour change theory Information re: basics of BC theory (e. g. COM-B, BC wheel, PRIME) 4. Training includes the 5 key elements of MECC Stop smoking; Increase PA; Reduce/maintain alcohol recc. Levels; maintain a healthy weight ; promote MHWB 5. Training is consistent with the latest advice on following a healthy lifestyle Latest guidance on all of the above* www. worcestershire. gov. uk Local plan to meet

6 Quality Marker Indicators of quality – what needs to be in place to meet quality marker Your assessment Fully met =3 Partially = 2 In development =1 Not Met =0 Skills and Knowledge: how to deliver MECC 6. The training provides advice on how to start conversations on hwb Tips on how to recognise opportunities. Overview of Ask, Assist, Advise. Open questions May include role play or video examples good/bad 7. Training provides info on local services How to contact local services www. worcestershire. gov. uk Local plan to meet

7 Quality Marker Indicators of quality – what needs to be in place to meet quality marker Your assessment Fully met =3 Partially = 2 In development =1 Not Met =0 Evaluation: is it working? 8. Evaluation process in place for assessing effectiveness Learning outcomes met? Post-training evaluation assesses satisfaction Changes made due to evaluation (evidence of) Numbers and groups trained captured 9. Staff competence and confidence is assessed Pre and post surveys Follow up support as required Attendance recorded 10. Staff trained in MECC are able to refresh/update as required System to update staff/trainers on services Refresher training available www. worcestershire. gov. uk Local plan to meet

8 Evaluation Guide www. worcestershire. gov. uk

9 Why evaluate MECC? • • • Is MECC delivering desired changes locally? Support improvement and adjustments to MECC To know how things are working Highlight any unintended outcomes and benefits Help communicate value of MECC by quantifying benefits • Help focus on the outcomes and benefits for MECC programmes www. worcestershire. gov. uk

10 Evaluation should include 3 components… • Process Evaluation to show any MECC outcomes or impact were achieved. Measuring the activities of the programme, the programme quality and who the programme or activity has been reaching. • Outcome evaluation to assess the effectiveness of a MECC programme in enabling change. This involves measuring the immediate and medium-term effects of a MECC programme and should be based on the programme’s aims and objectives • Impact evaluation to assess the contribution from the programme to longer-term changes and improvements - as defined within the local programme or project plan – resulting from delivery of a MECC intervention or programmes. www. worcestershire. gov. uk

11 www. worcestershire. gov. uk

12 MECC Inputs – selecting and measuring MECC Input Recommended measure Financial resource • Cost of training package/delivery Human resource • Size/number of staff group selected for training vs whole population Organisation leaders buyin • No. of key leaders/stakeholders engaged in training • No. of presentations/briefings made to leaders MECC governance and pathways • MECC strategy in place within organisation? • MECC Lead identified – including time/capacity • MECC part of contract delivery? Awareness of MECC amongst staff groups • No. of presentations made to staff groups • MECC publicity and no. of people reached? • Proportion of staff taking part in the training www. worcestershire. gov. uk

13 MECC Outputs – selecting and measuring MECC Output Recommended measure MECC governance and pathways • No. of pathways that now include MECC (compared to a baseline pre-programme/prerefresh) • MECC reporting structure – reporting to senior management/board members? Managers and service leads involvement • Supervision of MECC programme and practice/structure model in place • Method of peer observation to ensure MECC interventions are of good quality Reaching relevant staff groups • % of staff population participating • Participation satisfaction MECC Intervention • No. of patients/clients receiving a contact • Demographics of people reached • Forms of MECC contact (opportunistic/routine appt) www. worcestershire. gov. uk

14 MECC Outcomes – selecting and measuring MECC Input Short Term Recommended measure Training • Increase in knowledge (hwb) • No. of attendees • Increase in confidence (hwb) Intervention • No. of information only interventions • No. of people signposted to activities/services • No. of people who intend to change behaviour Longer Term MECC • No. of staff inductions include basic MECC embedded in • No. of JD’s that include MECC policy • MECC integrated into signposting (NCWMP) • Referral pathway in to local programmes Training www. worcestershire. gov. uk • Changes in behaviour of MECC staff • Progression to other BC training • Impact on staff sickness

15 BUT…. . Establishing the impact of MECC is complex • MECC may only be the first step toward BC • It may require multiple conversations before action • Attributing a change to a specific MECC intervention problematic • Impact of … • local delivery landscape changes • wider determinants of health; • hwb campaigns (local/regional/national) www. worcestershire. gov. uk

16 Types of data to consider… MECC Theme Narrative content Organisational readiness • Capture benefits of MECC to orgs • Goal for MECC project/Expectations of the changes • Process changes required internally • How do organisational leaders think/feel about MECC Staff Readiness • How staff feel about MECC • Are staff doing things differently around MECC Training • Feedback from trainees about content • How do they feel about implementing MECC delivery • Illustration of MECC pathway • Examples of expected benefits being delivered • Examples where things went wrong/right/unintended outcomes www. worcestershire. gov. uk

17 MECC Implementation Guide www. worcestershire. gov. uk

18 www. worcestershire. gov. uk

19 1. Organisational structure - To shape why MECC should be taken forward • What is the orgs vision – how does MECC fit? • Are there shared goals? • What are other orgs in your area doing in relation to MECC? • How does MECC fit in to wider health improvement plans or activity • Have benefits for patients/staff been identified? www. worcestershire. gov. uk

20 2. Senior leadership – Senior leadership buy is crucial to successful implementation • Senior leadership aware of MECC? • How can you increase their involvement? www. worcestershire. gov. uk

21 3. Planning – To implement MECC a team is needed to lead and champion the approach • Who will lead the MECC implementation? • Is a MECC implementation team needed? • Are meetings required? • Who should attend? • Who are the key stakeholders? • Who are the MECC champions? • How are they identified/engaged? www. worcestershire. gov. uk

22 4. Identifying resources – What resources are needed/available to support • • • Time Budget Staff capacity for training How will training be delivered? Facilities/equipment required? www. worcestershire. gov. uk

23 5. Infrastructure – Systems and Processes – Consider what systems are required to embed MECC • Activity monitoring – how will you know how many healthy conversations have taken place? • Can this be integrated into existing monitoring processes? • How will referrals/signposting to services be managed • Will MECC be an agenda item at staff meetings/1: 1’s? • Can MECC be written in to organisational policies/processes and procedures • Can MECC link with other projects? • Can all new staff be MECC trained/included in JD’s? www. worcestershire. gov. uk

24 6. Staff readiness and engagement – How staff can be engaged/empowered to improve hwb • Which workforces will be identified for MECC? • What criteria will be applied? • How will teams be recruited? • What can staff do to support the implementation of MECC? • Is a facility available for staff to share their experiences of MECC? www. worcestershire. gov. uk

25 7. Implementation: Training – MECC is about organisational change and workforce development • What knowledge and skills do staff have? • How will training be implemented? • How will staff be introduced to MECC? • How will they be trained in MECC www. worcestershire. gov. uk

26 8. Review and Evaluation • How will you know if monitoring systems are effective? • How will you evidence impact? • Will capture outcomes from patients/clients? • Will it include capturing changes in motivation of patients/clients/ • Could you use the friends and family test to evaluate MECC? • How will you capture feedback on referrals? www. worcestershire. gov. uk