# data[].attributes.body
The view that harm done by alcohol consumption is somehow self inflicted. E.g. Not treated the same as smoking, overeating.

# data[].attributes.body
Niche to the nhshc, not used more widely/linked in with other services so knowledge is lacking.
Not much additional support following initial training.
Lack of support from more senior clinicians- from experience in GP delivery, not the case across all, but no uniform approach.
Lack of formal training- cascade training from other staff with lack of understanding

# data[].attributes.headline
lack of confidence raising the topic or inadequate training

# data[].attributes.subject
lack of confidence raising the topic or inadequate training

# data[].attributes.body
Training for NHS delivery differs across the region.
Audit C and GPAQ/moving professionals training would be beneficial across Primary Care
Feedback on Audit C by alcohol commissioners was that is was a great tool to use but that often patients lie.

# data[].attributes.headline
Don't ask the question if I'm unsure of how to deal with the answer scenario. Staff may not want to broach a subject they feel they are not confident/equipped to answer fully

# data[].attributes.subject
Don't ask the question if I'm unsure of how to deal with the answer scenario. Staff may not want to broach a subject they feel they are not confident/equipped to answer fully

# data[].attributes.headline
Not just a training or knowledge gap. Time can be an issue also

# data[].attributes.subject
Not just a training or knowledge gap. Time can be an issue also

# data[].attributes.body
As well as using the tools staff delivering the health check would really benefit from motivational interview techniques, and strength based training to support healthy conversations around PA and alcohol

May be an opportunity to share some conversations starters, key facts and support resources and services all in one place to support practitioners

# data[].attributes.headline
patients may not be honest or underestimate the amount of alcohol they are consuming so HP doesn't delve any deeper.

# data[].attributes.subject
patients may not be honest or underestimate the amount of alcohol they are consuming so HP doesn't delve any deeper.

# data[].attributes.body
lack of follow up support, following initial health check training

lack of training in clinical roles to initiate conversation skills, too much focus on clinical skills

# data[].attributes.body
Yes still think we need to make the case in primary care that behavioural risk factors can make a difference.

reinforcing the commitment in the long-term plan around addressing behavioural risk factors in primary and secondary prevention.

# data[].attributes.body
Lack of time from commissioners and practitioners is always identified as a barrier for discussing behavioural risk factors

# data[].attributes.body
changing opinions/culture is difficult, needs to be embedded from their initial clinical training. Hollistic approach to interventions

# data[].attributes.headline
Improving the templates used for delivery may be able to support ease of tool using and conversations following this. Embedding links to local lifestyle/commissioned services can help

# data[].attributes.subject
Improving the templates used for delivery may be able to support ease of tool using and conversations following this. Embedding links to local lifestyle/commissioned services can help

# data[].attributes.body
Criticism from some commissioners was that patients lie with audit C to health professionals so are now sharing drinking apps instead

Similar belief around physical activity and lack of understanding around the evidence around increasing PA

# data[].attributes.body
raising the topic regardless of other health issues- it's still important but not considered so

Predudice, worry about offending if raising certain

# data[].attributes.body
we dont report on outcomes...what happens next, the impact with healthy behaviours
Health professionals may report on onward referral not commitment to make a small agreed change or an action plan.
Is there an opportunity to link with social prescribing lifestyle services to report outcomes

# data[].attributes.body
negative attitudes but caused by other influences i.e. time given to complete a check- do staff feel like they are able to offer effective intervention

Knowledge of local services and where to signpost.

No follow up for the practitioner so no knowledge of if it has been a successful intervention

# data[].attributes.body
Agree we are still making the case for prevention and NHSHC in some localities and practices