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Surrey County Council offer a range of generic and bespoke MECC training courses

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MECC is an approach to behaviour change that uses interactions that organisations and individuals have with other people to support positive changes

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This programme is in partnership with...

About the Making Every Contact Count programme

Aims and ambitions

Make Every Contact Count (MECC) enables the delivery of consistent and concise health and wellbeing information and encourages individuals to engage in conversations about their health at scale across organisations and populations.

The fundamental idea underpinning the MECC approach is simple. It recognises that staff across health and care, local authority and voluntary sectors have thousands of contacts every day with individuals and are ideally placed to support health and wellbeing.

MECC is intended for anyone who has contact with people to "Make Every Contact Count" and develop public health knowledge.

How learners will benefit from doing this course

The MECC elearning programme is designed to support learners in developing an understanding of public health and the factors that impact on a person's health and wellbeing. It focuses on how asking questions and listening effectively to people is a vital role for us all.

A MECC interaction takes a matter of minutes and is not intended to add to existing busy workloads, rather it is structured to fit into and complement existing engagement approaches.

Who it's aimed at?

MECC is for everyone, it is not restricted to one person, profession or organisation.

For organisations, MECC means providing staff with the leadership, environment, training and information they need to deliver the MECC approach.
For staff, MECC means having the competence and confidence to deliver health and wellbeing messages, to help encourage people to change their behaviour and to direct them to local services that can support them.
For individuals, MECC means seeking support and taking action to improve their own health and wellbeing.

More information

If you do not require a certificate, the Making Every Contact Count programme is freely available to access without having to register by clicking on the images below.

IMPORTANT: If you require evidence of learning, please register and then log in to access this programme on the elfh Hub. More information can be found on how to do this below

Gain CPD points and continue your personalised care learning experience.

This programme forms part of the Personalised Care Institute's library of personalised care training for all healthcare professions. If you would like to obtain a certificate and CPD points for your ongoing CPD records, and learn a lot more about personalised care, then please visit the Personalised Care Institute website to register and access.

Special thanks

Special thank you to the Project Reference Group who provided their expertise and guidance in the development of this eLearning.

Project Reference Group Members:

Phil Godfrey, Public Health Development Manager & MECC Programme Lead, HEE Wessex

Em Rahman, Head of Public Health Workforce Development, HEE Wessex

Lara Hogan, Programme Lead, Academy of Public Health

Sally James, Public Health Workforce Specialist, HEE West Midlands

Sarah Hassell, Workforce development manager, PHE East Midlands

Chris Sharpe, Workforce Development Manager, PHE Yorkshire and the Humber

Alison Farrar, Public Health workforce manager, HEE North West

Branwen Thomas, Workforce Programme Lead, PHE South East & HEE Thames Valley

Joanne McEwan, Public Health Development Manager, HEE Thames Valley

Deb Lear, Head of Public Health workforce development, HEE South West

Joanne Keeling, Workforce Development Manager, PHE South East

Lancashire Care Foundation Trust would like to thank staff from the New Economics Foundation for their contributions and support in developing the Five Ways to Wellbeing session.

How to access

Available to all

The Making Every Contact Countprogramme is freely available to access here.
Please note your progress and completion of sessions will not be recorded and you will not be able to generate a record of completion. If you require evidence of learning, please register and then log in to access this programme on the elfh Hub.

If you already have an account with elfh, then you can enrol on to the Making Every Contact Countprogramme by logging in to the elfh Hub, selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My elearning section.
Access guidance > Register >
To view the Making Every Contact Count programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.
View >
Not an NHS organisation?

If you are not an NHS health or care organisation and therefore do not qualify for free access elfh Hub, you may be able to access the service by creating an OpenAthens account.

To check whether or not you qualify for free access via OpenAthens, you can view the eligibility criteria and register on the ' OpenAthens ' portal.

Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the Making Every Contact Count programme, please contact elfh directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.

More information

Please select the following link for more information on how to use the elfh Hub.

elfh is a NHS England programme in partnership with the NHS and professional bodies

© elearning for healthcare 2023

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Making Every Contact Count - elearning for healthcare

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This programme is in partnership with... Aims and ambitions Make Every Contact Count (MECC) enables the delivery of consistent and concise health and wellbeing information and encourages individuals to engage in conversations about their health at scale across organisations and populations. The fundamental idea underpinning the MECC approach is simple.

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Understanding what influences behaviour is key to making behaviour change possible. Our brand new guide focuses on the COM-B model, which proposes ‘Behaviour’ is a result of ‘Capability’, ‘Opportunity’ and ‘Motivation’.

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This guideline covers a set of principles that can be used to help people change their behaviour. The aim is for practitioners to use these principles to encourage people to adopt a healthier lifestyle by, for example, stopping smoking, adopting a healthy diet and being more physically active.

Recommendations

This guideline recommends a set of principles to use as the basis for:

providing education and training for those delivering them

delivery of these activities, including one-to-one and community-based programmes and those aimed at specific populations

evaluation of their effectiveness and cost effectiveness

Who is it for?

National policy makers, commissioners, providers and practitioners in the NHS, local authorities and the community and voluntary sectors

Researchers, including those who oversee research funding

Social and behavioural scientists

Health economists working on health-related knowledge, attitude and behaviour change

Is this guideline up to date?

We checked this guideline in November 2017. We found no new evidence that affects the recommendations in this guideline.

Guideline development process
How we develop NICE guidelines
This guideline was previously called behaviour change.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

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This guideline covers a set of principles that can be used to help people change their behaviour. The aim is for practitioners to use these principles to encourage people to adopt a healthier lifestyle by, for example, stopping smoking, adopting a healthy diet and being more physically active

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Example MECC conversation - smoking

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Example MECC conversation - weight management

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Making Every Contact Count – Weight Management

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Example MECC conversation - alcohol

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Example MECC conversation - link worker

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Making Every Contact Count - Link worker

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How To Listen Better: 5 Essential Phrases for Reflective Listening — How Communication Works

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Listening is a skill, but many of us do it poorly. If we can learn to do it better, it can produce dramatic improvements in our lives. I am going to teach you five stock phrases I use when I do reflective listening, active listening, or looping back. It goes by a bunch of different names, but it

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Change Talk and Sustain Talk | Psychwire

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William Miller on the therapist’s active role in evoking change talk.…

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Clients tell us where they are in the process of change. In Tip #69 we looked at change talk, the specific client language we hear when a client is moving toward change. We support the change process by reflecting change talk and by skillfully eliciting more. Just as change talk can be usefully categorized, its opposite, sustain talk, can, too.

For example:

Desire: "I don't want to eat vegetables."

Ability: "I can't walk more."

Reasons: "Eating this won't help with my constipation."

Need: "I don't need to lose weight."

Commitment: "I'm not going to keep this food record."

Taking Steps: "I haven't done any exercise."

Feeling powerless means
you are focused on
something you can't control.

Drawing on my fine command
of the English language,
I said nothing.
Robert Benchley

When we encounter change talk, we reflect it in order to accentuate it. The best response to sustain talk is silence. An exception is when you are hearing only sustain talk. A brief reflection of sustain talk signals to the client that you are listening and accept what is true for him. This serves the important process of engagement. For example, you may notice you are arguing with the client. All the statements you hear are pointing to not changing. Very briefly reflecting some of what you hear can end the argument and regain rapport. Then switch to open-ended questions (Tip #60) that will elicit change talk.

Of course, it's wise to avoid anything that will evoke sustain talk. Examples: "Why don't you eat fruit?" "Could you walk after work?" "Why didn't you write in your food record?" "Why don't you want to lose weight?" This style of wording can be tricky to avoid. We ask these questions in an effort to move the change process along. Unfortunately, they are more likely to elicit sustain talk and stall the flow toward change. Review the questions that elicit change talk in Tip #69.

When using summaries to begin a transition or to end a session (Tip #72), mention just a bit of sustain talk and as carefully as possible include all the change talk you heard. Strike a balance between ignoring the sustain talk and acknowledging it. This may mean using minimizing language. For example: "You don't particularly like vegetables." "You haven't yet begun to exercise." "You are unsure about whether eating more fiber will help your constipation."

For those who use the decisional balance concept to work with ambivalence to change, it is common to explore each of the four squares. (Pros and cons of changing, pros and cons of staying the same.) This way of looking at decision-making is very useful when it does not matter what the person chooses to do. For example, choosing which type of equally beneficial exercise the client will pursue. However, for a food behavior change such as eating more fruits and veggies, there is an assumed "right" choice. The client came to you with a goal and this change is tied to that goal. In these discussions, it is counterproductive to deliberately evoke sustain talk.

A final note: Resistance and sustain talk are not exactly the same thing. Sustain talk is about the behavior, and resistance is about the relationship between you and the client. For example, take the statement "I won't drink skim milk and you can't make me." The first part is sustain talk. The second part is resistance. Understanding this distinction may help you decide which way to go when you encounter negative statements. If you are hearing resistance, roll with it. "Indeed, I can't make you do anything. It is your choice." In response to sustain talk, it will be more effective to ask questions likely to elicit change talk. "Tell me more about benefits you would get from eating lower fat foods."

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Clients tell us where they are in the process of change. In Tip #69 we looked at change talk, the specific client language we hear when a client is moving toward change. We support the change process by reflecting change talk and by skillfully eliciting more.

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It's Not About the Nail - Righting Reflex

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It's Not About the Nail - Righting Reflex

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Selfcare, information & signposting to local services available to Surrey residents

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Supported by the Health and Wellbeing Board, this website helps you find self-care information, as well as signposting to local services available to you as a Surrey resident.

You don't need a referral for most of these - you can book an appointment yourself. Why not give it a go and make a change today?

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Supported by the Health and Wellbeing Board, this website helps you find self-care information, as well as signposting to local services available to you as a Surrey resident. You don't need a referral for most of these - you can book an appointment yourself. Why not give it a go and make a change today?

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Welcome to the Surrey Five Ways to Wellbeing

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A way to think about the things you can do to help improve your mood, reduce the risk of depression and strengthen your relationships

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Health & Wellbeing programmes to support Surrey residents

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One You Surrey | Free Healthy Lifestyle Service

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We are Surrey's free Healthy Lifestyle Service, supporting the county's residents to lose weight and become smoke free.

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NHS advice about healthy living, including eating a balanced diet, healthy weight, exercise, quitting smoking and drinking less alcohol.

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NHS advice about healthy living, including eating a balanced diet, healthy weight, exercise, quitting smoking and drinking less alcohol.

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Who should hold the conversation?

Compassionate conversations can be held between, colleagues, a line manager, team leader or supervisor and those who they are responsible for, as well as between staff and patients. Tip: For some, holding a compassionate conversation may feel daunting at first. It is important to remember that your role is to hold the conversation, actively listen to your colleague, be compassionate and either signpost to further support and/or help; or enable colleagues to identify the most appropriate support for themselves.

What you bring to a compassionate conversation*?

A commitment - to cultivate self-awareness, suspend judgment and a desire to learn from others.

A skill set - to enhance interpersonal relations and navigate challenging conversations.

A process - to bring individuals or groups together and to appreciate our inter-connectiveness.

A gift - a connection, to really listen to a person and they feel heard.

*Adapted from: The Compassionate Listening Project, Seattle, USA.

How should I approach a compassionate conversation?

Whether it's taking place virtually or in person, it's important to hold a compassionate conversation in a safe, neutral, confidential space. This will enable you to focus on the individual, and they have the freedom to share their thoughts and feelings. Reassure the individual that the conversation is confidential (unless there is a stated intent to harm self or others).

Take a moment

Check your intentions - compassionate conversations happen when we want to have a meaningful and constructive conversation with someone.

Be self-compassionate - The foundation of compassion for others is with how we treat ourselves.

Make the time to listen - Avoid assumptions. Could we unwittingly giving the impression that their needs don't matter?

Recognise our shared humanity - Our interconnectedness and shared humanity.

Learn how be a different kind of observer - From 'passive' to an 'active' observer.

For example, an empathetic reflection and an offer of support, I notice you look a little concerned, could I
help at all?' can go a long way to supporting someone who may be feeling isolated and in need of support.

Take a moment, 'Compassionate Conversations', Linda Keenan and Gareth Corser, NHS Elect.

Tips

Be authentic. Authenticity is at the core of compassionate communication.

Be present: Listen to hear what the individual is saying. We sometimes listen to respond. When you listen to understand, you are in a better position to determine the appropriate response.

Avoid assumptions, as this can lead to misunderstanding. Ask the individual to explain anything that you need to understand more, to give you both clarity within the conversation. Be curious to find out the reasoning behind their decision.

Avoid judgement. However, do not be afraid to ask/hear the uncomfortable question, begin to lean in with the discomfort of uncomfortable discussions to promote learning and growth.

Explore, be aware of, and personally work through any biases you hold prior to commencing a 1-1 conversation in promoting equity and inclusive practice. For example, if you hold a negative bias towards accents that are different to yours, then ensure that you're listening to understand is even more earnest than usual.

Reflect on any outdated narratives or assumptions you've held and demonstrate a willingness to unlearn.

Good practice for compassionate conversations

Compassionate conversations are:

Caring and compassionate - they give space to enable employees to holistically explore their thinking.

Employee led - they enable the employee to lead the conversation and focus on the most important things to them.

Supportive - they enable colleagues to identify the most appropriate support for themselves.

Non-Judgemental - this helps us to stay neutral and focus on understanding others point of view. Recognise our ability to connect within sameness and difference whilst suspending judgement.

Do not

Take a traditional directive and argumentative style.

Identify and solve the problem for the individual.

Argue or debate. Make it known that you are there to listen to their concerns.

Rush through without listening.

Questions that can be asked as part of the conversation

Ask open-ended questions using "How", "What" or "Tell me...", to enable the individual to share and clearly articulate what they8want to say.

Inquiry - questioning hints*

Hints: What can help?

Be present for them- Turn-off your 'mind-chatter'

Ask open questions - 'How' or 'What'?

Empathy

Ask questions which follow their interests, not your agenda....

Mirror and paraphrase

Use bridges - 1-3 of their words

Don't feel you have to fill the silence

Stay out of judgement

Hints: What to avoid

Closed questions - 'Can' or 'Do'

'Why' questions (can sound interrogative or accusatory)

Don't make statements dressed as questions

Saying 'I know just how you feel'

Telling them your own story

Start a sentence with, 'At least...'

Avoid sympathy

Avoid collusion

Online blogs and guides

Websites

Books and guides

Self-Compassion: Dare to Lead, Brené Brown

Mindset: The Outward Mindset, The Arbinger Institute

Leading teams in difficult times: Teaming, Amy Edmondson

Compassionate Leadership: Compassionate Leadership: Sustaining Wisdom, Humanity and Presence in Health and Social Care, Professor Michael West

YouTube

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Compassionate conversations: a guide to holding compassionate conversations with colleagues

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Compassionate conversations can be held between, colleagues, a line manager, team leader or supervisor and those who they are responsible for, as well as between staff and patients. Tip: For some, holding a compassionate conversation may feel daunting at first.

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Health Equity in England: The Marmot Review 10 Years On

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This report by the Institute of Health Equity and commissioned by the Health Foundation explores widening health inequalities over the past decade and proposes recommendations for action.

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Understanding the drivers of healthy life expectancy: report

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Key points of the report are: healthy life expectancy (HLE) can be defined as 'a measure of the average number of years a person would expect to live in good health based on contemporary mortality rates and prevalence of self-reported good health' improving HLE remains a priority across government.