Physical activity and alcohol measurements in NHS Health Checks - breakout group 3 by https://padlet.com/hannahsullivan6/lqux38ua797ypedi Which of these are the biggest barriers? What are the root causes of the barriers preventing healthcare professionals (HCPs) from fully completing the alcohol and physical activity elements of an NHS Health Check? Do you have any suggested solutions which will help make improvements to these elements of the NHS Health Check? en-us 2021-11-09 09:37:06 UTC 2021-11-11 11:40:13 UTC hello@padlet.com Not enough time to complete a full AUDIT sensitively so it is avoided completely. Suggestion that NHS HC just includes AUDIT-C and then follow up as needed. https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883927123 2021-11-11 11:27:11 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883927123 Could you role out a targeted PA Clinical Champions programme, along with MECC to support this https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883927209 2021-11-11 11:27:15 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883927209 HCPs may not have the knowledge or confidence to use 'imperfect' tools to have a useful conversation https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883927221 2021-11-11 11:27:15 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883927221 Still some sense within the NHS that behavioural risk factors are harder/less effective to influence than giving drugs https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883928129 2021-11-11 11:27:52 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883928129 Providers reporting conversations are harder/more tense/defensive since COVID - a lot of us are drinking more but don't necessarily want to admit i https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883929066 2021-11-11 11:28:28 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883929066 training need - how familiar are practitioners with alcohol screening tools and explaining risk levels https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883929136 2021-11-11 11:28:30 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883929136 Belief that as physical activity and alcohol measures are not included in the QRISK score they are "added extras" rather than "must haves" https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883929153 2021-11-11 11:28:31 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883929153 Most HCP's I work with are familiar with the guidelines and the tools. However the physical activity and alcohol questions tend to open up/and or need clarification from the HCP. This would be difficult if there is little time to complete the full HC (we schedule 30 mins) https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883929367 2021-11-11 11:28:40 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883929367 Confidence to approach topic of alcohol consumption which can sometimes be seen as personal https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883930075 2021-11-11 11:29:08 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883930075 NHSHC providers/commissioners are trying to address a wider NHS workforce issue - many frontline HCPs are 'prevention competent' i.e. the 'NHSHC community' can't solve this alone https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883930923 2021-11-11 11:29:41 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883930923 We ran training on alcohol brief interventions specifically for our NHS HC delivery staff and it didn't make any significant difference to our alcohol recording! (Calderdale) https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883931168 2021-11-11 11:29:50 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883931168 COM-B: even if have skills and opportunity, don't always see it as their role to address behavioural risk factors if those around them don't advocate this https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883932312 2021-11-11 11:30:29 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883932312 HCP's would benefit from training about impacts of lower, but sustained alcohol consumption, particularly when they might also consume alcohol to a similar level - due to their cultural norms. Similarly - with phys act. We find using statistics from 'exercise the miracle cure, useful to open up this conversation https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883932866 2021-11-11 11:30:46 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883932866 The impact of COVID on NHS Health Checks https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883933011 Where HCs have been disrupted there is a risk that practitioners delivering the programme require refresh training. There is also the impact of turnover of staff. Opportunity with restarting NHS Health Checks fo build back better and ensure GPPAQ and alcohol recording improved.]]> 2021-11-11 11:30:51 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883933011 The Health Check is more than just a tick box exercise. It works best when there is a MECC/Behaviour change element. This isn't always the case when it's being conducted by PN's for example https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883935094 2021-11-11 11:32:10 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883935094 In part can be about pathways - no good just saying need to change behaviour if no services/support to help this https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883935413 2021-11-11 11:32:23 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883935413 reporting - need to close the loop so those providing checks get evidence of impact e.g. how many people access services, changed behaviour following checks.. https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883936518 2021-11-11 11:32:58 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883936518 There remains a feeling in some quarters that it should be an either/or - as opposed to the two being part of a method to help patients https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883938610 2021-11-11 11:34:21 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883938610 Time is all important. You can 'do' a health check in 10 minutes - but it takes much longer to do a 'good' one https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883939764 2021-11-11 11:35:09 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883939764 We've found that there is a cultural barrier in some communities. There is sometimes a reticence to open up about alcohol consumption with a member of their own community. https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883941762 2021-11-11 11:36:32 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883941762 I recently spent 3 years at Nurse Training. We spent hours during that whole process discussing lifestyle and a similar length of time on behaviour change. It's a crucial skill - particularly for Practice Nurses https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883944893  ]]> 2021-11-11 11:38:37 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883944893 We tend to find that some HCP (particularly PN's) tend to make an assumption about a patient's willingness to change - and almost discount them before before they've been offered a chance to change https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883947456 2021-11-11 11:40:13 UTC https://padlet.com/hannahsullivan6/lqux38ua797ypedi/wish/1883947456