Jane Holland: health trainer is a natural extension of her current
role |
NHS Health trainers
The concept of health trainers was first mooted
in 2004 in the Government’s
public health White Paper “Choosing health”. In 2005, “Choosing
health through pharmacy” suggested that pharmacy staff, particularly
medicines counter assistants, could obtain health trainer status.
It also proposed that pharmacies could be used as a setting where
health trainers are available, and that pharmacists and their staff
could have a role in supporting health trainers.
The role of a health trainer is to support and motivate individuals
to achieve the changes they want to make to improve their health.
Trainers are drawn from local communities with the aim that they
will understand the day-to-day concerns of the people they are supporting.
Health trainers will also provide signposting into other services
and support available locally, both in the NHS and the wider community.
In September 2005, 12 early implementer sites for health trainers
were given £200,000 to test out a draft set of core competencies
and job descriptions prepared by the Department of Health Skills
for Health programme. The most disadvantaged areas were chosen with
the aim of making it easier for individuals in these areas to make
healthier choices. Each site developed its own course based on the
draft competencies specified by the DoH.
In April 2006, national roll out of the scheme began, with public
health minister Caroline Flint predicting that by early 2007, about
1,200 trainers will be in place. All health trainers are attached
to a local project.
Health trainers are employed by the NHS and it is proposed that they
will be paid at Agenda for Change band 3. |
Nicky Roe: would like referrals into the pharmacy environment |
Jane Holland, a senior pharmacy assistant at Rowlands Pharmacy in Bolsover,
Derbyshire, is the first accredited NHS health trainer working within
community pharmacy. Mrs Holland qualified as a trainer in April and believes
that the role fits well with her existing work in the pharmacy. “I
was already providing smoking cessation advice and when this job came
up it seemed like a natural extension to what I was doing,” says
Mrs Holland. She believes that the health trainer role will give her
more time to spend with clients.
Mrs Holland has worked at the pharmacy for eight years and has lived
in Bolsover all her life. “A big part of the health trainer role
is knowing the local community,” she says. “I was born here
and all my family live here. The town has suffered from pit closures
over the years and I know the effect it has had on people within my family
as well as the wider community. Being a local, I understand the health
issues that are related to both mining and the chemical industry, which
was also a major employer here.”
When she learned via Rowlands that the local primary care trust was one
of the early implementer sites for the health trainer scheme, she was
keen to expand her knowledge of health-related issues and jumped at the
chance to get involved. She started her training in December 2005 with
three rounds of classroom training lasting a total of seven days. The
training started with topics such as learning skills and self-development,
behavioural change, motivation and support. The second stage of the training
was on-site at the project where Mrs Holland would be based — the
Bolsover Wellness Programme, in Cresswell. Here she attended seminars
on mental health, nutrition, smoking cessation, alcohol awareness, weight
management and sexual health. She also learnt how to understand body
language and to communicate effectively. She undertook a project to help
her get to grips with Bolsover as a community, including studying local
health statistics and demographics. She passed the training course in
April.
The Bolsover Wellness Programme is an exercise scheme, to which any member
of the primary care health team can refer people. Typical participants
are those with depression, diabetes, weight problems or cardiac problems.
Currently about 90 people per month are referred to the scheme.
Wider role
Nicky Roe, pharmacy service development manager at Rowlands, is excited
by the cross-boundary working opportunities that having a health trainer
in the pharmacy provides. “You have got a community pharmacy
employee working as a health trainer in a project hosted by the district
council but connected to health via PCT funding. There are inward and
onward referral pathways into that community pharmacy and finally we
begin to feel like part of a joined up, cohesive health movement,” she
says.
“Ideally we would like referrals into the pharmacy environment, through
other health care professionals,” says Mrs Roe. She would like
to see health trainers using consultation areas in community pharmacies
for appointments with their clients. She believes that the accessibility
of community pharmacies and the existing customer base make them the
perfect location for health trainers to be based. “We see people
come into the pharmacy who are suffering from social isolation or who
need these exercise programmes but we don’t have the formalised
pathways to link them into. Jane’s role as a health trainer is
enabling that to happen for this community.” Signposting
The signposting role of a health trainer is more extensive than that
required of community pharmacists under the new contract. Judy Derricott,
who works on the health improvement team at North Eastern Derbyshire
PCT and manages the health trainers, says: “You are giving information
but you are also supporting that person to take up that referral. And
that might involve going along with that person, or making a phone
call for that person, or motivating them to make their own phone call.”
Mrs Holland has built up a directory of local services and can signpost
clients to a wide variety, including social services, aids and equipment
and weight management services. Customer benefits
Mrs Roe believes that pharmacy customers benefit from having a health
trainer on the premises. “In a very busy pharmacy environment
you haven’t necessarily got the time that needs to be devoted
to that intense one-to-one conversation with a patient. Now, any member
of staff in the pharmacy can refer customers to the health trainer.”
North Eastern Derbyshire PCT compensated Rowlands for the time Mrs
Holland spent on her health trainer role and, from 1 July, she entered
into a
contract with the PCT and now works three days a week for Rowlands and
two days a week for the PCT. She will start by spending one morning a
week of her health trainer role in the pharmacy but hopes that this will
increase as time passes. “The most challenging thing for me now
is to get [the role] working in the pharmacy,” she says.
Mrs Roe believes that another challenge is how Mrs Holland can engage
with new clients coming into the pharmacy. “At the moment there
are posters up in the pharmacy and flyers going out in prescription bags,
and Jane is there on her days as a health trainer wearing her Bolsover
Wellness Programme tracksuit.” Government strategy
Gul Root, principal pharmaceutical officer at the Department of Health,
told The Journal that she is delighted to hear that a pharmacy assistant
has been trained and accredited as a health trainer. “In ‘Choosing
health through pharmacy’, a programme for pharmaceutical public
health, we said that some pharmacy staff, particularly medicines counter
assistants, who often come from the local community, could acquire
accredited health trainer status and that pharmacies could be used
as a setting where health trainers are available.
“I believe that Mrs Holland will be spending part of her time practising
as a health trainer within the pharmacy. This is very much in alignment
with our strategy, to maximise the contribution of pharmacists, their
staff, and the premises from where they practise, to help improve health
and reduce health inequalities.”
Mrs Root adds that as part of their signposting role within the new contractual
framework, pharmacists and their staff could put people in touch with
health trainers. “Other pharmacies in the area could put people
in touch with, for example, Mrs Holland, if the local primary care trust
wished to do so.” Workforce development
How the health trainer role can fit alongside a community pharmacy
skills set is something that Mrs Roe believes has to be examined at a
national
level. She proposes that health trainer training could be incorporated
into the national vocational qualification for pharmacy assistants. “Ideally
what I would like to see is potential progression from counter assistant
through to a specialist module to become a health trainer.”
Raising the profile of the health trainer role, both locally and nationally,
is something that needs to be addressed, says Mrs Roe. “There needs
to be a wider national understanding of how you can integrate with the
hubs. If I had a pharmacy in a community where I thought that a health
trainer was needed, I would without hesitation go to the PCT or local
authority and find out who the health trainer lead is.”
Rowlands will now look at the possibility of rolling out the health trainer
role in its other pharmacies.
Mrs Root hopes that hearing about Mrs Holland’s success will encourage
other pharmacy staff to become accredited health trainers. “Pharmacy
staff are ideally placed to attain health trainer status,” she
says. |
The
Pharmaceutical Journal