What Works, What doesn’t Work

1. What Works, What doesn’t Work Evaluation of Health Trainer Development across South Central

2. What works Hard data Questionnaires127 57 (45%) Health Trainers 68 30 (44%) Project Managers 8 4 (50%) Line Managers 13 9 (70%) Commissioners 16 6 (38%) Admin 8 3 (38%) Case Study Interviews (semi-structured) Telephone Interviews (structured) 4 HTS provided most data

3. What works Evidence • Interim Report • Recruitment and Selection; Training; Service Delivery Structure & Management; Financial Resources; Impact & Outcomes; Good Practice; Areas for Improvement & Strengthening • Final Report • Key emergent themes & Good Practice • purpose; recruitment and retention; training and accreditation; support; partnership working; community; HT activities – Impact of HTS

4. What works A Journey with Health Trainers Purpose • Addressing Health Inequalities, clients certainly come from TARGET groups and are helped. Hard to ascertain on broader scale, impact goes beyond clients to other community members and group. • Keeping quality assurance in mind at each stage of development • Evidence: positive; focused, designed to meet targets; aware of issues; achieving purpose

5. What works A Journey with Health Trainers Recruitment and Retention • I think that has been an achievement of the HT service in itself that local people are getting jobs and have a place in the health service so I think that is a strength • I think there is a commitment from the PCT they are giving people permanent posts as HT’s so I think that is promising • Evidence: target group recruitment; relevant recruitment process to support NHS process; NHS as employer; volunteers in step-up role/signposting role.

6. What works A Journey with Health Trainers Training • Very comprehensive – behaviour change management, lifestyle issues, inequalities etc. • Clear roles and training objectives, linkages between training received and role relevance, practical skills training combined with robust underpinning knowledge and wide variety of delivery methods. • I would like training in domestic violence, suicide prevention and those sort of areas, self harm, all those sort of stuff which has not been covered yet which I have come across • Ongoing support, supervision and workshops and network meetings provide continuous development and training • Evidence: consistent content - initial training; responsive to on-going training needs; supportive and integrated into workplace

7. What works A Journey with Health Trainers Portfolio • A detailed portfolio is constructed and addresses all key national competencies. • I will be supporting HTs and motivating them to complete set tasks • Support tutor/assessor reviews evidence against competency (1-3 items expected for each criteria) second review sample undertaken for internal consistency. • Evidence: core evidence used for portfolios is consistent; variety of other evidence is included; clear purpose

8. What works A Journey with Health Trainers Accreditation • C&G assignment require practice experience to complete appropriately, so this two stage approach seems to work best for local need • We are doing C&G as for our volunteers this is often a way back to work and it is something for them to have that will help with that. • RIHP - all passed with credit. • Evidence: accreditation is valued; a managed process can help HTs; support is given; HTs do well at RIHP

9. What works A Journey with Health Trainers Support • When we want any help and advice we can call anytime • Do more training within the community and to try and give people pathways into doing HT or similar roles as they come up. • I feel well supported and have had a good amount of training and clear pathway • Evidence: wide range of support; regular contact; support & supervision; mentorship

10. What works A Journey with Health Trainers Partnership Working • The service has developed in a way that it works across organisations and boundaries. • There are also going to be some more posts in the estates possibly some of them based in doctors surgeries. • main asset of the service is that it is not just within the NHS, but that other organisations are signed up to providing the service also. • Evidence: good communication & relationships; wide range of partnerships - formal and informal

11. What works A Journey with Health Trainers Community • The HTs are integrated within the probation service as members of staff • Recruiting & training members of the community to become Health Trainers, making it easier to reach and liaising with clients • The process has allowed health to be moved from the confines of the NHS into the community building Health knowledge and expertise in the community • Evidence: recruitment from target groups and communities; knowledge of communities; support from partners

12. What works A Journey with Health Trainers HT Activities: Impact of HT Service examples • I’m seeing a lady that’s got bi polar and she has been in hospital for 2 years and she wants help with shopping, healthy eating and doing a menu • Things like that for elderly people, just to ring up and make an appointment for them where they have been messed around • Some you sort them out with a gym and they are just gone • Evidence: behaviour change; closing gaps; meeting needs; improved access; signposting

13. What works A Journey with Health Trainers HT Activities: Impact of HT Service process • Being a health trainer is really good because you can signpost them to the agencies that they need to see and support them – see them weekly and say “how did you get on – how are you feeling this week.” • One went to a parenting course and gradually got to know the other parents on the course and she got quite a few clients from that; it was quite a long process to win their trust. • Evidence: signposting important; building trust; follow up; community relationships; NHS links

14. What works A Journey with Health Trainers HT Activities: Impact of HT Service 3 impact • what’s come out is you just get stopped and asked about everything and anything really; which I think is really good. • its really rewarding when you see the difference you have made to their lives and how you’ve helped them to change. • When I had to go and do that presentation in front of ten doctors the other day I thought “oh my God, how am I going to do this?” I was so nervous and then I thought “no, I know what I’m talking about – I am going to go in there and do it • what I’m finding over the two estates is that a lot of them can’t even think about those things yet because they have so many other problems such as debt, housing issues, trouble with their children so all those other things Evidence: impact on HTs; impact in community; awareness of needs in community

15. What doesn’t work Remedies • Recruitment: via NHS only • Workshops to prepare target group applicants • HT application process/form to supplement NHS • Support: potential isolation for some HTs • Regular support & supervision with Line Manager/other • Prioritise HT network meetings • Partnerships: “some come off, some don’t” • Must support HT purpose & HT individuals • Community: vulnerability of HT • Regular support & supervision with Line Man/other • Address in initial training and on-going training • HT Activities: role and personal boundaries • Very regular support and supervision

16. What doesn’t work Remedies • Training: initial period inconsistent across Hub • Hub workshop to develop best practice and relevant consistency • Portfolio: inconsistent assessment process; time consuming • Hub workshop to develop best practice for portfolio assessment & effective preparation of evidence to meet national competencies • Accreditation C&G : assessment; national competencies • Review existing award and include other evidence • Follow up NVQ option with C&G • Accreditation RIHP: uptake • Disseminate success • Incorporate at relevant stage of training