Making Every Contact Count (MECC)
Making Every Contact Count (MECC) is an approach to healthcare, developed by NHS England and local government. I think the Local Eye Health Network want to encourage staff and professionals working in optical practices to use the opportunities arising during their routine interactions with patients to have brief conversations on how they might make positive improvements to their health or wellbeing.
By engaging with community optical practices, making the most of their location, access, opening hours and availability within communities, local authorities can enlist their support in tackling these wider determinants of health and thus the ‘Making Every Contact Count’ is an approach to improving health and reducing health inequalities.
For example, today is National #NoSmoking day, and we know that someone is at higher risk of developing eye health problems might also be a smoker. #FACT ‘Smokers have 3 times the risk of age related macular degeneration, one of the leading causes of blindness.’ (RNIB)
Quality in Optometry
MECC is now included in the Quality in Optometry checklists in the NHS Standard Contract (Service Condition 8.6), which is a toolkit for clinical governance in Optometric practice and a requirement for providing Minor Eye Conditions Services and other ‘Extended Primary Care Services.’
A local optical practice could give advice and support to stop smoking. Similarly, people with diabetes could receive healthy eating and weight management services at an optical practice.
With increasing pressure on the NHS to reduce costs, there is a greater reliance on prevention, hence the promotion of health and well-being. So every opportunity should be used to deliver brief support and help in the prevention of eye disease, in the population you serve.
Organisations that commit to and support MECC will see improved health and well-being for the population it serves and the staff that delivers the service.
Professionals working across the whole eye health pathway will find that they have opportunities to raise the issues of lifestyle behaviours which impact on their patients’ eye health. With training, this can be achieved with a brief conversation lasting just 30 seconds to a minute, ideally suited for Optometrists when they are asking a patient “Do you smoke?”
Learning Outcomes for MECC sub-contractors:
- Recognise suitable opportunities in everyday practice to start brief conversations which promote healthier behaviours
- Have the confidence and competence to deliver evidence-based brief interventions
- Know where to signpost clients for further information and support
- Level 1 MECC – very brief intervention – Ask, Advise, Assist delivered by everyone, to everyone
MECC involves:
- systematically promoting the benefits of healthy living across the organisation
- asking individuals about their lifestyle and changes they may wish to make, when there is an appropriate opportunity to do so
- responding appropriately to the lifestyle issue/s once raised
- taking the appropriate action to either give information, signpost or refer individuals to the support they need.
Most commonly a lifestyle issue will be about encouraging individuals to:
- stop smoking
- eat healthily
- maintain a healthy weight
- drink alcohol within the recommended daily limits
- undertake the recommended amount of physical activity
- improve their mental health and wellbeing.
What MECC is not about:
- adding another job to already busy working days
- staff becoming specialists or experts in certain lifestyle areas
- staff becoming counsellors or providing ongoing support to particular individuals
- staff telling somebody what to do and how to live their life.
Wednesday 14th March 2018 #Nosmokingday
The facts about Smoking and Sight Loss:
As a eye-professional, and hence with the knowledge that the impact of smoking on sight loss is huge, over 2 million people in the UK are living with sight loss and that number is set to increase to 2,250,000 by 2020 (RNIB).
The amount of money the NHS is spending on sight loss in the UK is almost £22 billion a year (RNIB).
The harsh reality is that smoking and sight loss is as strong as the link between smoking and lung cancer. But, awareness of this fact is low amongst Britain’s 10 million smokers at 9.7%, compared to lung cancer (92.2%).
One in six adults smoke, but do they know these facts:
- Cigarettes contain 4,000 chemicals including tar, arsenic and ammonia. These chemicals get into the bloodstream of smokers, damaging the blood vessels inside the eye and the health of the cornea.
- Tobacco smoke, including second-hand smoke, is an irritant that worsens dry eye, a very uncomfortable eye condition that is most common in women after menopause.
- Smoking also raises the risks for cardiovascular diseases that indirectly influence your eyes’ health.
- Smoking prevalence is highest in the 25-34 age group (25%) and lowest over 60 (11%).
Patients know smoking is bad for their health, so it’s not that they don’t want to quit, they are not capable of quitting, and after all nicotine is highly addictive. Opportunities like being signposted to local stop smoking services by their eye –care professional might be the encouragement they need.
How can I deliver MECC?
Smoking is a good place to start in an optical practice:
LEVEL 1 MECC VERY BRIEF INTERVENTION (MECC in a minute)
AIM: Raise awareness of lifestyle services to support people to improve their health and well-being. Delivered by everyone to everyone, regardless of risk.
- ASK: Use a simple status question “One of the best things we can to do look after our eyes is to quit smoking. Do you smoke?” or “We know that smoking can affect your eye health – may I ask do you smoke?”
- ADVISE: Give simple sound-bites of information. POP in a positive. Be enthusiastic and persuasive about local services that can support people to change. “You are 4 times more likely to suffer sight loss if you are a smoker than a non-smoker. We have some great services that can help you when you are ready to quit.”
“Your local stop smoking service provides expert advice and encouragement to quit”
“You can get free one-to-one support along with stop-smoking medicines, which are available at the cost of a prescription”
“Quitting smoking can be an important part of looking after your eye health. You are more likely to quite successfully with support.”
- ASSIST: Signpost to local support “Here’s a leaflet…why not give them a call? Many people find them really helpful and are 4 times more likely to quit successfully with support. (A bit like slimming world)”
“You don’t have to give them a call right now, sometimes it’s just good to know there is support out there.”
If you get a positive response:
SIGNPOSTING:
- ONE YOU WEBSITE
- ONE YOU APP
- NHS CHOICES
- CHANGE4 LIFE
- Local stop smoking services
For those not interested – close the conversation.
Sources
- Future of Sight Loss UK (1): The economic impact of partial sight and blindness in the UK adult population. (RNIB)
- National Eye Health Week Smoking and Sight Loss leaflet visionmatters.org.uk
- MECC (Make every contact count) training by Deryn Bishop BA PGD(Psych) Cert PH
- An Implementation guide and toolkit for MECC http://learning.wm.hee.nhs.uk/sites/default/files/Making%20Every%20Contact%20Count%20Toolkit%20Final%20Draft%20V4_0.pdf
- nhs.uk/livewell.eyehealth
- quit51.co.uk
- Quit 51 call 0800 622 6968 or text smokefree to 66777
Resources
Order leaflets,posters and guides from https://campaignresources.phe.gov.uk/resources/campaigns/44/resources
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