Thursday 27 June 2013

Using Motivational Interviewing during NHS Health Checks

Among the most keenly discussed topics at this month’s NHS Health Check Leadership Forum was the need to make every contact count. The approach aims to ensure that NHS Health Check providers maximise every opportunity to talk to individuals about their health. What’s more, meaningful and motivational consultations are essential if the programme is to achieve the impact it promises.
In reality, the process of encouraging individuals to consider behaviour change is a delicate task. However, having constructive conversations can be greatly assisted by practicing certain Motivational Interviewing (MI) techniques. A central idea of MI is that individuals are far more likely to be convinced by their own arguments than those imposed by others. As such, the method looks to elicit an individual's inner motivation to change. Above all, a non-judgemental attitude that facilitates a conversation that’s relevant to the concerns of the person having the health check is essential.
Achieving these objectives is possible through a combination of techniques outlined by Miller and Rollnick in MI-3. However, given the specific circumstances offered during a health check, brief interventions often need to be – as their name would suggest – brief. As such, delivering a 20 minute counselling session is often not possible. The question for health check providers is then, ‘how can we make a difference in the minutes that are available to us?’

In order to provide guidance on precisely this matter, Health Diagnostics have produced a pack of training and consultation materials. These are provided to anyone trained at a Health Diagnostics training day. (See below for image). The pack includes:
  • A booklet that condenses the techniques outlined in MI-3 into a framework for approaching NHS Health Check consultations
  • A range of Top Tip cards which may be used by practitioners to offer bite-size practical advice on lifestyle choices
  • Access to a video demonstrating some of the MI techniques in action
Due to the time pressures during a NHS Health Check, using visual tools as a support is an invaluable way to encourage behaviour change. With this in mind, Health Diagnostics have built a number of tools into Health Options® in order to aid the user in explaining and eliciting information about lifestyle. Targeted use of these tools is covered in the pack materials, as well as being featured in the forthcoming video of the recent NHS Health Check Leadership Forum which was hosted by Health Diagnostics earlier this month.
During the Leadership Forum, a number of topics were examined by public health experts implementing and delivering health checks. The audience and panel discussed many issues, including how to cleverly target the checks, transferring data electronically to the patient’s record, and innovative ways of boosting uptake. The initial findings from the national evaluation were also presented by Dr Michael Soljak, Clinical Research Fellow at Imperial College London.
As a follow up to the event, the findings will be published on as both as a video and PDF thought piece in early July. More details on the panel can be accessed here.
In addition to the aforementioned resources, there are some useful interactive online learning resources provided by the NHS that can be accessed through the professional learning environment.

(above: the Motivational Interviewing pack)