Post your reactions to the document produced after the health trainers event on 12 April

The document produced from the event I have to say is very longwinded and messy. I know the intention was to feedback all the comments produced on the day, but some overall conclusions, defined themes etc would have helped. Feeding this back to my colleagues has taken quite a bit of time sifting through the document. I'm sure some of the specific comments will be useful later, but they don't help with the clarification of issues.
The whole event itself seemed a bit back-to-front. At no point did anyone ask: what is the actual need for health trainers? I try to work on the basis of 'need' first and then decide what will work, not decide a need a particular role or title and then wonder what it is this person should be doing!!
The only evidence that we need health trainers seems to be in Choosing Health - and it certainly can't close all the gaps in current health service provision. Such a lot of work looking at something new, when expanding similar services that are already there would be better.
I feel I am being swayed by an ideal of 'what a health trainer should be' rather than focusing on 'what do local people want and what would actually work'.

I would suggest discussing ways to develop this role with the Neighbourhood Wardens team at the Neighbourhood Renewal Unit. Neighbourhood Wardens are community based workers whose role is to become familiar with and to local communities and work on issues of concern with them. They can be working on problems with litter, young people in gangs at one moment and then offering individual support to a person on accessing benefits advice. They have been appointed as an additional workforce in neighbourhood renewal activity and are regarded as frontline/personal support within that field. There are broad similarities in what we are trying to achieve with Health Trainers (although clearly the context is more specific). As they have been in place for a couple of years in some areas and have been evaluated I think it could be worth finding out about how they've worked so far.

Whilst I welcome the drive to have a 'health trainer' role, I am concerned, as the previous member's posting, that we are looking away from the 'needs' of communities and driven by targets. I also believe that there is a lot of excellent work being undertaken out in the field, around peer education and working within the principles of community development which naturally lead to a 'champion' role in communities which is a firm footing for such a task. We should start by appraising what exists as for many of us this has taken many years to achieve. If we target the people who have adequate basic skills already, to be identified in the role of 'health trainer' within the timescales for the Spearhead PCT's, what we will be doing is contributing to the inequalities within society and not creating chances for those who are least able to access opportunities and develop their skills within this role.
Another key concern I have is the underestimation of the time and support needed to develop these individuals into a role as broad as this without creating risk to others potentially needing to access appropriate services. Because of the allocation to Spearhead PCT's, naturally with highest deprivation areas, the investment in the development of these roles should be of the greatest order. This is borne out by the fact that the local people are the ones most likely to relate to and have the confidence of their peers and speak more openly to them. To engage these people who are already disadvantaged, there needs to be a greater investment of resources to ensure parity with their journey compared to others in more advantageous situations.
There's still a way to go but let's see what structures and systems are already on the road to delivery before imposing a structure which has no foundations.

I have to agree...we have so many people in varieties of settings and with vastly different levels of experience and expertise. Hoe can the user know who is going to give them best advice /leadership

I work in Brighton Health Promotion with responsibility for Active Living.

I wasn't at the April event but I have just come back from a REACH conference in Liverpool where Health Trainers were the subject of one of the workshops.

While the role was welcomed in principle, there were a number of questions raised which I wonder if someone may be able ot help with:

1. In this evidence-based world, where is the evidence that health trainers are a) what the public want and b) will do the job required?
2. Are we creating new posts or devleoping existing staff and where is the funding coming from?
3. Who will recruit, train, manage and supervise them?

I hoped I might find some answers in the report from the April event but it seemed to be more a list of everything that was said by everybody!

Is there anywhere else I might find the answers?

Kind regards

Paul Jarvis
Brighton & Hove Teaching PCT

Experience within the NHS has replicated that elsewhere to indicate that the people who are most expert in managing long term conditions are the people with the conditions - see EPP web-site http://www.expertpatients.nhs.uk/about.shtml for information on evidence-base, and benefits.

Therefore EPP insists that all of our tutors have experience of behaviour change as a result of living with a long term condition. EPP is based around self-efficacy theory - it's not about teaching people how to manage disease, but boosting confidence to set goals and solve problems.

EPP will not, I imagine, cross paths with the new Health Trainers - it sounds as if they are predicated on an entirely different approach. For EPP, as we move to mainstreaming the job of setting up systems, structures and processes for management, support and retention of volunteer tutors becomes paramount. We are launching our document "Stepping Stones to Practice" to illustrate current best practice in this regard.

My understanding is that health trainers were an outcome of the Choosing Health consultation last year. How the outcomes of the consultation were then translated into the final documents and delivery plans is anyone's guess and whether this was based on evidence or just the general feedback from the public and health professionals is again open to a variety of opinions.
From a consutlation workshop I attended last year health trainers were mentioned by several members of the public as being seen to be a good way forward for the following;
Being more accessible both in geography (community based) and in times of access (available weekends and evenings when those who work need to access trainers)
Encompassing the wider determinants of health
Being a source of knowledge for signposting
Not being seen as "core" health professionals eg closer links to local authorities etc

Having looked at the debates so far I can see that there are pluses and minuses to this debate. For me the whole sticking point will be around engagement as some of the'captain mainwaring' approaches are a real turn off whereas an approach which seeks to use a persons own motivation, routine and support systems can work. The scheme needs to work with people'where they are at' and not where professionals think they should be.

Does anyone have any information on the sites chosen following the tendering process
I understood that there was to be an announcement this week about role out