Wellbeing and Regeneration

Project: Tower Hamlets' Pilot Health Trainers Initiative Evaluation

Project Lead: Patrick Tobi, Faye Adams-Eaton

Project Partners: Tower Hamlets Primary Care Trust (Public Health Department)

The Tower Hamlets Partnership

---

Description

The 2004 White Paper Choosing Health introduced the concept of health trainers - a new level of support in the public health workforce. Drawn from and representative of the local communities they serve, the trainers role is to offer personalised health promotion advice, motivation and practical support to individuals who want to adopt healthier life styles. Choosing Health committed to establishing health trainers in all 88 spearhead primary care trusts from April 2006 and throughout the country from 2007.

Tower Hamlets is one of London’s smallest boroughs and hosts a relatively young, ethnically diverse population. The area is highly deprived and ranks as the second most deprived borough in England based on the Index of Multiple Deprivation.

With funding from the Neighbourhood Renewal Fund, the PCT began a pilot health trainer initiative in the first quarter of 2007. It wishes to further expand the programme informed by evidence of what works and has commissioned IHHD to carry out an evaluation of the pilot intervention.

The evaluation employs a mixed-methods approach and addresses 3 broad themes:

• Theme One: Supporting local people from marginalised groups into employment

• Theme Two: Promoting and supporting healthy lifestyles and appropriate use of services amongst at risk groups, with a particular emphasis on smoking cessation, healthy eating and physical activity

• Theme Three: Assessing the community development approach used to deliver the intervention

A final report is due to be submitted to the PCT in January 2008

For further details contact Patrick Tobi or Faye Adams-Eaton

Tower Hamlets health trainers’ evaluation - Summary of key findings

The evaluation identified a number of design and delivery factors that were influential in shaping the initiative, some acting as facilitators and others as barriers. They are summarised in the table below.

Enablers/facilitators What has worked well	Impeders/barriers What has not worked well
Community development approach (i.e. partnership with local delivery organisations) - vertical relationship between PCT and host organisations	Partnership working – horizontal relationship between host organisations
Project manager in dedicated post, proactive, hands-on, effective communicator	Uncertainty by providers and clients about sustainability (funding) of the project
Capacity of host organisations – locally embedded, strong track record of delivering similar services	Training – time, delivery, uncertainty surrounding qualification, communication with THC
Managerial skills of team leaders	Time – no slippage time built into project (.e.g. to replace drop-outs in training course, for host organisations to build relationships with local partners
Methods of engagement: 1-on-1, small groups, gender-based, flexible (organised around client’s convenience)	Engagement with GP practices –lack of understanding of HT role, perception of HTs as competitive rather than complementary
Part time role of most health trainers seems to allow more overall flexibility of service delivery.	Remuneration
	Heavy workload – this raises questions around the appropriateness of the targets(targets)
	High attrition rate of health trainers

In conclusion, while this is a local intervention, the health trainers’ scheme is a national programme and it is important that the Tower Hamlets initiative is developed and monitored in a way that fits into the national framework. The minimum data set for the National Health Trainers produced by the National Evaluation Steering Group provides a useful guide to deciding what type of data is required to show achievement against the outcomes elaborated in the original concept of Health Trainers. The minimum data set is intended to add to the existing body of evidence by focusing attention on those outcomes which represent the benefits the Health Trainers initiative can have for Health Trainers, their clients and local communities. The minimum data set has been approved by the National Implementation Team with an agreement that full recording of Minimum Data Set information will commence from 1 April 2008 in all partnerships. It has also been accepted by the National Health Trainers Data Collection System Steering group to be integrated into version 2 of the system (in April 2008).

National Evaluation Steering Group. A Minimum Data set for the National Health Trainers - ‘Evidencing Delivery’ (Version 1). December 2007.

© 2010