Storyboard Entry Form 2014
Main author:Lisa Williams, National Nutrition Training Facilitator
Employed by Cardiff and ValeUniversity Health Board
Email:
Telephone:02920 668089
Follow the detailed instructions in this template for writing your storyboard. Add your information in each section below and save this completed storyboard document. Please not amend this template.
Follow the instructions in the Information Guide for Authors to submit your storyboard.
The word limit is 1100 words including references. Your storyboard will not be accepted if you exceed the word limit.
1. Storyboard title:a clear concise title which describes the workNUTRITION SKILLS FOR LIFETMDelivering Quality Assured Nutrition Training in Wales.
2. Brief outline of context:where this improvement work was done; what sort of unit/department; what staff/client groups were involved
TheNUTRITION SKILLS FOR LIFE™service is an All Wales service, developed and delivered by Registered Dietitians working in the NHS in Wales. Itprovides training and professional support to enable community workers from health, social care and third sector organisations to promote healthy eating and prevent malnutrition by incorporating evidence based, consistent food and nutrition messages into their work.
3. Brief outline of problem:statement of problem; how you set out to tackle it; how it affected patient/client care
Diet is a key modifiable risk factor in the prevention and risk reduction of obesity, diabetes, cardiovascular diseases (CVD), and some cancers, all of which disproportionately affect those in lower socioeconomic groups. Lifestyle choices pre-determining health risks in adulthood are made during childhood and adolescence.1Lack of knowledge of what constitutes a healthy diet and lack of skills to prepare healthy foods are recognised as barriers to healthy eating.2
1. Food and Fitness 5 year Implementation plan (2006) Welsh Government
2. Nutrition and Food Poverty Toolkit (2004) National Heart Forum
4.Assessment of problem and analysis of its causes:quantified problem; staff involvement; assessment of the cause of problem; solutions/changes needed to make improvements
Dietetic services in Walesexperienced increasing demand from community workers for quality assured nutrition training and were unable to meet this demand. Many health board areas lacked specialist public health dietitians to undertake this work. The development of the health care support worker role and national programmes including Flying Start and Communities First, provided significant opportunities to train the wider workforce to incorporate evidence based nutrition messages in their work.
The development of an All Wales nutrition skills training programme would provide a standardised, consistent, evidence based approach to meet this increasing demand. Utilising dietetic expertise to train and support community workers to cascade evidence based nutrition messages would reach more people than the dietetic service would be able to do alone.
5. Strategy for change: how the proposed change was implemented; clear client or staff group described; explain how you disseminated the results of the analysis and plans for change to the groups involved with/affected by the planned change; include a timetable for change
April 2005- An all wales working group was established to share nutrition learning and teaching resources and develop a unified training programme. This would be submitted for accreditation to allow learners to claim credit for learning.
Sept to Dec 2005 -The Community Food and Nutrition Skills course, was piloted with community workers in 4 areas of Wales.
Early 2006 -The findings from the pilot were disseminated to members of the All Wales Dietetic Advisory Group (dietetic service managers), Public Health Dietitians in Wales group and colleagues in the Public Health Improvement Division of the Welsh Government.
Sept 2006- Grant funding was secured to increase dietetic capacity to deliver nutrition skills training and provide specialist professional support in all local health boards in Wales with external evaluation undertaken by Glyndwr University from 2006-2010.3Specialist public health dietitians and dietetic support workers were recruited in all health boards and bi annual networking meetings were held to share good practice.
The programme continued to change in response to new policy and strategy developments e.g.
- Accredited nutrition training for those caring for frail older adults, focussing on prevention of malnutrition
- A structured weight management programme, Foodwise for Life, designed to be delivered by frontline staff.
3. An Evaluation of the All Wales Dietetic Capacity Grant (2009) Glyndwr Uni.
4. Mark Friedman (2005) Trying Hard is Not Good Enough.
6. Measurement of improvement:details of how the effects of the planned changes were measured
Minimum data set (MDS) templates were completed by dietetic services in all health boards for each 6 month period providing a summary of projects’ progress including;
- delivery and organisation of training,
- personal reflections on progress,
- impact and perception of training
- impact on the community.
7. Effects of changes:statement of the effects of the change; how far these changes resolve the problem that triggered the work; how this improved patient/client care; the problems encountered with the process of changes or with the changes
The development of an All Wales nutrition skills training programme has resulted in
- An increase in the number of specialist pubic health dietitians and dietetic support workers delivering pubic health dietetic services in Wales.
- In increase in the number of community workers completing nutrition skills training (see table 1 below) and able to incorporate key nutrition messages into their work.
- Increased community capacity empowering individuals to improve their nutritional health through knowledge, practical skills and support.
- Increased confidence amongst frontline staff to cascade evidence based nutrition messages to community groups.
- Supporting nutrition elements of other national schemes resulting in wider population reach e.g. the Healthy and Sustainable Pre School Scheme (see figure 1 below).
- Opportunities to embed this approach into strategic work plans of partner organisations, including Communities First, preventing duplication and maximising efficiency.
Agored Cymru accredited Course / Number of courses / Number of staff
/people trained / Staff groups trained / Comment
Level 2 Community Food and Nutrition Skills (3 credits)
NH22CY001 / 21 / 258 / Youth workers, Disability sports development officer, school nurses, National Exercise on Referral Scheme (NERS) co-ordinators, Designed to Smile staff, Communities First workers,
GP practice nurses, learning support assistant. / Delivered in 5 health boards (HBs).
Level 2 Community Food and Nutrition Skills for the Early Years (2 credits)
NH22CY007 / 46 / 535 / Early years practitioners, Home Start volunteers, Flying Start support workers, childminders, Healthy and Sustainable Pre School Scheme (HSPSS) setting staff, after school clubs, community nursery nurses, HSPSS co-ordinator. / Delivered in all areas.
Level 2 Food and Nutrition Skills for those providing care (1 credit)
NH22CY011 / 45 / 507 / Social workers, care home staff, caterers,local authority contract and commissioning inspectors,Registered Nurses, generic carers, managers. / Delivered in all areas
Level 2 Improving Food and Nutrition Care (1 credit)
NH22CY010 / 41 / 425 / Social workers, care home staff, caterers,local authority contract and commissioning inspectors,Registered Nurses, generic carers, managers. / Delivered in all areas
Level 1 Introduction to Community Food and Nutrition Skills (1 credit)
NH21CY019 / 13 / 147 / Parents, young adults, owners of food businesses participating in Healthy Options Award, leavers of care, foster carers, school pupils/peer leaders. / Delivered in 4 HBs (1 HB delivered 2 x CFNS for the Early Years (Level 1)
Level 1 Practical Food Skills
Healthy Eating through Practical Cookery (
Get Cooking (2 credits)
NF41CY026 / 9 / 39 / Parents, Communities First staff and volunteers and development officers. / Delivered in 2 HBs. Healthy Eating through Practical Cookery (ABHB) n=1
Get Cooking (C&V) n=8
Total / 175
(153 to staff, 22 to community groups) / 1911 (1725 staff, 186 community members)
Problems encountered include the challenges of maintaining support for existing partners to deliver their food and health actions whilst meeting continued demand for training. Quality assurance of accredited learning, including supporting frontline staff to deliver accredited programmes continues to put pressure on the small public health dietetic resource in each health board.
8. Lessons learnt:statement of lessons learnt from the work; what would be done differently next time
We have recognised the benefits of working nationally as a profession, not reinventing the wheel, gathering ideas and inputs, and working together to continually up date and develop standardised national nutrition learning and teaching resources.
Working in partnership with an awarding body (Agored Cymru) enables learners to gain credit for learning has been an important lesson. This has ensured the quality and integrity of the service is maintained.
The service has continued to develop to support new initiatives e.g. the infrastructure has supported the roll out of other programmes utilising the same model i.e. ‘Foodwise for Life’ structured weight management programme, launched in April 2013.
Weaknesses include the initial short term funding and insecurity of jobs for staff employed by the scheme. There were difficulties in recruiting in rural areas initially but as the scheme has expanded and become recognised for its work this has been easier.
9. Message for others: statement of the main message you would like to convey to others, based on the experience described
This All Wales approach to the development, implementation and evaluation of standardised nutrition training initiatives provided an efficient and effective model which can be adapted for other public health initiatives e.g. Making Every Contact Count.
The service aims to reach community groups who may not have the knowledge, confidence and skills to prepare and eat a healthy balanced diet. By training those who work closely with, and understand the needs of local people, the programme successfully supports communities across Wales to learn more about healthy eating and put knowledge and skills into practice.
The NHS Wales Awards are organised by the 1000 Lives Improvement Service in Public Health Wales.