December 3, 2024 • 27 mins
In this episode we hear from Toni Martin, Physical Activity Clinical Champion (PACC) for the Advanced Wellbeing Research Centre (AWRC) at Sheffield Hallam University and an Associate Lecturer of Midwifery, teaching at BSc and MSC level at the University of Worcester.
Toni shares how PACC training can empower healthcare professionals to understand and communicate the benefits of increasing physical activity to improve health and wellbeing outcomes. Highlighting the hugely positive health impact of going from doing nothing at all, to moving just a little bit more is resourced by Moving Medicine Moving Medicine Consultation Guides; sharing guidance and tips, designed for short patient conversations which can be tailored to health conditions and is backed by insight and real impact stories.
Toni shares a realistic insight into working with patients within the NHS and delivery of the funded PACC training to healthcare professionals. Demonstrating understanding of professional and patient barriers; aimed to support appropriate conversations to get people moving more for long-term health benefits.
For further information regarding the benefits of PACC training, access the PACC section of the Moving Medicine website or express an interest directly by emailing Sheffield Hallum University who currently lead on the national project funded by Sport England.
Disclaimer: Projects are subject to funding which may be liable to change after the release date of December 2024.
Links related to this episode:
We are providing some information relating to some of the external projects and support mentioned in this episode.
Active Hospitals - Moving Medicine
Why Active Conversations? - Moving Medicine We are Undefeatable - Get active whilst managing a health condition Moving Healthcare Professionals NHS - Better Health ELearning for healthcare - elfh This Girl Can The RCGP Physical Activity Hub BMJ Learning
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Rich Hurst (00:05):
Hello and thanks for joining the active best practice
network presented by activeHerefordshire and Worcestershire
and hosted by me. Rich Hurstfrom gifted gab productions. In
this series, we've identifiedregional partners to share
common challenges and bestpractices intended for
(00:26):
professionals, communities andindividuals involved in tackling
and sustaining change in thehealth voluntary and community
sectors, with a particularemphasis on how physical
activity and movement cancontribute to prevention and
recovery. With these podcasts,we're aiming to support you, if
(00:48):
you're dealing with similarchallenges, and draw upon the
knowledge of expertise we've gotfrom strategic projects right
through to grassroots projectsall across the two counties of
periforshire and Worcestershire,our podcasts will cover
everything from communityengagement, social prescribing,
positive aging, flood defenses,physical activity, clinical
(01:09):
champions, funding, integratedcare systems and vcse
partnership, working plus girlsengagement in sport. We release
a new episode every month, somake sure you subscribe to be
notified when a new one's out.And if you could take time to
review the podcast, we'd reallyappreciate it. So let's get on
with today's episode. In thisepisode, you're going to hear
(01:33):
from Tony Martin, physicalactivity clinical champion, or
PAC she works for the advancedwell being Research Center at
Sheffield Hallam University, andalso an associate lecturer at
midwifery teaching BSc and MSclevel at the University of
Worcester and Tony. Shares howPAC training can empower
healthcare professionals tounderstand and communicate the
(01:56):
benefits of increasing physicalactivity to improve health and
wellbeing outcomes, highlightingthe hugely positive health
impact of going from doingnothing at all to moving just a
little bit more. We asked her togive guidance and tips designed
for short patient conversations,which can be tailored to health
conditions and is backed byinsight and real impact stories.
(02:19):
She gave some realistic insightinto working with patients
within the NHS and delivery ofthe funded PAC training to
healthcare professionals,demonstrating understanding of
professional and patientbarriers, aimed to support
appropriate conversations to getpeople moving more for long term
health benefits. To start with,I asked Tony to explain what a
PAC does.
Toni Martin (02:42):
A physical activity clinical champion, or PAC, as we
can call it, from now on, issomebody a healthcare
professional who's been trainedby initially, it was Public
Health England, and then itmoved to ohit, and now sits with
Sheffield Hallam University todeliver free training on the
principles and the importance ofmoving more effectively. We try
(03:04):
not to say exercise, becausethat's quite people feel
uncomfortable. It's like beingasked, Do you drink much? When
you think, do you exercise much?And you think the gym, we're
asked actually talking about, doyou move more? So we talk about
physical activity. So there's agroup of about 15 of us in the
country. Now, there used to bemore, but it's now a smaller
group and linked to activehospitals as well as the
(03:28):
shuvildhallam and we deliverfree training on the principles
of the Chief Medical Officer,guidance on moving on how active
we as a nation should be.
Rich Hurst (03:39):
Just give us a bit of your background and how it's
brought you to this point.
Toni Martin (03:44):
I'm a midwife. I'm a nurse from Ireland originally,
but I'm a midwife professionalfor about I think it's 40 years
this year, which is reallyhorrifying. And I've been the
clinical midwife, middle freemanager, and in the last 1011,
years, 10 years, I've been anacademic working at a
university. I officially retiredin 2019 and but went straight
(04:05):
back, because COVID happened2020 actually. But around that
time, I was looking at thetransition from being working as
a within University to what elseI would do. And my colleague
told me about being a pack, andI thought it was a fantastic
idea, because it's you're selfmotivated quite a lot of the
time. You gain your ownemployment. So if you don't
(04:28):
work, you don't get them, youdon't get asked for a payment.
And I just love the idea oftalking to people about moving a
bit more. I'm not a healthexercise or physical activity
fanatic, but I like moving, likemoving a bit more. So I was
really fortunate, and I got,became appointed. COVID
happened, and there were no itwas no more, no training. So
(04:51):
officially, starting whenlockdown first, lockdown ended
in September 2020, and I've beendoing it since then.
Rich Hurst (04:58):
What? Why is this training? Important.
Toni Martin (05:03):
I think it's surprising how little health
professionals know about howimportant this physical activity
is for their client group. Wedeal with sick people. Most of
us deal with unwell people orpeople who are going through
conditions. And I consider andpregnancies is considered a long
term condition. Can you believeand post childbirth? But we
(05:26):
don't talk about the importanceof staying active. You know,
I'll try not to talk all thetime about pregnant women. But
in the old days, you were toldto lie down, rest, put your feet
up, eat for two. That'scompletely wrong. You actually
have to be as normal aspossible. You still have to do
same level of activity as prepregnancy, and it's really
(05:46):
important, and your diet isequally as important. So I
recognize that I didn't knowenough about it, and I've been a
midwife for centuries. And so itis being taught more now, for
sure, but it's not being it'snot as prevalent. We don't
realize that moving more isreally effective, like smoking
less or not, smoking is reallyeffective. So it's something
(06:10):
that we can do. We can dosomething about it ourselves. It
doesn't cost us anything. And Ithink it's really important that
health professionals know thisfor themselves, to maintain
their own well being, and thenfor their client group
Rich Hurst (06:22):
And obviously our focus here is on that, that best
practice and the success. Sofrom your from your training
point of view, what does successlook like? I suppose there's
stages, I guess, of trainingcertain people and then
delivering that
Toni Martin (06:36):
So there's, there's. The great thing about
the pack training is that it'svery evidence based. And part of
that was a big evaluation in2022 three, undertaken by
Sheffield Hallam, actually onhow effective we were, which is
was really brilliant. So we wereasked, the people we trained
were asked, and what they foundwas, after you'd been on a pack
(06:59):
session, not low as one, thenyou remembered that advice more.
You were far more likely to givethat advice you had. You were
more empowered. We give peoplehints and tips because it's a
lot of slides we have, but youreally try to have some key
messages so that you'll rememberthose. You can't carry around a
pack of 50 slides, and you can'tremember all of that
(07:22):
information, but you knowexactly where to go for it and
what. And they found out thatall of us, all healthcare
professionals who in previousservice have been shown not to
know what the CMO guidelinesreally did remember it. And if
we delivered, if we told ourclient group, our client group,
women, patients, whatever wewant to call them, remember that
(07:44):
advice for longer. So that'samazing. And the power of the
healthcare professional. I thinkthere was a study done that said
you could talk to talk aboutsomebody could give you advice
50 times. Healthcareprofessional to do it once, and
you're more likely, far morelikely to listen, because you
believe them, you believe themessage from them. And if the
(08:06):
you come across as enthusiastic,motivated and realistic in what
you're advising people to do,then they're more likely to
listen to and may think thatmight be possible, particularly
people with long termconditions,
Rich Hurst (08:18):
is is that? Is that trust a big part of it, those
kind of making sure that yourinformation is in the places
that people
Toni Martin (08:25):
trust absolutely and that you deliver the message
without lecturing people. Youdon't tell a woman or a man or a
patient you should do this. Youcheck out that they're ready to
hear you first. Would you liketo hear this and they are? Would
you like to hear a little bitmore about it? Did you know? Can
you spend one minute talking toyou about to say, No, you move
(08:46):
away? Because actually, it's notyou. You shouldn't, you
shouldn't lecture people. Youshouldn't judge people. Feel
judged enough as it is. So it's,it's guiding people so that
they're able to raise theconversation with confidence and
step back. But come back to itagain, because people are in
different parts of their cycleof change where they're ready to
start thinking about and thenext time they might actually be
(09:08):
ready to do something aboutthat.
Rich Hurst (09:11):
Are there other barriers that either wouldn't
necessarily stop the trainingbeing delivered, but are there
other barriers that maybe stopit getting through to that next
level.
Toni Martin (09:22):
So I'll sort of divide that into two. One is
training the healthcareprofessionals. The barriers for
healthcare professionals istime. You know, being given that
stand alone time and hour is theshortest we can do in it. And
sometimes you feel you'rerattled through it. You're
really trying not to, but youtailor it to the audience very
much so, but ideally a lotlonger. I did a two hour session
(09:44):
with my colleague this morning,and oh, the feedback was
brilliant, because people wereable to really engage and not
rushed, and that will make adifference so that that's a huge
thing, because this is free. Ikeep saying it's free, and
there's nothing free in the NHS,but. Then delivering it to
patients. Patients are worriedabout when they've got a long
(10:07):
term condition, one or two orhowever many, that they're going
to feel worse. They're going tohave more pain, more breathless,
more tired. That's a statisticdone by some recent research.
It's a perceived barrier, andthey can't they're already in a
lot of pain. I think, well, Idon't want to feel worse than I
do now. And then. It's for thehealthcare professional to try
and talk them around toactually, if you, if you
(10:29):
increase your muscles so you canhold yourself differently, so
your lungs can expand, you willstart to feel better. And it's
encouraging them to take thatlittle step, that one little
step to get up from the chairand walk to the kitchen, to walk
to the end of their to thegarden. Tiny, tiny steps. The
(10:50):
CMO guidance is about 150minutes. That's exhausting and
an incomprehensible thought fora lot of people. 150 minutes for
a healthy person, yes, you coulddo it. We might not want to, but
for somebody who's ill and sitsat home every day and actually
doesn't, don't know how they canmove much more that's
(11:10):
impossible.
Rich Hurst (11:12):
And in your experience, where else have
presumptions caused causebarriers. We talk about gaps
between what a healthcareprofessional might think and
what the patient might think.Yeah,
Toni Martin (11:30):
we can't all know what patients feel, what their
conditions are like, but we areexpected to have empathy and to
be able to understand howdifficult it is to live with a
long term condition, howdifficult it is live with
constant pain, a breathlessnessand isolation and all the things
that go with that, depression,mental health issues. So we are
(11:52):
expected to be able to read theperson that we're with, to be
able to pick up on their signalsand understand that, I don't
know, but I can help you. Helpme understand what it's like,
and I'll work with you then.Now, this takes time, and this
is the other issue. We'retalking about, people with 10
minute consultations with theirclient group, and they've got to
(12:12):
pack all of this in as well.That's quite difficult. It's
very, very difficult, but a lotof us see the same people over
and over again, or a number ofus see the same people over and
over again when we're pride andcare. So we can drip feed
messages in, and if we're alldoing it, then we're all giving
a concerted message. But empathyfor somebody else is really,
(12:35):
really important to understandthe shoes that they might be in.
Rich Hurst (12:41):
Right? We'll get you back to this episode with Tony
shortly, but we're just going totake some time to remind you of
our previous episode in theseries. There are, in fact, two
parts to episode four, as wecovered flooding and its effect
on sport clubs, followed by achat with Sport England about
their support and newsustainability initiatives. In
(13:02):
part one, Nigel and Dondiscussed the impact of flooding
on their sports clubs, Eveshambowling club and Ledbury rugby
club, respectively. Now thelearnings gained from increases
in flood occurrences andsuccessful funding applications
were all talked about and howthey minimize the damage of
sport related assets.
Steve Brewster (13:19):
Have your contingency arrangements,
rehearse them. So if you've gotto move ket and caboodle,
because you know it's going toflood, and we do that, we take
stuff to higher ground and someof the ket rehearse and make
sure that all your club membersknow about it and know how to
work with you. Part
Rich Hurst (13:35):
Two of episode four, features Denise Ludlum,
strategic lead for environmentalsustainability at Sport England
and Stephen Brewster, ChiefExecutive Officer at active
Herefordshire andWorcestershire, both of them
discuss sport England's everymove strategy and its commitment
to supporting clubs andorganizations with different
measures to address climatechange issues.
Denise Ludlam (13:53):
So we have had a flood relief fund that people
have been able to apply to toput to make good the damage done
by flooding. And
Steve Brewster (14:06):
it could be something simple, like getting
rid of single use plastics. Itcould be flooded flood
mitigations or bouncing backafter a flood, or it could be
something larger, like solarpanels on
Rich Hurst (14:17):
the roof. Both of those parts of episode four,
along with all our otherepisodes so far are all
available right now as part ofthe active best practice
network. In the meantime, it'sback to our chat with Tony
Martin. I wonder if you canelaborate a little bit more on
the mixture and the diversity ofsome of the groups that you work
(14:39):
with to deliver the training,whether it's the ones you're
delivering the training to orthe ones that eventually that
has to reach.
Toni Martin (14:50):
There are the 15 of us packs. We're all different
professionals. I think I'm theonly midwife left now, but
there's nurses, there's physios.Think there might be no teeth.
Lots of lots of nurses, lots ofdoctors, GPS specialists. It's
really, really different group.It's brilliant. But it doesn't
(15:10):
matter who you are. You mighthave a greater link within your
networks that GPS will deliverto GPS and doctors to doctors,
but actually it's where yourlocal really can make a big
difference. So I've delivered toGPS, OTs, physios, midwives,
nurses, healthcare assistants,different specialist groups
within all of those as wellsocial prescribers and lots of
(15:35):
students. And if students arelistening, they are fantastic to
talk to. I've delivered at theuniversity a number of times,
and they're brilliant, andthat's really important for
them. They're starting out atthe beginning of their difficult
NHS career. How important it isto maintain your own well being
first, and then you can helpother people do the same. So
(15:57):
it's a very, very wide range.This morning, it was, oh my
gosh, there are loads of people,psychotherapists, counselors,
you deliver to whoever turnedyou set up a session, ideally,
minimum 12, so that it's minimum12 healthcare professions and
then any number of nonhealthcare professions. But
honestly, I never turn anybodydown. I've done a one to two
(16:19):
before. Now, not ideal, but whenthey've taken the time out,
you'll talk to them. You mightchange it considerably, but you
will definitely deliver thesession, because it's important.
Rich Hurst (16:29):
How important is real life experience, as opposed
to, say, studied experience,when it comes to prescribing and
delivering the training,
Toni Martin (16:40):
I think that's why they've pointed ask for people
who are healthcareprofessionals. I think it'll
move to differently, and that'sfine, because we bring, I
suppose, a breath of real lifeexperiences. And you can give
examples, and you have to bevery careful not bringing
yourself into it, though,because actually, you've got to
be, you've got to be sensibleabout that, I think, but you can
(17:01):
give examples of like, Iregularly say, I don't, I'm not
madly on exercise. In fact, Iused to hate it, but I've
learned to love it because Iunderstood the importance of it.
And as I grew older, howimportant it is for women to
maintain be physically active.But it is, it's it is really
important that we bring our ownstories as well, and sometimes
(17:27):
hints and tips, but sometimesit's about, I think it's about
showing that you know whatyou're on about, and if you're
not, you know, if I'm deliveringto a physio group or an OT I
will actively look out all thephysio and OT things, because
that's really important. Yougive them examples of the
differences their professionsmade. That's really important to
engage. It brings
Rich Hurst (17:47):
me nicely onto that idea of tailoring your training.
How much do you How much do youfind you have to do that? I
suppose it depends on diversity
Toni Martin (17:55):
of your groups. We're given a set of slides by
Shu Sheffield Hallam, and we arenot really supposed to go off
script, but they, they'rerecognized that you do have you
can, you do have to tailor it,and you do spend more time now
working with my colleague thismorning, we're doing a session
(18:17):
on mental health, and she's aphysio, And she mixed the two
and but what what's happeningwithin Shu is now their Shu is
that they're creating packages,slide packages, that are going
to be focused on mental health,focus on diabetes, and so the in
the middle of them, witheverything else, you'll have a
bit on that specific thing,which is brilliant. And I'm
(18:38):
working with them on looking atpregnancy and childbirth again,
which is brilliant. Butregardless of what group I talk
to, I talk about how importantit is to look after your pelvic
floor, because we all have one,and people forget that. So I'll
always bring in things from myprofession, and I'll always talk
a little bit about pregnancy andchildbirth as well, because most
(18:59):
people know somebody who's had ababy or post postpartum. So,
yeah, you do tailor us. You haveto, you have to engage your
audience. You have to tell
Rich Hurst (19:07):
us where the active partnership have come in and
changed what you're doing.
Toni Martin (19:12):
I've always worked with the active partnerships,
but you tended to, I didn't knowthem, and I did work with
somebody locally, and then,unfortunately, he left, and then
I came across the activepartnership with Lauria, and she
and I have really worked welltogether with we've worked
remotely quite a bit. Andfinally met today, which is
lovely, and I think it's just, Isay to Lori, or I'm doing a
(19:36):
session, and we get together,and I say, How much time do you
need? Because I need a minimumof an hour, and we work together
to fill the time, becauseGloria's bit active partners, I
should say, but I'm going to sayLaurie. Laurie's bit is about
making it real for here, for herchildren, wants to share and
that everybody, you can see,everybody, they're interested in
(19:56):
what I'm saying, but they reallylove what Gloria says, because
she. Makes it real. She talksabout the local area, about
signposting, and if she can'tsign post because the audience
is too broad, as sometimeshappens in terms of area, then
she'll give them hints and tipson where to look. So working
with an active partner andworking regularly has made a big
(20:17):
difference to how I present aswell, because I steal stuff from
Lauria now when she's notaround, and take it to other
areas, you know, so that I can,if I haven't got a partner
working with me, then, then Ican give them ideas on where to
look and where and how importantit is. So, yeah, I love working
with with the actor partnership,
Rich Hurst (20:37):
I suppose, from a general hints and tips angle, I
want to kind of finish with youon the on the ways that you a
make sure you can promote thebenefits of physical activity
to, I suppose, almost anyaudience and and those ways
that, if you are speaking topeople who can then deliver
(20:57):
that, how do you Best get themto remember to have it at the
leave at the forefront of theirconsciousness. Okay,
Toni Martin (21:07):
one of the things I would always say is that we are
probably, not unsurprisingly,far less active than we were
back in 60s. And that's nosurprise. However, that trend is
increasing all the time, sowe're becoming less and less
active that links directly tosome significant long term
conditions. If we move a littlebit more at just a couple of
(21:31):
minutes more every day, it makesa significant difference. So the
greatest gains come from peoplewho go from nothing to anything
just they are. It's anincredible you know, there's
that curve where, if you if drugcompanies had a pill that they
could give, where they could seethe impact, they would it would
(21:52):
be like a miracle pill exercise.Unfortunately, there isn't a
miracle cure, because it's up tous to be motivated to do it. So
it is every step counts, andstep a little bit more every
day. If you can think of it interms of small, small amounts.
They used to say terms of 10minutes. That was too off,
putting any minute counts, anddo a little bit more the next
day and a little bit more thefollowing day. These are for
(22:14):
people who are completelydemotivated. For the rest of the
population, get out and move.Take your dog for take your dog,
go on your bike, park your caris the standard thing. Park your
car at the other end of the carpark. Move just that little bit
more, bring it into your dailyroutine. It's very hard, because
you just want to get on withlife and you're busy, but it
(22:37):
makes a big difference. As weget older, the need to stay
active is even more important,particularly for women, for
menopausal women, that they needto particularly introduce
strength based activities. Thatdoesn't mean you have to go to
the gym at all. You don't haveto go to those sort of things at
all. The sort of impact it has,you know, it has reduces all
(22:57):
cause mortality by 30% 30% fallsby 60% some cancers by 20% and
there's a real move now onpeople who are pre, who are
diagnosed, just diagnosed withcancer, already being given
almost exercise prescriptionexercises, because it's so
important. So my take homemessages are, start, start. Now.
(23:20):
Don't wait. Just start. Go fromdoing nothing to doing
something, and you will thebenefit is immediate in your
body. You might not feel it, butit's happening, and don't expect
moving more will necessarilyhelp you to lose weight, because
that's quite demotivating. Youlose body fat on the end, you
lose some visceral fat on theinside the fat you can't see
(23:42):
definitely, but with a littlebit of a calorie reduction, you
definitely will lose weight. Butwe don't try to sell that as you
will lose weight, because youwon't. You build muscle, so you
might even gain weight.
Rich Hurst (23:53):
Bodies are different. Metabolisms are
different. For anyone who is ismaybe in your position, maybe
not in an official packcapacity, but is still in the
position of trying to convincepeople of all of those messages,
or is in charge of delivering,you know, messages to a group
(24:15):
you did touch on it earlier. Ijust wanted to come back to it a
little bit. What are the bestways when you know you're loaded
with information, but you needthat person to take away what
you're saying, have it in theforefront of their mind so they
can deliver that to the nextperson. Because I think that's
the real that's the real kind ofgem we've almost hit on here is
the stats and the activity.Information speaks for itself,
(24:38):
but I suppose we want to get anidea of your your techniques or
the best practice in regards togetting someone to take a
message away, keep it at theforefront of mine and deliver it
to other people.
Toni Martin (24:51):
Okay, I think every healthcare professional should
ask everybody in front of them,do you move. Are you physically
active? We always ask, Do theysmoke? Do they drink? All that
sort of stuff? But physicalactivity is just as important,
and we can do something aboutthis. So I think we should get
into the habit of it. I don'tthink we should ever assume by
(25:13):
looking at people that she looksthin, whatever. I won't ask her.
It's not about that. You don'tknow what people are like, but
you my wise and also theinternet, internal fat I talked
about, but there's somefantastic resources out there
where they help you. It's calledMoving medicine, and it's
really, really accessible. It'sfree, and you're literally
(25:35):
typing with moving medicine UK,and you'll find it, and it gives
you hints on one minuteconversations, five minute
conversations, and more. Oneminute conversation is amazing.
Would you like to do you haveone minute to talk about, and
it's amazing, and then you just,you watch people's reactions,
and if they're not into it,leave it. I'd always say, I
always say to health, healthcare professionals of the 57
(25:58):
slides, I have take two. Havetwo with you. One is the CMO
guidelines. Have them therebecause it's just quick. You can
have a look, and you can say tothe person, okay, maybe not 150,
minutes. But look at this. Itsays, move a little bit more.
And then there's the one thatsays, the difference moving more
makes you know that all causemortality and how it's so good
(26:18):
for your physical, mental andand lifestyle, lifestyle well
being, I like
Rich Hurst (26:25):
how it starts with the time element. It's that idea
of like, okay, look, if you cando nothing else, take this one
minute, yeah, and work fromthere. Yeah,
Toni Martin (26:32):
absolutely. That's brilliant. One minute is
brilliant because people mightbe motivated due to the next
time. Really good
Rich Hurst (26:38):
thinking. Yeah, really good thing. Okay, Tony,
thank you very much. You're verymuch.
Toni Martin (26:41):
You're very welcome.
Rich Hurst (26:42):
Good to speak to you. Thank you for imparting
your wisdom.
Toni Martin (26:44):
A pleasure.
Rich Hurst (26:48):
So huge. Thanks to Tony for her time and insight
into movement and empoweringothers. There are plenty of
links in the show notes if youwant to find out more or want to
connect with some of theorganizations she mentioned to
find out more about what activeHerefordshire and Worcestershire
do, you can go to their website,active hw.co.uk, remember,
(27:08):
there's a new episode of theactive best practice network
every month, so make sure you'resubscribed, and keep an eye on
active Herefordshire andWorcestershire social channels
for more details, thanks againfor listening, and we look
forward to welcoming you backinto the active best practice
network very soon. You.
Hello and thanks for joining the active best practice
network presented by activeHerefordshire and Worcestershire
and hosted by me. Rich Hurstfrom gifted gab productions. In
this series, we've identifiedregional partners to share
common challenges and bestpractices intended for
(00:26):
professionals, communities andindividuals involved in tackling
and sustaining change in thehealth voluntary and community
sectors, with a particularemphasis on how physical
activity and movement cancontribute to prevention and
recovery. With these podcasts,we're aiming to support you, if
(00:48):
you're dealing with similarchallenges, and draw upon the
knowledge of expertise we've gotfrom strategic projects right
through to grassroots projectsall across the two counties of
periforshire and Worcestershire,our podcasts will cover
everything from communityengagement, social prescribing,
positive aging, flood defenses,physical activity, clinical
(01:09):
champions, funding, integratedcare systems and vcse
partnership, working plus girlsengagement in sport. We release
a new episode every month, somake sure you subscribe to be
notified when a new one's out.And if you could take time to
review the podcast, we'd reallyappreciate it. So let's get on
with today's episode. In thisepisode, you're going to hear
(01:33):
from Tony Martin, physicalactivity clinical champion, or
PAC she works for the advancedwell being Research Center at
Sheffield Hallam University, andalso an associate lecturer at
midwifery teaching BSc and MSclevel at the University of
Worcester and Tony. Shares howPAC training can empower
healthcare professionals tounderstand and communicate the
(01:56):
benefits of increasing physicalactivity to improve health and
wellbeing outcomes, highlightingthe hugely positive health
impact of going from doingnothing at all to moving just a
little bit more. We asked her togive guidance and tips designed
for short patient conversations,which can be tailored to health
conditions and is backed byinsight and real impact stories.
(02:19):
She gave some realistic insightinto working with patients
within the NHS and delivery ofthe funded PAC training to
healthcare professionals,demonstrating understanding of
professional and patientbarriers, aimed to support
appropriate conversations to getpeople moving more for long term
health benefits. To start with,I asked Tony to explain what a
PAC does.
Toni Martin (02:42):
A physical activity clinical champion, or PAC, as we
can call it, from now on, issomebody a healthcare
professional who's been trainedby initially, it was Public
Health England, and then itmoved to ohit, and now sits with
Sheffield Hallam University todeliver free training on the
principles and the importance ofmoving more effectively. We try
(03:04):
not to say exercise, becausethat's quite people feel
uncomfortable. It's like beingasked, Do you drink much? When
you think, do you exercise much?And you think the gym, we're
asked actually talking about, doyou move more? So we talk about
physical activity. So there's agroup of about 15 of us in the
country. Now, there used to bemore, but it's now a smaller
group and linked to activehospitals as well as the
(03:28):
shuvildhallam and we deliverfree training on the principles
of the Chief Medical Officer,guidance on moving on how active
we as a nation should be.
Rich Hurst (03:39):
Just give us a bit of your background and how it's
brought you to this point.
Toni Martin (03:44):
I'm a midwife. I'm a nurse from Ireland originally,
but I'm a midwife professionalfor about I think it's 40 years
this year, which is reallyhorrifying. And I've been the
clinical midwife, middle freemanager, and in the last 1011,
years, 10 years, I've been anacademic working at a
university. I officially retiredin 2019 and but went straight
(04:05):
back, because COVID happened2020 actually. But around that
time, I was looking at thetransition from being working as
a within University to what elseI would do. And my colleague
told me about being a pack, andI thought it was a fantastic
idea, because it's you're selfmotivated quite a lot of the
time. You gain your ownemployment. So if you don't
(04:28):
work, you don't get them, youdon't get asked for a payment.
And I just love the idea oftalking to people about moving a
bit more. I'm not a healthexercise or physical activity
fanatic, but I like moving, likemoving a bit more. So I was
really fortunate, and I got,became appointed. COVID
happened, and there were no itwas no more, no training. So
(04:51):
officially, starting whenlockdown first, lockdown ended
in September 2020, and I've beendoing it since then.
Rich Hurst (04:58):
What? Why is this training? Important.
Toni Martin (05:03):
I think it's surprising how little health
professionals know about howimportant this physical activity
is for their client group. Wedeal with sick people. Most of
us deal with unwell people orpeople who are going through
conditions. And I consider andpregnancies is considered a long
term condition. Can you believeand post childbirth? But we
(05:26):
don't talk about the importanceof staying active. You know,
I'll try not to talk all thetime about pregnant women. But
in the old days, you were toldto lie down, rest, put your feet
up, eat for two. That'scompletely wrong. You actually
have to be as normal aspossible. You still have to do
same level of activity as prepregnancy, and it's really
(05:46):
important, and your diet isequally as important. So I
recognize that I didn't knowenough about it, and I've been a
midwife for centuries. And so itis being taught more now, for
sure, but it's not being it'snot as prevalent. We don't
realize that moving more isreally effective, like smoking
less or not, smoking is reallyeffective. So it's something
(06:10):
that we can do. We can dosomething about it ourselves. It
doesn't cost us anything. And Ithink it's really important that
health professionals know thisfor themselves, to maintain
their own well being, and thenfor their client group
Rich Hurst (06:22):
And obviously our focus here is on that, that best
practice and the success. Sofrom your from your training
point of view, what does successlook like? I suppose there's
stages, I guess, of trainingcertain people and then
delivering that
Toni Martin (06:36):
So there's, there's. The great thing about
the pack training is that it'svery evidence based. And part of
that was a big evaluation in2022 three, undertaken by
Sheffield Hallam, actually onhow effective we were, which is
was really brilliant. So we wereasked, the people we trained
were asked, and what they foundwas, after you'd been on a pack
(06:59):
session, not low as one, thenyou remembered that advice more.
You were far more likely to givethat advice you had. You were
more empowered. We give peoplehints and tips because it's a
lot of slides we have, but youreally try to have some key
messages so that you'll rememberthose. You can't carry around a
pack of 50 slides, and you can'tremember all of that
(07:22):
information, but you knowexactly where to go for it and
what. And they found out thatall of us, all healthcare
professionals who in previousservice have been shown not to
know what the CMO guidelinesreally did remember it. And if
we delivered, if we told ourclient group, our client group,
women, patients, whatever wewant to call them, remember that
(07:44):
advice for longer. So that'samazing. And the power of the
healthcare professional. I thinkthere was a study done that said
you could talk to talk aboutsomebody could give you advice
50 times. Healthcareprofessional to do it once, and
you're more likely, far morelikely to listen, because you
believe them, you believe themessage from them. And if the
(08:06):
you come across as enthusiastic,motivated and realistic in what
you're advising people to do,then they're more likely to
listen to and may think thatmight be possible, particularly
people with long termconditions,
Rich Hurst (08:18):
is is that? Is that trust a big part of it, those
kind of making sure that yourinformation is in the places
that people
Toni Martin (08:25):
trust absolutely and that you deliver the message
without lecturing people. Youdon't tell a woman or a man or a
patient you should do this. Youcheck out that they're ready to
hear you first. Would you liketo hear this and they are? Would
you like to hear a little bitmore about it? Did you know? Can
you spend one minute talking toyou about to say, No, you move
(08:46):
away? Because actually, it's notyou. You shouldn't, you
shouldn't lecture people. Youshouldn't judge people. Feel
judged enough as it is. So it's,it's guiding people so that
they're able to raise theconversation with confidence and
step back. But come back to itagain, because people are in
different parts of their cycleof change where they're ready to
start thinking about and thenext time they might actually be
(09:08):
ready to do something aboutthat.
Rich Hurst (09:11):
Are there other barriers that either wouldn't
necessarily stop the trainingbeing delivered, but are there
other barriers that maybe stopit getting through to that next
level.
Toni Martin (09:22):
So I'll sort of divide that into two. One is
training the healthcareprofessionals. The barriers for
healthcare professionals istime. You know, being given that
stand alone time and hour is theshortest we can do in it. And
sometimes you feel you'rerattled through it. You're
really trying not to, but youtailor it to the audience very
much so, but ideally a lotlonger. I did a two hour session
(09:44):
with my colleague this morning,and oh, the feedback was
brilliant, because people wereable to really engage and not
rushed, and that will make adifference so that that's a huge
thing, because this is free. Ikeep saying it's free, and
there's nothing free in the NHS,but. Then delivering it to
patients. Patients are worriedabout when they've got a long
(10:07):
term condition, one or two orhowever many, that they're going
to feel worse. They're going tohave more pain, more breathless,
more tired. That's a statisticdone by some recent research.
It's a perceived barrier, andthey can't they're already in a
lot of pain. I think, well, Idon't want to feel worse than I
do now. And then. It's for thehealthcare professional to try
and talk them around toactually, if you, if you
(10:29):
increase your muscles so you canhold yourself differently, so
your lungs can expand, you willstart to feel better. And it's
encouraging them to take thatlittle step, that one little
step to get up from the chairand walk to the kitchen, to walk
to the end of their to thegarden. Tiny, tiny steps. The
(10:50):
CMO guidance is about 150minutes. That's exhausting and
an incomprehensible thought fora lot of people. 150 minutes for
a healthy person, yes, you coulddo it. We might not want to, but
for somebody who's ill and sitsat home every day and actually
doesn't, don't know how they canmove much more that's
(11:10):
impossible.
Rich Hurst (11:12):
And in your experience, where else have
presumptions caused causebarriers. We talk about gaps
between what a healthcareprofessional might think and
what the patient might think.Yeah,
Toni Martin (11:30):
we can't all know what patients feel, what their
conditions are like, but we areexpected to have empathy and to
be able to understand howdifficult it is to live with a
long term condition, howdifficult it is live with
constant pain, a breathlessnessand isolation and all the things
that go with that, depression,mental health issues. So we are
(11:52):
expected to be able to read theperson that we're with, to be
able to pick up on their signalsand understand that, I don't
know, but I can help you. Helpme understand what it's like,
and I'll work with you then.Now, this takes time, and this
is the other issue. We'retalking about, people with 10
minute consultations with theirclient group, and they've got to
(12:12):
pack all of this in as well.That's quite difficult. It's
very, very difficult, but a lotof us see the same people over
and over again, or a number ofus see the same people over and
over again when we're pride andcare. So we can drip feed
messages in, and if we're alldoing it, then we're all giving
a concerted message. But empathyfor somebody else is really,
(12:35):
really important to understandthe shoes that they might be in.
Rich Hurst (12:41):
Right? We'll get you back to this episode with Tony
shortly, but we're just going totake some time to remind you of
our previous episode in theseries. There are, in fact, two
parts to episode four, as wecovered flooding and its effect
on sport clubs, followed by achat with Sport England about
their support and newsustainability initiatives. In
(13:02):
part one, Nigel and Dondiscussed the impact of flooding
on their sports clubs, Eveshambowling club and Ledbury rugby
club, respectively. Now thelearnings gained from increases
in flood occurrences andsuccessful funding applications
were all talked about and howthey minimize the damage of
sport related assets.
Steve Brewster (13:19):
Have your contingency arrangements,
rehearse them. So if you've gotto move ket and caboodle,
because you know it's going toflood, and we do that, we take
stuff to higher ground and someof the ket rehearse and make
sure that all your club membersknow about it and know how to
work with you. Part
Rich Hurst (13:35):
Two of episode four, features Denise Ludlum,
strategic lead for environmentalsustainability at Sport England
and Stephen Brewster, ChiefExecutive Officer at active
Herefordshire andWorcestershire, both of them
discuss sport England's everymove strategy and its commitment
to supporting clubs andorganizations with different
measures to address climatechange issues.
Denise Ludlam (13:53):
So we have had a flood relief fund that people
have been able to apply to toput to make good the damage done
by flooding. And
Steve Brewster (14:06):
it could be something simple, like getting
rid of single use plastics. Itcould be flooded flood
mitigations or bouncing backafter a flood, or it could be
something larger, like solarpanels on
Rich Hurst (14:17):
the roof. Both of those parts of episode four,
along with all our otherepisodes so far are all
available right now as part ofthe active best practice
network. In the meantime, it'sback to our chat with Tony
Martin. I wonder if you canelaborate a little bit more on
the mixture and the diversity ofsome of the groups that you work
(14:39):
with to deliver the training,whether it's the ones you're
delivering the training to orthe ones that eventually that
has to reach.
Toni Martin (14:50):
There are the 15 of us packs. We're all different
professionals. I think I'm theonly midwife left now, but
there's nurses, there's physios.Think there might be no teeth.
Lots of lots of nurses, lots ofdoctors, GPS specialists. It's
really, really different group.It's brilliant. But it doesn't
(15:10):
matter who you are. You mighthave a greater link within your
networks that GPS will deliverto GPS and doctors to doctors,
but actually it's where yourlocal really can make a big
difference. So I've delivered toGPS, OTs, physios, midwives,
nurses, healthcare assistants,different specialist groups
within all of those as wellsocial prescribers and lots of
(15:35):
students. And if students arelistening, they are fantastic to
talk to. I've delivered at theuniversity a number of times,
and they're brilliant, andthat's really important for
them. They're starting out atthe beginning of their difficult
NHS career. How important it isto maintain your own well being
first, and then you can helpother people do the same. So
(15:57):
it's a very, very wide range.This morning, it was, oh my
gosh, there are loads of people,psychotherapists, counselors,
you deliver to whoever turnedyou set up a session, ideally,
minimum 12, so that it's minimum12 healthcare professions and
then any number of nonhealthcare professions. But
honestly, I never turn anybodydown. I've done a one to two
(16:19):
before. Now, not ideal, but whenthey've taken the time out,
you'll talk to them. You mightchange it considerably, but you
will definitely deliver thesession, because it's important.
Rich Hurst (16:29):
How important is real life experience, as opposed
to, say, studied experience,when it comes to prescribing and
delivering the training,
Toni Martin (16:40):
I think that's why they've pointed ask for people
who are healthcareprofessionals. I think it'll
move to differently, and that'sfine, because we bring, I
suppose, a breath of real lifeexperiences. And you can give
examples, and you have to bevery careful not bringing
yourself into it, though,because actually, you've got to
be, you've got to be sensibleabout that, I think, but you can
(17:01):
give examples of like, Iregularly say, I don't, I'm not
madly on exercise. In fact, Iused to hate it, but I've
learned to love it because Iunderstood the importance of it.
And as I grew older, howimportant it is for women to
maintain be physically active.But it is, it's it is really
important that we bring our ownstories as well, and sometimes
(17:27):
hints and tips, but sometimesit's about, I think it's about
showing that you know whatyou're on about, and if you're
not, you know, if I'm deliveringto a physio group or an OT I
will actively look out all thephysio and OT things, because
that's really important. Yougive them examples of the
differences their professionsmade. That's really important to
engage. It brings
Rich Hurst (17:47):
me nicely onto that idea of tailoring your training.
How much do you How much do youfind you have to do that? I
suppose it depends on diversity
Toni Martin (17:55):
of your groups. We're given a set of slides by
Shu Sheffield Hallam, and we arenot really supposed to go off
script, but they, they'rerecognized that you do have you
can, you do have to tailor it,and you do spend more time now
working with my colleague thismorning, we're doing a session
(18:17):
on mental health, and she's aphysio, And she mixed the two
and but what what's happeningwithin Shu is now their Shu is
that they're creating packages,slide packages, that are going
to be focused on mental health,focus on diabetes, and so the in
the middle of them, witheverything else, you'll have a
bit on that specific thing,which is brilliant. And I'm
(18:38):
working with them on looking atpregnancy and childbirth again,
which is brilliant. Butregardless of what group I talk
to, I talk about how importantit is to look after your pelvic
floor, because we all have one,and people forget that. So I'll
always bring in things from myprofession, and I'll always talk
a little bit about pregnancy andchildbirth as well, because most
(18:59):
people know somebody who's had ababy or post postpartum. So,
yeah, you do tailor us. You haveto, you have to engage your
audience. You have to tell
Rich Hurst (19:07):
us where the active partnership have come in and
changed what you're doing.
Toni Martin (19:12):
I've always worked with the active partnerships,
but you tended to, I didn't knowthem, and I did work with
somebody locally, and then,unfortunately, he left, and then
I came across the activepartnership with Lauria, and she
and I have really worked welltogether with we've worked
remotely quite a bit. Andfinally met today, which is
lovely, and I think it's just, Isay to Lori, or I'm doing a
(19:36):
session, and we get together,and I say, How much time do you
need? Because I need a minimumof an hour, and we work together
to fill the time, becauseGloria's bit active partners, I
should say, but I'm going to sayLaurie. Laurie's bit is about
making it real for here, for herchildren, wants to share and
that everybody, you can see,everybody, they're interested in
(19:56):
what I'm saying, but they reallylove what Gloria says, because
she. Makes it real. She talksabout the local area, about
signposting, and if she can'tsign post because the audience
is too broad, as sometimeshappens in terms of area, then
she'll give them hints and tipson where to look. So working
with an active partner andworking regularly has made a big
(20:17):
difference to how I present aswell, because I steal stuff from
Lauria now when she's notaround, and take it to other
areas, you know, so that I can,if I haven't got a partner
working with me, then, then Ican give them ideas on where to
look and where and how importantit is. So, yeah, I love working
with with the actor partnership,
Rich Hurst (20:37):
I suppose, from a general hints and tips angle, I
want to kind of finish with youon the on the ways that you a
make sure you can promote thebenefits of physical activity
to, I suppose, almost anyaudience and and those ways
that, if you are speaking topeople who can then deliver
(20:57):
that, how do you Best get themto remember to have it at the
leave at the forefront of theirconsciousness. Okay,
Toni Martin (21:07):
one of the things I would always say is that we are
probably, not unsurprisingly,far less active than we were
back in 60s. And that's nosurprise. However, that trend is
increasing all the time, sowe're becoming less and less
active that links directly tosome significant long term
conditions. If we move a littlebit more at just a couple of
(21:31):
minutes more every day, it makesa significant difference. So the
greatest gains come from peoplewho go from nothing to anything
just they are. It's anincredible you know, there's
that curve where, if you if drugcompanies had a pill that they
could give, where they could seethe impact, they would it would
(21:52):
be like a miracle pill exercise.Unfortunately, there isn't a
miracle cure, because it's up tous to be motivated to do it. So
it is every step counts, andstep a little bit more every
day. If you can think of it interms of small, small amounts.
They used to say terms of 10minutes. That was too off,
putting any minute counts, anddo a little bit more the next
day and a little bit more thefollowing day. These are for
(22:14):
people who are completelydemotivated. For the rest of the
population, get out and move.Take your dog for take your dog,
go on your bike, park your caris the standard thing. Park your
car at the other end of the carpark. Move just that little bit
more, bring it into your dailyroutine. It's very hard, because
you just want to get on withlife and you're busy, but it
(22:37):
makes a big difference. As weget older, the need to stay
active is even more important,particularly for women, for
menopausal women, that they needto particularly introduce
strength based activities. Thatdoesn't mean you have to go to
the gym at all. You don't haveto go to those sort of things at
all. The sort of impact it has,you know, it has reduces all
(22:57):
cause mortality by 30% 30% fallsby 60% some cancers by 20% and
there's a real move now onpeople who are pre, who are
diagnosed, just diagnosed withcancer, already being given
almost exercise prescriptionexercises, because it's so
important. So my take homemessages are, start, start. Now.
(23:20):
Don't wait. Just start. Go fromdoing nothing to doing
something, and you will thebenefit is immediate in your
body. You might not feel it, butit's happening, and don't expect
moving more will necessarilyhelp you to lose weight, because
that's quite demotivating. Youlose body fat on the end, you
lose some visceral fat on theinside the fat you can't see
(23:42):
definitely, but with a littlebit of a calorie reduction, you
definitely will lose weight. Butwe don't try to sell that as you
will lose weight, because youwon't. You build muscle, so you
might even gain weight.
Rich Hurst (23:53):
Bodies are different. Metabolisms are
different. For anyone who is ismaybe in your position, maybe
not in an official packcapacity, but is still in the
position of trying to convincepeople of all of those messages,
or is in charge of delivering,you know, messages to a group
(24:15):
you did touch on it earlier. Ijust wanted to come back to it a
little bit. What are the bestways when you know you're loaded
with information, but you needthat person to take away what
you're saying, have it in theforefront of their mind so they
can deliver that to the nextperson. Because I think that's
the real that's the real kind ofgem we've almost hit on here is
the stats and the activity.Information speaks for itself,
(24:38):
but I suppose we want to get anidea of your your techniques or
the best practice in regards togetting someone to take a
message away, keep it at theforefront of mine and deliver it
to other people.
Toni Martin (24:51):
Okay, I think every healthcare professional should
ask everybody in front of them,do you move. Are you physically
active? We always ask, Do theysmoke? Do they drink? All that
sort of stuff? But physicalactivity is just as important,
and we can do something aboutthis. So I think we should get
into the habit of it. I don'tthink we should ever assume by
(25:13):
looking at people that she looksthin, whatever. I won't ask her.
It's not about that. You don'tknow what people are like, but
you my wise and also theinternet, internal fat I talked
about, but there's somefantastic resources out there
where they help you. It's calledMoving medicine, and it's
really, really accessible. It'sfree, and you're literally
(25:35):
typing with moving medicine UK,and you'll find it, and it gives
you hints on one minuteconversations, five minute
conversations, and more. Oneminute conversation is amazing.
Would you like to do you haveone minute to talk about, and
it's amazing, and then you just,you watch people's reactions,
and if they're not into it,leave it. I'd always say, I
always say to health, healthcare professionals of the 57
(25:58):
slides, I have take two. Havetwo with you. One is the CMO
guidelines. Have them therebecause it's just quick. You can
have a look, and you can say tothe person, okay, maybe not 150,
minutes. But look at this. Itsays, move a little bit more.
And then there's the one thatsays, the difference moving more
makes you know that all causemortality and how it's so good
(26:18):
for your physical, mental andand lifestyle, lifestyle well
being, I like
Rich Hurst (26:25):
how it starts with the time element. It's that idea
of like, okay, look, if you cando nothing else, take this one
minute, yeah, and work fromthere. Yeah,
Toni Martin (26:32):
absolutely. That's brilliant. One minute is
brilliant because people mightbe motivated due to the next
time. Really good
Rich Hurst (26:38):
thinking. Yeah, really good thing. Okay, Tony,
thank you very much. You're verymuch.
Toni Martin (26:41):
You're very welcome.
Rich Hurst (26:42):
Good to speak to you. Thank you for imparting
your wisdom.
Toni Martin (26:44):
A pleasure.
Rich Hurst (26:48):
So huge. Thanks to Tony for her time and insight
into movement and empoweringothers. There are plenty of
links in the show notes if youwant to find out more or want to
connect with some of theorganizations she mentioned to
find out more about what activeHerefordshire and Worcestershire
do, you can go to their website,active hw.co.uk, remember,
(27:08):
there's a new episode of theactive best practice network
every month, so make sure you'resubscribed, and keep an eye on
active Herefordshire andWorcestershire social channels
for more details, thanks againfor listening, and we look
forward to welcoming you backinto the active best practice
network very soon. You.
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