Developing an evidence-based Making Every Contact Count (MECC) model of practice


Population health and prevention is a major priority of the recently formed Greater Manchester Health and Social Care Partnership and is an area in which physiotherapists can make a positive contribution.

The Physiotherapy MSK services within the Bury Care Organisation, have successfully developed a MECC model of practice into their service pathways. This quality improvement, uses evidence based behaviour change principles to support patients in making positive lifestyle changes which can impact on their physical and mental health and wellbeing.

It also aims to support Trust staff to become more active and promotes health and wellbeing within the wider communities.

50% improvement
in healthy conversations between 2014-2016
70% increase
in physiotherapy referrals to the local exercise on referral scheme between 2016 -2017


Developing a staff training and mentoring framework which equips staff with the knowledge, skills and confidence to deliver brief advice in a range of lifestyle areas (physical activity, smoking, alcohol, mental wellbeing etc)

  • Analysis of staff confidence levels pre and post training
  • Creating leadership opportunities for all grades of staff
  • Working collaboratively with a range of community services providers to develop intelligent signposting pathways
  • Use of Public Health England's Everyday Interactions logic models to develop a health and wellbeing assessment tool and to measure impact
  • Developing capacity in the use of social media to deliver health prevention campaigns


  • Staff confidence levels showed average improvement changes of: 2.8 points post training, and 4.6 in intelligent signposting to community services
  • Healthy conversations improved by 50% (from 24% to 74%) between 2014 - 2016
  • A┬ásteady increase in signposting numbers: in 2016, 160 referrals were made to a range of lifestyle services and physiotherapy referrals to the local exercise on referral scheme increased by 70% between 2016 -2017. These accounted for 40% of the total referrals to the local exercise on referral scheme. 73% of these patients were still physically active at 12 months, with 52% of them achieving 150 mins a week.
  • From the first 664 PHE logic model assessments (2017), 93% were addressing physical activity levels, 94% smoking, 89% alcohol, 72% healthy weight, and 28% mental wellbeing
  • One Physiotherapist was selected to undertake smoking research as a PHE advocate and is due to poster present at CAPHO conference in June.
  • Community engagement through Social Media campaigns have been positive: the 10k to Christmas 2016 campaign generated 600 000 impressions and the CSP Workout at Work 2017 event reaching 2.5million impressions
  • Funding has been secured from the local Director of Public Health to evaluate the model as part of the plan to roll out MECC across Greater Manchester


The successful integration of this MECC model into MSK services: supports staff leadership at all levels, affords greater community collaboration, improves the quality of service delivery and adds value in terms of future service commissioning.

Physiotherapists can confidently adopt evidence-based strategies to improve the health and wellbeing of individuals and populations when given adequate opportunity and support.

Funding acknowledgements

This work was not funded.

Additional notes

This work was presented at Physiotherapy Uk 2018.