Updated from: Department of Health (2010). Health Trainers Questions and Answers February 2010

Who are Health Trainers?

Health trainers provide local people with motivation and practical support to improve health and are either drawn from their local communities, or are knowledgeable about those communities. They will identify, or have referred to them, appropriate “clients” drawn from hard to reach, disadvantaged groups. In addition, clients can self-refer. Health trainers will work with these clients on a one-to-one basis to support them to decide what aspects of their lifestyles and well being they want to address, to set goals, agree action plans and provide individual support focusing on behaviour change.

Why were Health Trainers programmes set up?

The 2004 White Paper, Choosing Health: Making Healthy Choices Easier, made a commitment that, from 2006, health trainers would be “giving support to people who want it in the areas with highest need and from 2007 progressively across the country.” People from disadvantaged and hard to reach communities often have lower life expectancy and higher levels of ill-health than the national average. Health trainers are a key tool in addressing these health inequalities, as they support local people and draw on their own knowledge and understanding of the communities they work in.

How many Health Trainers are there?

We estimate that in 2015 there are approximately 3000 health trainers across England. They may be based in NHS provider organisations, in local authorities, the voluntary and community sector and some in the private sector. Most are commissioned by Public Health Directorates in local authorities. There were some health trainers in prisons, and the British Army and the Royal Mail and Football Foundation did train some health trainers in the early days of the national programme but no up to date picture is available of health trainer activity in these settings.

What training do Health Trainers get?

Health trainers are trained in a variety of settings, determined according to local requirements. This can include classroom-based learning, as well as on-the-job training. There are two levels of national accreditation developed with our technical advisers, Skills for Health. The first is a Level 3 National award accredited by City and Guilds and the second is a Level 2 National award, accredited by the Royal Society for Public Health. The Level 3 qualification is designed for Health Trainers, whose role includes providing support for behaviour change, based on psychological theory. The Level 2 qualification is designed for Health Trainer Champions, (who provide information and sign posting only) but some Health Trainers are now doing this qualification together with the RSPH Level 2 Award in Behaviour Change.

Is there a job description?

Exemplar job descriptions have been developed which are then tailored to reflect local circumstances. Each health trainer needs to be able to meet locally identified needs, so a single job description applied to all the health trainer services in England would be inappropriate.See the ‘Careers and Service Management’ section of this site for some sample job descriptions.

Does the Health Trainer programme operate nationally?

Since the demise of the National Teams and Regional Hubs there is no overview of which Districts now have Health Trainer Services. Public Health Directorates in Local Authorities should know about services in their districts.

How are Health Trainers funded?

Originally Primary Care Trusts received money from the Department of Health to fund Health Trainer Services. The money was allocated through the NHS baseline, although it was up to individual PCTs to decide where they allocated resources and how many health trainers they needed to meet the needs of the local population. Public Health Directorates in Local Authorities and Clinical Commissioning Groups are now the main commissioners of health trainer services.

How much does each Health Trainer get paid?

The Agenda for Change banding for health trainers is Level 3. However levels of pay vary, according to local circumstances and a few health trainers work on an unpaid basis. The skills and experience gained by health trainers have enabled them some to go on to develop careers in public health or health and social care, but there is no set career pathway for health trainers.

Do Health Trainers help people to avoid taking responsibility for themselves?

Quite the reverse. Health trainers help people to take responsibility for themselves and for their own lives by providing the help and support they need to live healthier lives. Whether that is support on diet and exercise, stopping smoking, improving self-confidence or accessing primary healthcare services, for many people health trainers are about increasing, rather than decreasing, personal responsibility and providing the tools to exercise it effectively. Most importantly health trainers listen to clients and help them decide what their priorities are and how they want to take them forward, thereby helping people gain confidence to take action to benefit their health.

What evidence is there that Health trainers work?

From the start of the initiative, anecdotal evidence showed that health trainers were having a positive impact on the health and lifestyles of individuals and communities. Since then, however, a growing evidence base indicates that health trainers’ supportive approach and use of behaviour change techniques is producing lasting results. Quantitative and qualitative data are collected by local services, many using the  Data Collection and Recording System (DCRS) which was initially set up by the Department of Health to collect information on health trainers. See the Evidence section of this website for more information.


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